Basic Energy Balance in the Human Body
Conservation of energy is a natural law. It is also called the "First Law of
Thermodynamics". Natural laws are based upon observation; they remain true from
time to time and place to place and everywhere. The first law of thermodynamics
tells us that energy is never created from nothing nor is it destroyed although it
can change form. This is true for cars, planes, physics experiments, trees, bees and
human bodies. Energy is never created from nothing nor is it destroyed.

Let's apply this law to the energy balance that controls human body weight. What
it means is that energy we consume must go somewhere. It cannot simply vanish
into nothing. So where can food energy go? Here is a partial list:

It can be stored as body fat
It can be burned as heat
It can be used to perform work (muscular contraction)
It can be used to make chemical bonds
It can be lost to malabsorbtion

It can do many things, but it cannot vanish.

Now, the body is generally very good at storing energy. If it weren't, our ancestors
would have died in famines and we wouldn't be here. This means that generally we
make fat out of any calories that we absorb and do not immediately burn. Fat is
how we store energy. Fat also has mass; it has weight. Therefore, when we store
excess energy, we gain weight as fat.

Conversely, if we receive too little energy by absorbtion (we don't get enough
calories to meet daily demand), then we make up the difference by converting
some of the fat in our body into energy to power all our vital life functions (like
heart beat, breathing, metabolism and running from predators). Thus when calorie
intake drops below our delay need, we lose weight as fat.

Finally, when we absorb exactly the same number of calories as we burn, our fat
stores are neither increased nor depleted; they remain stable.

The three paragraphs above represent plain-English descriptions of how energy
balance is related to human fat storage. They are more traditionally stated as
follows

When the rate of calorie intake exceeds output we gain weight
When the rate of calorie output exceeds intake, we lose weight
When the rates of intake and output are equal, weight remains stable

If we turn the middle statement around what we get is this:

To lose weight, our calorie output must be greater than our calorie input. To
reiterate: this simple fact is a direct consequence of a law of nature. It is
incontrovertable.

And finally, to state things with utmost clarity: when we lose weight it is because
we burn more calories than we consume- this is true when we lose weight by
counting calories, by exercising, by following a low fat diet or a low-carb diet or
starving or after bariatric surgery or because we are on the Cambridge diet, the
Atkins diet, the Drinking Man's Diet, The Cabbage Soup Diet, The Ice Cream Diet,
The Raw Brains Diet, the Eat Nothing Diet....you get the point. No matter what else
is true of any weight control plan, if it works, it does so because it causes a higher
rate of calorie output than input.

Does This Mean Calorie Counting is the Best (or Only) Way to Lose Weight?

NO!

As we shall see, calorie counting is torture; it causes hunger. There are better
(easier, healthier) ways to lose weight BUT.....BUT in the end, from the perspective
of basic energy balance,
any diet that produces weight loss ultimately does so
by causing calorie deficit
. So the REAL question in weight control is NOT whether
there is any way around the basic facts of energy balance, but rather, what is the
easiest, healthiest, most livable long-term way to achieve a net calorie deficit.

The answer(s) to THAT question is the subject of everything else written here.
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100% Medical Weight Control Program












We offer an office-based and internet-based medical weight control program designed and
implimented by our medical director, Mark Holland MD. Doctor Holland began practicing bariatric
medicine (medical weight control) in Albuquerque, New Mexico in 1991. In the 19 years since then
he has helped over ten thousand patients manage their weight. We practice 'evidence-based'
weight control, meaning that we do not rely upon untested theory or opinion but upon critically
analyzed published scientific research.

Getting Started as a New Patient

Patients who are new to our practice are given an extended first visit with doctor Holland at which
time he takes a medical history, performs a brief physical examination, explains in detail his
dietary and excercise program and, when medically indicated, may prescribe an anorectic
(weight-loss) medication.

Followup visits are usually monthly.

Treatment duration varies widely among patients depending upon degree of over-weight and health.

Our diet and exercise plans are not radical and are predicated upon the notion that long-term
weight loss requires long-term lifestyle change which can only be achieved through sensible and
liveable eating and activity. We do not sell food to our patients but instead work with them to make
good choices in the real world of supermarkets and restaurants.

Appetite control medications may be prescribed when patients carry enough excess weight to
have or be at risk for weight related illness. Appetite medications do indeed help many patients
lose weight but they are not miracles and they are not for everyone. Only Dr. Holland can decide,
in consulatation with you, whether such medication might be indicated in your care.

We define succesful weight loss in terms of health and risk. Most people do not have to be
'model-thin' to be healthy or at least healthier. Generally weight loss of 10% starting weight or more
significantly reduces one's risks for diabetes and high blood pressure. Your personal idea of
successful weight loss may involve more dramatic goals and insofar as those goal are
commensurate with good health we will work with you to achieve them.

