More than a dozen weeks into season nine of the mega-reality show The Biggest Loser and it is still drawing upwards of seven million viewers per episode. Some say the program has produced the most drama of any other season, with new twists, turns and, lest we forget, a set of contestants who weighed in heavier than any other season in the past. Add up the weight on-air participants have shed across the show's first 12 weeks and it amounts to more than 1,600 pounds. A simple calculation later, and you will find it's equivalent to more than 6,400 McDonald's Quarter-Pounders -- that's a lot of burgers.
As the show continues on its journey to find the biggest loser of all, many will continue to flock to their televisions in hopes of being inspired to jump-start their own weight-loss miracle and, once and for all, conquer their extra weight.
But, seriously, "weight-loss miracle" and "reality show?" This program offers neither. The truth is that obese Americans face a very different reality -- and it doesn't include a personal trainer, nutritionist, psychologist and doctor on call at all times. It doesn't include a brush with fame or weekly national television exposure. And it doesn't include the possibility of winning a quarter of a million dollars at the end.
Instead, the possibilities are very high that their realities will lead to a life spent struggling to overcome their weight challenges complicated by serious chronic health conditions like type 2 diabetes, heart disease or any number of the dozens of co-morbid conditions complicated or onset by obesity. Moreover, the show features the morbidly obese, yet fails to address the unique needs of this population. Instead, it falls into the trap of generically categorizing a "one-size-fits-all" approach of extreme exercising and low caloric intake.
A danger of the show is that its hype reinforces two myths that continue to undermine the chances we have at successfully overcoming and preventing obesity in America. The first is that success should be measured by the amount and speed of weight lost and the second is that willpower is all that is necessary to succeed.
So let's start with success. On what should success be based? We certainly don't know all the answers, but we do know this. When defining success, many set their goals based on cosmetic appeal rather than health improvement. It's no wonder that many Americans define 100 percent loss of excess weight as the singular measurement for success. Consider the magazines covered with pictures of people who have experienced "miracle weight loss" alongside the always shocking before and after images. It is hard for many of us not to aspire to similar results, despite our nagging doubt that the reason it is presented as a weight loss miracle is because it is. Such a drastic weight loss is extremely difficult to sustain or achieve.
If instead of appearance we shift the focus to health improvement, science provides us with a healthy -- and proven -- successful weight loss approach. Studies have shown losing five to 10 percent of total body weight can have a tremendous impact on the risk for serious chronic diseases such as type 2 diabetes. For a 200-pound person, that translates into a weight loss of 10 to 20 pounds. This might seem small, but it is achievable and sustainable in the long-term.
Additionally, studies have found that people who enter weight loss programs expecting to see a huge weight loss tend to drop out sooner, lose less weight overall, and have a harder time maintaining weight loss . Those who were more focused on health benefits tended to have better success and longer maintenance.
Now, onto the other major myth this show continues to reinforce: the long-held belief that obesity is simply a matter of willpower. The show's website promotes a club for viewers that asks people to "join now to get the motivation to lose weight." Certainly, personal choice and motivation are part of the equation, but even The Biggest Loser proves that weight loss requires enormously supportive environments. The hosts, trainers and experts involved in the program are almost as numerous as the contestants themselves. Even the Wall Street Journal gets it. In 2009, they wrote an article on a report from the Centers for Disease Control and Prevention (CDC) that showed "it takes a village" to successfully overcome obesity. The CDC's recommended strategies for combating obesity reflect the often overlooked influence that our communities play in encouraging and reinforcing the healthy lifestyles that are paramount to overcoming this epidemic.
Equally important is recognizing that the village also includes our health care system and the workplace for adults. Medical professionals must look for evidence-based guidance on the best practices for reducing risk for the illnesses associated with obesity. And employers are increasingly recognizing their own interests in promoting healthy lifestyles and supporting weight loss efforts in the workplace. Health costs associated with weight are literally tipping the scales of affordability for employers -- and that doesn't even take into account the impact overweight, obesity and poor health have on productivity.
Obesity is a complex problem. To oversimplify it as a matter of aesthetics and bad personal decisions is to avoid the reality we know exists. So, as we continue to watch the show unfold and lead to its ultimate conclusion, let's promise to remember that there are no easy fixes and that all of us need to focus on this issue not to improve our looks, but to improve our health.
Christine C. Ferguson, J.D.
Director, STOP Obesity Alliance
Research Professor, School of Public Health and Health Services Department of Healthy Policy
The George Washington University
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