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They climb mountains, flip tires, run marathons and even drag airplanes down runways to burn off every calorie they ingest. The goal: Lose the most weight. The prize: $250,000. The hook: This group of aspiring role models is so overweight and deconditioned that even walking leaves them breathless.
The show is NBC's reality TV hit, The Biggest Loser--a glorified weight loss competition among bariatric contestants. Entertaining? Eight seasons worth of millions of viewers seem to think so. But at what cost?
While NBC is fattening up its ratings and gaining where it counts, clinicians are questioning the principles and safety behind boot camp weight loss programs--and with good reason.
Obesity is a serious condition that results from an imbalance between caloric input and energy output. It's associated with numerous comorbidities, including cardiovascular disease, pulmonary hypertension, diabetes and osteoarthritis, which can lead to serious health problems and functional limitations. Yet rigorous workouts, strict diets and rapid weight loss are being celebrated by the show and its online community weight-loss boards.
"I believe this is very dangerous TV that sends the absolute wrong message to the public--especially the obese," says Laura Gideon MS, CPT, an exercise physiologist, certified personal trainer, Pilates trainer, nutrition consultant and co-owner of Bamboo Balance LLC, a fitness and aquatics training company in Los Angeles. "The show marginalizes a segment of the population based on appearance and is concerned with high ratings created through hyped 'infotainment' while pulling on emotional heart strings."
This exploitive formula may be the basis for most reality TV, but the obesity angle packs a powerful punch. According to the Centers of Disease Control and Prevention, the rise of obesity in the United States has reached epidemic proportions. With 53 percent of Americans trying to shed extra pounds,1It's no surprise people are tuning in to a program where people drop pant sizes faster than a tailor can take them in. However, portraying successful stories of extreme weight loss under extreme conditions actually undermines decades of bariatric research findings and common sense. To whittle a waistline permanently, slow and steady wins the race, say experts.
"Many people watch these shows hoping to find the magic answer to weight loss," says Tamara L. Burlis, PT, DPT, MHS, CCS, associate director of clinical education and assistant professor at Washington University's program in physical therapy in St. Louis, Mo. Dr. Burlis, who also helps manage patients undergoing bariatric surgery, is concerned that viewers may attempt the same exercise and diet tactics at home without consulting a physician or health care professional to discuss safe parameters.
America doesn't get to see what's happening behind the scenes of these shows from a medical perspective, she points out. Health histories and screenings, continuous checkups, changes to medications, and behavioral and social support are crucial to lose weight safely and effectively.
In addition, contestants aren't living normal lives during filming. Exercising for hours with a celebrity personal trainer and eating chef-prepared predetermined meals are luxuries most people can't afford. When the show wraps, former contestants are faced with real life demands and the numbers on the scale can start climbing.
Despite what Loser may portray, real weight loss doesn't happen overnight. The overall key to weight management and obesity control is behavioral modification and lifestyle change, says Jack A. Bennett, PT, SCS, MEd, CSCS, assistant professor of physical therapy at Maryville University-St. Louis in Missouri. To truly win the battle of the bulge, people who are obese need realistic, sustainable programs that are monitored by health care professionals.
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