The sensory properties of foods and beverages are primary determinants of food choice. Some flavor components have an inherent hedonic valence that influences ingestive behavior. However, these hedonic impressions may be modified and others newly formed through their association with the post-ingestive consequences of food and beverage consumption. Flavor-active compounds, including spices, also modify digestive, absorptive and metabolic processes through direct activation of signaling pathways or via neurally-mediated cephalic phase responses. These may modify energy balance through effects on food digestion, energy absorption and metabolism. Thus, collectively, flavor has the potential to modify energy balance. Attempts to purposefully augment energy and nutrient intake have largely focused on the aging population where flavor fortification is posited to correct for diminishing sensory function. Evidence of efficacy is not strong, possibly due to methodological issues such as low statistical power and failure to match documented sensory limitations with the nature of the intervention. More rigorous testing should determine the viability of this therapeutic application of food flavors. The use of flavor compounds for weight reduction has yielded mixed results. Most trials have delivered the compounds via capsule precluding assessment of flavor to outcomes. Work with red pepper suggests there is an independent, albeit subtle, sensory effect on substrate oxidation coupled with a more general reduction of appetite and enhancement of energy expenditure. Flavor active compounds hold some promise for being more a part of the solution than the problem of disordered eating and unhealthy weight.