If you take a few moments to browse our site you will find more detailed information within. Wether
you choose to seek care with us or not, we are glad for your interest and wish you the very best
health and happiness.
Located in Albuquerque, New Mexico, we
specialize in medical (non-surgical) weight control.
This web site is designed to introduce our services
to newcomers as well as to provide information and
support to established active patients. Please be
aware that this site is intended for informational
purposes only, that none of the information
presented here constitutes medical advice and that
you should obtain a physician's consultation prior
to undertaking any weight control program.
100% Medical Weight Control Program












We offer an office-based and internet-based medical weight control program designed and
implimented by our medical director, Mark Holland MD. Doctor Holland began practicing bariatric
medicine (medical weight control) in Albuquerque, New Mexico in 1991. In the 19 years since then
he has helped over ten thousand patients manage their weight. We practice 'evidence-based'
weight control, meaning that we do not rely upon untested theory or opinion but upon critically
analyzed published scientific research.

Getting Started as a New Patient

Patients who are new to our practice are given an extended first visit with doctor Holland at which
time he takes a medical history, performs a brief physical examination, explains in detail his
dietary and excercise program and, when medically indicated, may prescribe an anorectic
(weight-loss) medication.

Followup visits are usually monthly.

Treatment duration varies widely among patients depending upon degree of over-weight and health.

Our diet and exercise plans are not radical and are predicated upon the notion that long-term
weight loss requires long-term lifestyle change which can only be achieved through sensible and
liveable eating and activity. We do not sell food to our patients but instead work with them to make
good choices in the real world of supermarkets and restaurants.

Appetite control medications may be prescribed when patients carry enough excess weight to
have or be at risk for weight related illness. Appetite medications do indeed help many patients
lose weight but they are not miracles and they are not for everyone. Only Dr. Holland can decide,
in consulatation with you, whether such medication might be indicated in your care.

We define succesful weight loss in terms of health and risk. Most people do not have to be
'model-thin' to be healthy or at least healthier. Generally weight loss of 10% starting weight or more
significantly reduces one's risks for diabetes and high blood pressure. Your personal idea of
successful weight loss may involve more dramatic goals and insofar as those goal are
commensurate with good health we will work with you to achieve them.

If you take a few moments to browse our site you will find more detailed information within. Wether
you choose to seek care with us or not, we are glad for your interest and wish you the very best
health and happiness.
Located in Albuquerque, New Mexico, we
specialize in medical (non-surgical) weight control.
This web site is designed to introduce our services
to newcomers as well as to provide information and
support to established active patients. Please be
aware that this site is intended for informational
purposes only, that none of the information
presented here constitutes medical advice and that
you should obtain a physician's consultation prior
to undertaking any weight control program.
100% Medical Weight Control Program












We offer an office-based and internet-based medical weight control program designed and
implimented by our medical director, Mark Holland MD. Doctor Holland began practicing bariatric
medicine (medical weight control) in Albuquerque, New Mexico in 1991. In the 19 years since then
he has helped over ten thousand patients manage their weight. We practice 'evidence-based'
weight control, meaning that we do not rely upon untested theory or opinion but upon critically
analyzed published scientific research.

Getting Started as a New Patient

Patients who are new to our practice are given an extended first visit with doctor Holland at which
time he takes a medical history, performs a brief physical examination, explains in detail his
dietary and excercise program and, when medically indicated, may prescribe an anorectic
(weight-loss) medication.

Followup visits are usually monthly.

Treatment duration varies widely among patients depending upon degree of over-weight and health.

Our diet and exercise plans are not radical and are predicated upon the notion that long-term
weight loss requires long-term lifestyle change which can only be achieved through sensible and
liveable eating and activity. We do not sell food to our patients but instead work with them to make
good choices in the real world of supermarkets and restaurants.

Appetite control medications may be prescribed when patients carry enough excess weight to
have or be at risk for weight related illness. Appetite medications do indeed help many patients
lose weight but they are not miracles and they are not for everyone. Only Dr. Holland can decide,
in consulatation with you, whether such medication might be indicated in your care.

We define succesful weight loss in terms of health and risk. Most people do not have to be
'model-thin' to be healthy or at least healthier. Generally weight loss of 10% starting weight or more
significantly reduces one's risks for diabetes and high blood pressure. Your personal idea of
successful weight loss may involve more dramatic goals and insofar as those goal are
commensurate with good health we will work with you to achieve them.

If you take a few moments to browse our site you will find more detailed information within. Wether
you choose to seek care with us or not, we are glad for your interest and wish you the very best
health and happiness.
Located in Albuquerque, New Mexico, we
specialize in medical (non-surgical) weight control.
This web site is designed to introduce our services
to newcomers as well as to provide information and
support to established active patients. Please be
aware that this site is intended for informational
purposes only, that none of the information
presented here constitutes medical advice and that
you should obtain a physician's consultation prior
to undertaking any weight control program.