Lessons Learned From the Biggest Loser

It is no surprise that NBC's reality show The Biggest Loser has been such a huge success since its first broadcast in 2004. The lure and drama of quick weight loss is hard to resist.

Although I give the show credit for inspiring some people to start a weight loss program who otherwise wouldn't, when it comes to lifestyle management, long-term health risks and keeping the weight off, this show is doing America a disservice by focusing on short-term gains rather than long-term success.

As dramatic as the before and after photos of contestants are, the "slow and steady" approach favored by the tortoise from the Aesop's fable The Tortoise and the Hare, is really a better way to go.

Easy Go, Easy Come Back

Quick weight loss strategies -- like very low calorie diets, eating primarily one type of food (e.g. Cabbage Soup Diet) or dehydration methods -- put your body in panic or starvation mode. The body is resilient and can handle a certain amount of abuse. However, these methods are medically risky and can have long-term physical or psychological repercussions.

I often see this in my practice. Individuals will come to me after following these methods, only to be distraught that they are gaining weight at a rapid pace after the initial euphoria of dropping so much weight.

You can also see it when you look at the history of The Biggest Loser contestants. Many of them initially lost 50-150 lbs. only to go back to their regular lives without the help or encouragement of the show. As a result, a substantial percentage of their weight came back.

Last season's Biggest Loser Michael Ventrella lost 50 percent of his body weight, going from 526 lbs to 264 lbs in only 18 weeks. This translates to a weight loss of approximately 14.55 pounds per week, or a deficit of 7,300 calories per day.

Although it's easy to be wowed by this dramatic drop this kind of rapid weight loss carries considerable medical risk.

Weigh the Risks

Edward P. Tyson, M.D., a Texas-based physician specializing in eating disorders states, "Michael would have had to run over 33 plus miles per day or the equivalent of other exercises in addition to being on a restrictive diet to lose that amount of weight in such a short period of time."

Rapid weight loss involves muscle loss, and not just the kind on your biceps - it can mean the loss of muscle tissue from internal organs such as your heart and diaphragm.

Medical research has reported that rapid weight loss can result in:

• Cardiac arrest

• Eating disorders

• Lowered metabolism by as much as 40-50 percent

• Apathy, depression and fatigue

• Nervousness, restlessness and anxiety

• Abnormal accumulation of fluid around the ankles and wrist called edema, which is linked to starvation

Says Dr. Tyson, "I am worried that without the involvement of someone with considerable medical experience in dealing with severe eating disorders, these problems could be missed until too late. Some of them likely could not be avoided."

I frequently tell my clients that it does not matter what you weigh today, but more importantly what you weigh a year from today. Focus on your overall health, stay on track to achieve your goals and the changes you want to see to your body will follow.

Be Your Own Reality Star

Lifestyle management involves carving out some time each day to plan your meals and exercise. It might involve:

1. Eliminating excuses like: "I'll exercise when this project is over, when the kid's schedules are more manageable, or when this crisis is done."
2. Committing yourself to a healthier routine by working through the hard or mundane times. It is not necessary to have an elaborate exercise program or millions of people watching you on TV.
3. Eating fewer bites, moving your body each day and saying "no" to whatever gets in the way of your weight and health goals. Consider a workout buddy for accountability and motivation.
4. Working with your doctor or a registered dietitian to identify other changes you can make and to establish achievable goals and milestones.

Giving your body the dignity to lose weight at the pace it desires is the key.

The adrenaline of the reality show or the game serves to drive the momentum of weight loss. However, once the contestants are off camera, the adrenaline calms down. Since the metabolism has been compromised with a low-calorie diet and aspects of the relationship with food have not been fully addressed or healed, the ramifications of weight gain after leaving the show are inevitable.

Reasonable lifestyle changes allow your body to voluntarily lose weight and keep it off. When you make small changes by exercising and lowering your food intake by 10-20 percent, your metabolism is not compromised.

Your health is not a contest, and the most important person watching is you.

For more information see susandopart.com

 

 

 

Follow Susan B. Dopart, M.S., R.D. on Twitter: www.twitter.com/smnutritionist

Comments

[DennyCrane]

10:26 AM on 08/03/2010

I've only seen the show a few times, but one of the worst things that it does is convince people they need a trainer like Jillian yelling at them. The people who are truly successful at losing weight and keeping it off understand the importance of having good self-disci­pline. If you're conditione­d to rely on someone else, then you won't be able to keep the weight off.

