A Clinician's Guide to Non-Exercise Activity Thermogenesis (NEAT)

Non-exercise activity thermogenesis, or NEAT, looms large in the public consciousness. It’s always existed, of course, but mainstream media has been singing its praises in recent years. This is one fad that medical professionals concerned with obesity may want to embrace. It is generally easy for patients to understand and holds real potential to increase calorie expenditure in an accessible way.

NEAT refers to the energy expended for all activities that are not sleeping, eating, or structured exercise. This includes walking to work, standing, fidgeting, household chores, and occupational activities. The cumulative effect of these seemingly minor movements can be substantial. Differences in NEAT can account for up to 2,000 kcal/day between individuals of similar body size, primarily due to differences in occupation and lifestyle. This idea that you can get exercise without technically exercising appeals to a lot of people. It could be a tool to help motivate some patients who need to increase their daily energy expenditure. The question is, can it significantly affect body weight?

We will explain what it is, how it’s calculated, and what to say about it to patients.

Understanding NEAT and Its Role in Energy Balance

There are a few ways in which the human body uses energy, which can help inform choices for calorie consumption, exercise, and the role of NEAT.

Basic Metabolic Rate (BMR)

The basic level of energy expenditure is basal metabolic rate (BMR) or resting metabolic rate (RMR). It uses about 60-70% of the calories a person consumes in a day. A person’s BMR varies according to their age, gender, body size, and muscle-to-fat ratio, among other factors. The rate may vary temporarily due to illness, stress, pregnancy, or use of stimulants.

An accurate measurement of a person’s BMR requires laboratory conditions, but the Harris-Benedict equation provides a guideline.

• For males: 88.362 + (13.397 x weight in kilograms) + (4.799 x height in centimeters) - (5.677 x age in years)

• For females: 447.593 + (9.247 x weight in kilograms) + (3.098 x height in centimeters) - (4.330 x age in years)

People can increase BMR by increasing muscle mass. This is one reason it’s important to make strength training part of an exercise routine and to preserve muscle when attempting to lose weight.

Diet-Induced Thermogenesis (DIT)

The next consideration is diet-induced thermogenesis (DIT), the energy expenditure that results from consuming food. It’s estimated that DIT burns about 10% of daily calories.

More specifically, postprandial thermogenesis describes the energy the body uses immediately after a meal. Studies on this phenomenon exhibit contradictory results and tend to rely on small sample sizes. Some research links obesity to a reduction in this form of energy expenditure. It is also suggested that people who are more physically active have higher rates of postprandial thermogenesis.

DIT may also be influenced by the macronutrients being consumed, as well as the person’s circadian rhythm and age.

Exercise Activity Thermogenesis (EAT)

Exercise activity thermogenesis (EAT) may be the form of energy expenditure that patients are most familiar with. It refers simply to the amount of calories burned by formal exercise of any kind.

Although the current recommendation is 150 minutes of moderate-intensity aerobic activity (or 75 minutes of vigorous-intensity) per week, with two days that include strength-building exercises, we know that many people do not achieve that.

Physical activity is one of the Four Pillars of Obesity Treatment, which extends beyond formal exercise. Any physical activity uses energy and can, therefore, burn calories. Getting enough physical activity can help protect a person from obesity, insulin resistance, and other metabolic issues.

Non-Exercise Activity Thermogenesis (NEAT)

Dr. James Levine at Mayo Clinic coined the term NEAT in 1999 while studying weight gain. He’s also the man behind the adage “sitting is the new smoking.” Dr. Levine noticed that, when consuming the same quantity of excess calories and exercising the same amount, not everyone in a study sample gained weight at the same rate. Later, he fitted study participants with activity monitors and observed that standing and moving—everything from typing to walking up a flight of stairs—were associated with less weight gain.

Importantly, NEAT is not just behavioral—it is biologically regulated. Central neural and endocrine pathways, including orexin, influence spontaneous movement, and animal studies show that increasing orexin can enhance NEAT and reduce weight. NEAT also adapts: it tends to increase during overfeeding and decrease during caloric restriction, highlighting its role in energy balance

What’s the Difference Between NEAT and EAT?

The main difference between EAT and NEAT is that the former is usually planned and timed, with calorie burning as one of the goals. It’s important to remember that people exercise for other reasons, such as to enjoy a sport, bond with friends, or boost their mood.

There is some gray area between EAT and NEAT. For instance, someone may choose to take a 30-minute walk purely for exercise, or they may choose to walk to a friend’s house instead of driving. In theory, the former is EAT and the latter is NEAT. The main difference between EAT and NEAT is that the former is usually planned and timed, with calorie burning as one of the goals. The American College of Sports Medicine (ACSM) highlights that NEAT is distinct from planned physical activity but equally important for energy balance and weight regulation.

As medical professionals, we know that movement is movement, and most people need all they can get to balance energy intake in our modern society. What’s important is that thinking about it in different ways can help people overcome their reasons for not exercising. The question of NEAT vs. EAT sometimes comes down to mindset.

Who Gets the Most NEAT?

The amount of NEAT someone gets depends a lot on their lifestyle. The amount can vary from one person to the next by as much as 2,000 kcal. For example, someone with young children may spend a lot of time picking them up, carrying them, or chasing after them. People with dogs move by playing with and walking their beloved pets. Someone who works in agriculture or construction may engage in physically strenuous activities all day long.

The amount of NEAT someone gets depends heavily on lifestyle and occupation. Epidemiological studies show that obese individuals tend to spend more time seated compared to lean individuals. Increasing standing and ambulation by just 2.5 hours per day can increase energy expenditure by ~350 kcal/day.y

People with more active jobs naturally get more NEAT in their day, but even desk workers can modify their NEAT. By using a stand-up desk or walking between offices instead of messaging a colleague, they can expend more energy.

