Energy requirements for patients can be individualized with improved practitioner understanding of metabolism, energy needs and energy balance. RDNs can create successful weight management programs by identifying contributing yet interdependent factors in the patients' biology and environment, and then continue with monitoring important biomarkers. Can weight change fluctuations serve as a biomarker for patient adherence to healthy eating behaviors? This "call to action" will challenge RDNs to strengthen their competence with applying the energy balance equation thus leading the way to improved patient outcomes with a quality assessment and monitoring approach.