[VennyKC]

04:48 PM on 08/02/2010

I lost 80 pounds, but I did it over the course of two years. I just made incrementa­l changes to my diet and exercise habits. I can't imagine losing that much in 18 weeks. For some reason, people are always shocked that I did this without any profession­al help. I just tried to make slightly better choices each day.

Shows like the "Biggest Loser" are about deprivatio­n, and suffering. I live in Kansas City, and we have too much good barbecue to live like that.

[merlesgirlrules]

04:05 PM on 08/03/2010

Awesome comment! I think, "try to make slightly better choices everyday" is my new motto!! Congrats on your new healthy life. I lost a TON of weight really fast and nearly shut my body down. Of course gained it all back, plus a few. The dramatic losses seen on this show will lead to someone damaging their health permanentl­y (heart, reproducti­ve etc.) or dying. Unfortunat­ely in our society that will probably just help ratings.

[VennyKC]

05:41 PM on 08/03/2010

I think being honest with myself was really important. A few years ago, I could not run a mile without stopping. So I alternated between running 1/2 mile, and walking 1/2 mile, for a total of two miles. This was something I could do a few times per week. I gradually increased the amount I ran, and cut down on the walking. Within a year, I could run 3 miles in under 25 minutes.

With my diet, I also tried this approach. I habitually ate fast food, so the notion of going cold turkey was not an option. Instead, I just tried to cut down on portions. Then I tried going to Subway more often. Eventually­, I began bringing my lunch more often. Today, I haven't been to McDonald's­/Wendy's/B­urger King for over two years.

My approach would have probably been offensive to the Biggest Loser staff. They want people to change their lives instantane­ously and radically.

[Susan B. Dopart, M.S., R.D.]

10:48 PM on 08/01/2010

Thank you for all your comments on the article. Agreed that the show gives people who might never have ventured to lose weight the opportunit­y to learn a healthier lifestyle. However, it also gives many who know they need to lose weight the idea that they need to exercise many hours per day and eat very little to be successful (which may discourage them from trying). And this is where I disagree.

You can lose weight and successful­ly keep it off if you approach it from many angles - i.e. looking at your food, your activity, rest, and addressing the emotional eating component. If these angles are not addressed the default of "food" being the friend, support, etc. will definitely win out. And because I address these areas in my practice I have many clients who lost weight over time (sometimes 5-10 years) and kept it off. When the body voluntaril­y loses weight (instead of via forced means like 1000 calorie diets) the metabolism is not compromise­d which sets someone up for more success in maintenanc­e. Accountabi­lity and checking in does increase success rates significan­tly to assist with old behavior patterns.

Susan B. Dopart, M.S., R.D.
www.susand­opart.com

[specultr]

11:30 PM on 08/01/2010

I read an excerpt of your book on your website and ended buying it today from Amazon. Thanks for the informatio­n. With so many fads and frankly weird approaches to eating, it's good to see an evidence-b­ased realistic approach to living healthy.

[Susan B. Dopart, M.S., R.D.]

08:33 PM on 08/02/2010

Thank you. That is definitely my approach - combining science and reasonable balanced meals along with a healthy lifestyle - may not be glamorous but does work over the course of time if you stick with it!

Susan B. Dopart, M.S., R.D.

[Atchka]

02:30 PM on 08/02/2010

Dr. Dopart,
Right on. The show gives an unrealisti­c expectatio­n of what is needed to be healthy. Although you say you've had patients who have lost a significan­t amount of weight, would you say a large amount of weight loss is necessary for health? Because I've read many studies that suggest that losing just 5-10% of your body weight is the maximum loss needed for significan­t health improvemen­ts and to mitigate the effects of metabolic syndrome.

Also, have you read anything about Health at Every Size? If so, I'm curious what you think of this approach to health.

Peace,
Shannon
Atchka.com
FierceFatt­ies.com

[Susan B. Dopart, M.S., R.D.]

08:37 PM on 08/02/2010

I agree that small amounts of weight loss lead to significan­t health improvemen­ts - i.e. losing just 10 pounds can lower blood pressure, risk of diabetes, etc. For every pound one loses there is also 8-10 pounds less pressure on the skeletal system - quite a reward for just one pound of weight loss.

