Framework for understanding obesity in children and youth. Framework for understanding obesity in children and youth. Energy intake is excessive when compared to energy expenditure, leading to an energy imbalance resulting in obesity. Reprinted with permission from Preventing Childhood Obesity: Health in the Balance, by the National Academy of Sciences, 2005, courtesy of the National Acadamies Press, Washington, D.C. Sarah R.S. Stender et al. Diabetes Spectr 2005;18:240-248 ©2005 by American Diabetes Association