“…PWS is recognized as the most common known cause of marked obesity in humans (Butler, ) resulting from chronic imbalance between energy intake and expenditure because of hyperphagia with an inability to vomit, decreased muscle mass, tone, and physical activity with a reduced resting metabolic rate (Butler et al, ; Butler, Theodoro, Bittel, & Donnelly, ; Hill, Kaler, Spetalnick, Reed, & Butler, ). Body fat in individuals with PWS without growth hormone treatment can account for 40%–50% of their body composition, which is two or three times higher than in the general population (Butler, Meaney, & Palmer, ), about one‐third of individuals weigh more than 200% of their ideal body weight (Butler & Meaney, ; Meaney & Butler, , ). Total energy, resting energy, sleeping energy, and active energy expenditure are lower in individuals with PWS than in control individuals without the syndrome (Butler et al, ; Hill et al, ; Schoeller, Levitsky, Bandini, Dietz, & Walczak, ).…”