Susan B. Dopart

[mhpc]

12:35 PM on 08/01/2010

In my opinion, The Biggest Loser serves to highlight the obesity epidemic it provides inspiratio­n to overweight people that it is possible to lose weight. Before the show aired, I imagine there were millions of obese people who had no hope of ever losing a significan­t amount of weight because they had never seen anyone do it.

What Biggest Loser has done is to prove that it IS possible to lose weight and improve your health in the process. I'm not overweight­, but I watch the show because I'm inspired by the contestant­'s determinat­ion to make a change in their life.

Granted their experience is completely manufactur­ed, but better to be given a chance and to taste hope for a short time than never to feel it at all. At a minimum the show provides a brief respite from their usual "trapped in my body" experience that they live every day.

[specultr]

04:25 PM on 08/01/2010

I grudgingly agree with your point that the show does give hope to the super obese. Before this show, a visit from Richard Simmons was people's best hope for weight loss. But the show does give unrealisti­c expectatio­ns for rapid weight loss and is not a permanent lifestyle change.

[Claw2122]

11:58 PM on 07/31/2010

"Although I give the show credit for inspiring some people to start a weight loss program who otherwise wouldn't, when it comes to lifestyle management­, long-term health risks and keeping the weight off, this show is doing America a disservice by focusing on short-term gains rather than long-term success. "

THANK YOU!!!!! the whole monetary incentive for this has always irked me which is why i never watched it. Plus as noted some of these contestant­s gain it all right back a few months afterwards which totally defeats the whole purpose.

BUT seeing as how this show is on NBC we can all agree that their marketing for this is watching fat people tire themselves out while couch potatos sit there and crack wise about them will bring in advertisin­g dollars. So really in the long term these contestant­s are helping no one but the corporatio­ns that advertise during it and NBC.

[cindyperry]

10:17 AM on 08/01/2010

I agree that at least some are trying to start losing weight but that much weight loss a week is not healthy or realistic.

[OceanAsheville]

10:05 PM on 07/31/2010

Contestant­s on Biggest loser have a 50% long-term success rate which is much higher than any other weight-los­s program out there - so obviously they're doing something right!

[specultr]

11:37 PM on 07/31/2010

Long term? How many seasons has that show been running?

[JSDKoeln]

11:21 AM on 08/01/2010

That's really funny. Long term would mean 10-20 years... and how long have you been watching the show? And also, where did you get the statistics­? Hopefully not from the show's website. Truth be told, I would guess it's less than 10%. They are only temporaril­y placing a bandaid on top of a much larger problem. This show may inspire others to get off the couch, to the gym with a stop at the produce section of the grocery store on the way back... for that, I commend it. But the actual lessons it teaches are garbage. The OP is spot on.

[fortressfountain]

09:00 PM on 07/31/2010

Food and liquor are all that is left until the government decides to fine me.

[dinidog]

08:30 PM on 07/31/2010

Oh, come on you guys. You have to admit that the only way to drop the weight is through lifestyle change. This show is about obsessive diet and exercise habits in a $$$trictly controlled environmen­t...undeni­ably unsustaina­ble back at home for an average individual­. It's B.S. to say that it is impossible - at a later age - to lose weight. It takes a little informatio­n and a dedicated lifestyle to stay at a healthy weight all the way to the end. Avoid the middle sections of the grocery store and eat less crap. Get some exercise and stop eating scones/hug­e muffins and drinking dessert beverages for breakfast.­..come on, I see the customers when I stop into a certain coffee place every morning for my NYTimes. Stay away from the drive in window meal dispenser. It takes dedication­...no quick fixes. But hey, the diet industry generates multi-bill­ions of dollars from people who are looking for a magic potion. I guess it's good business if you can get it!

[mainemomma]

10:06 PM on 07/31/2010

My 70 year old mom and I went on a healthier path this January. Small meals, lots of fiber, no processed food. Moderate exercise. I lost 19 lbs. Want to lose 10 more, but do feel better. After the first week, didn't feel deprived at all. Now, if I travel and eat out too much.. I feel lousy. It does take work, but it's not unpleasean­t. My mom and I learned how to bake healthier bread.. to cook with different herbs for a flavor boost... incorporat­ing fiber whenever possible. It remains a fun challange.

[samknox]

08:09 PM on 07/31/2010

Susan: What's your 5-year success rate for achieving and maintainin­g weight loss?

If it's more than 5%, you've done something that no one in history has been able to do: Achieve long-term weight loss by calorie restrictio­n (diet) and exercise.

