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Energy expenditure has not declined over the last decades, a period during which obesity rates have increased. Neither is energy expenditure in Western society lower than that in the third world, nor lower from measures of wild terrestrial mammals. The data indicate that reduced energy expenditure due to lowered physical activity induced energy expenditure has not fuelled the increased obesity rates.

This chapter describes attempts to clarify the cause of obesity of the patients with Laron syndrome. Determinations of nutritional intake and measurement of resting energy expenditure by indirect calorimetry proved that the obesity is not due to an increased caloric intake or reduced energy expenditure.