The same is true of hobbies. For example, gardening probably burns more calories than sewing, although both count as NEAT.

Weather and climate might also affect NEAT. Someone in a place with milder weather might walk or bike more often. People might also engage in these activities more or less depending on the seasons and the hours of available daylight.

There are less obvious ways to achieve NEAT, too. For example, one study showed that laughter could support weight loss, among several other health benefits. Fidgeting, having sex, and even shopping also “count” as NEAT.

Benefits of NEAT for Weight Management and Metabolic Health

Physical activity is linked to weight and a full range of metabolic and cardiovascular factors. Some results are immediate; increased blood flow can improve mood and thinking.

In the longer term, exercise has a protective effect against cardiovascular disease, type 2 diabetes, and many cancers. By preventing or combating obesity, we can further protect and improve a patient’s overall health by increasing their level of physical activity.

A combination of EAT and NEAT is probably a good recommendation for most patients. In fact, exercise without NEAT may fall short. A 2013 study concluded, “One hour of daily physical exercise cannot compensate for the negative effects of inactivity on insulin level and plasma lipids if the rest of the day is spent sitting. Reducing inactivity by increasing the time spent walking/standing is more effective than one hour of physical exercise, when energy expenditure is kept constant.”

As anyone who has discussed exercise with a patient knows, not everyone is receptive to the recommendation. Even with good intentions, many patients report that they struggle to find the time to exercise or to stick with a routine. NEAT may provide a smoother path to changing someone’s behavior.

Measuring and Assessing NEAT in Clinical Practice

Researchers studying NEAT have suggested two approaches to measuring it. The first is to start with total energy expenditure, then subtract BMR, DIT, and EAT. You then attribute what remains to NEAT.

The other, trickier approach is to measure activity that constitutes NEAT. In a non-clinical setting, this measurement relies on an individual’s ability to track and record daily activities. The interesting part is, measurement itself can lead to increased NEAT.

Some people find that tracking their daily movement using a smart watch or fitness tracker helps motivate them to move more. Research is still developing on this phenomenon, but one research review showed that people who used physical activity monitors took, on average, an extra 1,235 steps per day and stood for an extra 10 minutes per day.

Integrating NEAT into Obesity Treatment Plans

Because so many people have sedentary jobs—expending a mean 140 kcal/d less through occupational activities today than in 1960—any increase in movement is positive. Formal exercise is still highly important, and patients should try for the recommended amount, especially if they are being treated for obesity. However, NEAT may help with motivation, enhance their current exercise routine, or potentially help them maintain weight loss.

The ACSM specifically recommends incorporating behavioral strategies to reduce sedentary time and increase incidental activity as part of comprehensive obesity treatment and prevention efforts.

NEAT can play an important role in obesity treatment. Help your patients talk through how they might achieve more NEAT. Some ways in which they might incorporate more NEAT into their lives include:

At Work

• Use a standing or treadmill desk

• Use stairs instead of elevators

• Walk to in-person meetings instead of meeting virtually

• Break Reminders

At Home

• Do chores by hand, such as:

• washing dishes instead of using the dishwasher

• vacuuming instead of relying on a robo-vac,

• cook meals from scratch (cutting, stirring, kneading)

• If working from home, take breaks to go for walks, play with kids or pets, or stretch.

Commuting and Errands

• Walk or bike to work, and when running errands, if possible

• Park farther away from the office or store

Leisure / “Hidden” NEAT

• Gardening (digging, planting, carrying watering cans)

• Yard work (mowing, raking leaves, shoveling snow)

• Window shopping, flea markets, or strolling in museums

• Hobbies like woodworking, painting large canvases, or DIY home projects

• Even laughter and fidgeting increase NEAT in measurable ways

How many calories a person burns and how it affects their weight and metabolism will vary considerably from person to person. However, according to Dr. Levine, to lose weight, they would need to spend an additional 280-350 kcal/day through NEAT.

NEAT is Just One Element of Weight Loss

Remember, physical activity is only one of the Four Pillars of Obesity Treatment. The addition of NEAT to a patient’s treatment plan in no way invalidates the others. In fact, a study published in June 2025 positioned diet as the primary culprit in the obesity epidemic.

Help patients understand that an overall lifestyle approach may be their best bet for losing and maintaining weight. For some, incorporating medication into their treatment plan may be appropriate. Even the newer GLP-1s, you will recall, are designed to be used in combination with a healthy diet and exercise. NEAT can complement this holistic approach.

Learn about current approaches to treating overweight and obesity by becoming a member of OMA today.

FAQs

What are safe NEAT options for patients with mobility limitations?

Any movement counts as NEAT, so a person can move in whatever way their body allows.

Is walking considered NEAT or exercise?

Walking may be considered EAT or NEAT, depending on how a person approaches it. For example, walking for its own sake, for a set period of time each day, might be considered exercise. Walking to work or the store at a leisurely pace would be considered NEAT. Either type of walking expends calories, though the former may be easier to track.

Is NEAT better than cardio?

NEAT can take the form of cardiovascular exercise. Cardiovascular exercise in a formal setting, such as on a treadmill, is easier to measure than gardening. Both can expend the same amount of calories.

Does NEAT lower cardiovascular risk?

Maintaining a BMI in the healthy range, as well as a healthy body fat percentage and hip-to-waist ratio, is associated with a lower risk for cardiovascular disease. Research suggests that, for someone who is overweight, a loss of 5-10% can yield meaningful cardiovascular improvements.