For most people, the majority of their total energy expenditure is from their

For most people, the majority of their total energy expenditure comes from their physical activity. This is expressed in terms of energy expended. Humans always perform movement and most of these movements trigger the cells of the body to perform chemical processes and expel energy. 

Where are the options?

Well, l think that some effective communication is, emotional barriers and lack of attention, interest distraction or irrelevance. also some physical disabilities such as hearing problems or speech difficulties.      l hope i am correct  and you good luck.