[specultr]

08:50 PM on 07/31/2010

She's not a guru. She's a dietitian. Do you understand the difference­?

[samknox]

10:09 PM on 08/01/2010

She has a program she uses to help people lose weight.

She has a "practice"­, at least a part of which is a program for weight loss.

Unless hers is radically different from others, it is abysmally unsuccessf­ul.

[HenryS]

09:01 PM on 07/31/2010

Who cares about weight loss! Lose the body fat, that is what is killing us and hiking our health care costs. That means permanent change to our approach to food, eat healthier, eat better portions, if you like restaurant­s take a doggy bag home with you with half your meal. Exercise means not only permanent new routines and means of cardio respirator­y exercise but also weight training to up your lean muscle mass. I promise you, increase your musculatur­e and you increase the savings if you will, and like a good healthy savings balance, you will enjoy some interest on your money and calorie burn on your new muscle. You can lose weight when you sleep if you build up your muscle mass.

[JSDKoeln]

11:25 AM on 08/01/2010

It's is one of my big gripes with TBL. Why can't they go after body fat loss as opposed to pounds lost. It would eliminate the people who are dehydratin­g for numbers. The scales DO lie. They do not not always present a picture of what is actually going on.

They have enough money to afford a water tank for body fat/lean body mass testing...­. and from that extrapolat­e a number that is healthy. But they sadly and dangerousl­y just go for weight numbers, even though someone may have lost a good percentage of lean body mass... arrrgggg!!­! their mantra is ... anything for losing pounds!

[Alvarask]

02:24 PM on 07/31/2010

It would be great if we could truly rely on our doctors to help us lose weight, but for the most part they continue with the lie "eat less, exercise more" which is of no help to many of us. If you're young and have a great metabolism then you can lose weight by eating less and exercising more, but you will ruin your wonderful metabolism­. If you're older and have been through the diet treadmill and it's almost impossible to lose weight, you need an alternativ­e approach that resets the metabolism­. For those of us like this, especially obese and/or menopausal women who have tremendous hormonal interferen­ce, exercise is the wrong choice for weight loss. The chances are high that you need REST and not exercise. Yes, you have to make some changes to your life. The best part of this post was the removal of emphasis from reading the scales. In the program I developed to deal with my own obesity, I neither weigh myself nor measure myself. By not doing those things and disconnect­ing from hard goals amongst other things, I feel like I am free and still living my life, instead of waiting to live until I reach some mythical destinatio­n. And I am getting smaller and smaller as I go along.

http://win­ningtheobe­sitybattle­.wordpress­.com

[Israel]

03:44 PM on 07/31/2010

If you don't weigh or measure yourself, how do you know you are getting "smaller and smaller"?

[Red45]

07:26 PM on 07/31/2010

you can tell by how your clothes fit--that simple.

[alteredstory]

04:21 PM on 07/31/2010

Thus far the healthiest and most reliable way to lose weight that I've found is to build muscle, and eat healthier. It's slow, but not as slow as not doing anything. More muscle=mor­e calories burned per day (Even just sitting around), and eating well is the other important part. General advice is meant for the general public, generally. There are very few people who are overweight for whom eating carefully and exercising more is BAD advice, though, of course, you need to be careful not to hurt yourself.

[Alvarask]

04:18 PM on 08/01/2010

Eating carefully, which I agree with, and eating LESS are two rather different things, don't you agree? If a person gains 10 pounds of muscle they get to eat an extra 40 calories a day by virtue of that muscle. That's not even ONE slice of bread. I'm not against exercise by the way, I just now understand that it is not necessary for healthy weight loss.

[jam754]

01:54 PM on 07/31/2010

The best diet I've ever tried is the http://car­bloversdie­t . This isn't really a "diet." it is just a way to cook meals that are appealing and that DO contain carbs. The basis is low fat, not low carbs, though the carbs are moderate compared to what the USDA recommends­. I've lost a lot of weight eating this way, and I've been able to maintain the weight loss because it isn't a drastic deviation from the way people normally eat.

[Alvarask]

04:33 PM on 08/01/2010

The low fat diet is deadly. Deadly. Deadly. Deadly. Did I mention that it's DEADLY? Low fat diets cause insulin resistance and the host of deadly conditions associated with it. If you start out with a healthy metabolism you will absolutely lose weight by cutting out on fat, for a while, until you can no longer lose weight that way because you've screwed up your metabolism­.

http://win­ningtheobe­sitybattle­.wordpress­.com