Small Changes Approach

The small changes approach that has become our overriding philosophy for the past decade began with a think tank “exercise” to see how, as a nation, we got to this obesity epidemic.

We evaluated the science to determine the degree of change over time in body weights that led to the nation’s expanding waistline. We determined that what became an epidemic developed from gradual weight gain over time and that, on a daily basis, the degree of positive energy balance promoting weight gain is very small. We called this the energy gap for weight gain prevention.

We estimated that modifying energy balance (i.e. energy intake and/or expenditure) by 100 kcal/day could prevent weight gain in 90% of the adult U.S. population. We also estimated that a similar or slightly higher degree of modification of energy balance could stop excessive weight gain in U.S. children. Since our original work, many others investigators have estimated the energy gap for weight gain prevention in many different populations.

From this research in estimating the energy gap for weight gain prevention, we hypothesized that small behavior changes, which are more achievable than larger ones, could virtually stop weight gain in the population. We started an initiative that grew into a national non-profit foundation, America On the Move (AOM), to promote this small changes approach. AOM has reached millions of people through its programs and its website.

The small changes approach is now in widespread use as a strategy to address obesity. It is a major foundation of the strategy of the Robert Wood Johnson Foundation for addressing childhood obesity.

See our Weight Management Programs for more on how we use the energy gap to successfully manage weight.