Made-for-TV Weight Loss

Like cheese-filled pizza crusts and giant-gulp beverages, reality-based weight-loss TV shows have proven irresistible to the American public. One of the most popular, The Biggest Loser, regularly attracts more than 10 million viewers a week. Now in its 11th season on NBC, the megahit has spawned a spate of wannabe programs that have helped turn weight loss into a spectator sport.

On VH1’s Celebrity Fit Club, overweight D-list celebrities and ex-reality-show players, whose likes have included Bobby Brown, Tina Yothers and Chaz Bono, are divided into two teams and challenged to get fit in a 14-week period. Bravo TV’s Thintervention has celebrity-trainer Jackie Warner kicking her charges’ butts to get fit and lose weight by reprioritizing their lives. On Oxygen’s Dance Your A** Off, full-figured contestants shake their booties to shed pounds. MTV’s I Used to Be Fat follows college-bound teens as they lose weight and get buff before beginning a new chapter in their lives.

While the shows’ focus on health and fitness is arguably inspirational, it’s difficult to say whether the vicarious thrill of watching actually inspires positive changes in viewers — most of whom are, let’s face it, couchbound through the entire viewing experience. And many leading fitness experts cringe at the shows’ prescribed weight-loss methods, most of which would not translate well to real life.

In a bid for must-watch moments and sky-high ratings, trainers often drive contestants — most of whom are moderately to extremely obese — to the brink of collapse. Often intent on nabbing a big cash prize, contestants follow diets that are dangerously low in calories and nutrients, avoid fluids to cheat the scale, and work out well beyond the four or so hours required of them each day. The results? Well, let’s just say they make for great TV.

One contestant on The Biggest Loser managed to drop 41 pounds in a single week — a feat that delighted viewers but horrified just about every health expert who witnessed it. “Every behavior that is modeled on these shows is inappropriate,” says Michael Boyle, MEd, founder of www.strengthcoach.com. “It’s the theater of the absurd.”

Still, for the viewer, it can be difficult to draw the line between reality TV and reality. You see people dropping 10 pounds a week and think, Why can’t I do that? Even if you know rationally that the contestants have experts leading them every step of the way and are quarantined so they can concentrate solely on dieting and exercising — a situation totally unlike real life — witnessing such dramatic successes can subconsciously influence your expectations for yourself.

Nonetheless, many viewers love these shows. Roughly as many report being helped or uplifted in some way as report being compelled by sheer drama to watch.

One oft-noted redeeming characteristic: The shows regularly stress the complex emotional and psychological role that food plays in the life of many heavy people. There’s usually a psychoemotional factor — a traumatic memory, a toxic relationship, a negative self-perception — goosing their disordered eating into gear. Bringing that fact to light may help viewers reflect on similar dynamics in their own lives, or help them take comfort in the fact that they’re not the only ones struggling with such issues. As a result, some may wind up seeking the kind of support that could help them pursue weight loss more successfully.

But that’s not enough to convince most experts that reality-TV weight-loss shows are a net positive for their viewers. “I have mixed feelings,” says Michele Olson, PhD, FACSM, a professor of physical education and exercise science at Auburn University Montgomery in Alabama. “The transformations are undeniably inspiring and might help viewers get moving, but the training methods are very extreme.”

After cutting through all the hype and drama that these weight-loss shows provide, she notes, important questions remain: Do they offer enough inspiration to offset the unrealistic expectations they might engender? Do they pose a hazard to the overweight population they are purporting to help?

Questionable Advice

“Weight-loss shows basically torture people for entertainment,” says Boyle. They achieve extraordinary things, he notes (weekly losses of 6 to 10 pounds aren’t unusual), but through methods that are neither healthy nor sustainable for the general population.

“We were working out three to six hours a day,” says Kai Hibbard, who finished second during season three of The Biggest Loser. “And we were encouraged to do more. One person slept in front of the gym doors so they could be sure not to miss a chance to work out.” For a conditioned, healthy person, a four-hour workout is extreme; for an obese person, it can be downright dangerous.

“I’d never recommend that type of volume,” says Alwyn Cosgrove, coauthor of The New Rules of Lifting: Six Basic Moves for Maximum Muscle (Avery, 2008). “Four to six hours is on par with what some professional athletes do.”

These contestants aren’t just starting with a 20-minute walk, as many people new to exercise are counseled to do. They’re starting with long, super-intense sessions. During the first week of The Biggest Loser’s eighth season, the totally unconditioned contestants had to participate in a milelong race. Two of them ended up in the hospital. “If we had to do it over, we wouldn’t [have done] it,” Rob Huizenga, MD, the show’s medical consultant, told the New York Times.

The next season, the show opened with teams riding stationary bikes for 26.2 miles, a distance equal to a marathon. One contestant had to be treated for exhaustion. Medical staff forcibly dragged another contestant off her bike when she was hit with severe cramps.

These are not approaches any real-life trainer would advise. “If I’m starting with a new, overweight client, I’m not putting them on cardio equipment for hours or making them run,” says Mark Nutting, CSCS*D, NSCA-CPT*D, the 2009 NSCA personal trainer of the year. “I want to give them the sense that they can do it and help them create the habit of coming in.”

Such patience and empathy have no place on reality TV, however, where producers have clearly concluded that humiliation and schadenfreude (a German term meaning “pleasure derived from the misery of others”) net far better ratings.

On The Biggest Loser, trainer Jillian Michaels sits on a contestant’s back as he does pushups and stands atop another’s legs during wall sits. Trainers regularly holler at their clients, pushing them well beyond what most fitness pros would consider appropriate or productive boundaries. Obese contestants are often seen doing plyometric exercises their bodies aren’t yet ready for.

This combination of high volume and iffy practices produces visual drama, but it can result in physical trauma, too. On season seven of The Biggest Loser, one contestant sustained a stress fracture in her hip. On season 10, contestant Burgandy Keel was sidelined with tendonitis.

And yet as viewers, we never see the really tough parts — the long, maddening wait for results to become visible, the internal struggle to shift one’s sense of identity in a healthier direction. Because these shows run on pure drama, a week’s worth of workouts gets distilled to 30-second spots. The producers select only the most sensational moments: a pair of flaccid arms shaking violently under the strain of pushups; the last lung-sucking sprint in a long series of intervals.

They may enthrall viewers, but such intense methods of exercise are hardly necessary for weight loss, nor are they advisable for a beginning exerciser. And they may have the unintended negative result of scaring a lot of would-be exercisers away from ever getting started at all.

High Drama, Low Calories

Of course, on weight-loss TV, over-the-top exercise is only half the viewing excitement. The other half of the jaw-dropping results comes from draconian dietary restriction.

Weighing in at 231 pounds at the beginning of the season, Keel was encouraged to limit herself to 1,200 calories a day. Such daily calorie counts are barely enough to sustain a sedentary human, let alone one actively burning 3,000 calories through intense exercise.

“That level of restriction is drastic,” says David Grotto, RD, LDN, author of 101 Optimal Life Foods (Bantam, 2009). “It’s almost impossible to meet your nutritional needs on that amount of calories unless you’re taking dietary supplements.”

Perhaps more disturbing, enduring that kind of caloric restriction is virtually guaranteed to slow your metabolism in the long run, Grotto adds. “You may lose weight quickly at first, but then your body goes into survival mechanism. You’re going to have a tough time keeping it off.”

It’s estimated that over the course of a few years, only about half the contestants on The Biggest Loser are able to maintain anything close to their final show weight. Although Hibbard, for instance, lost 118 pounds during her stint on the show, she quickly gained 30 pounds back when she began drinking more water and eating a more appropriate number of calories again. “I regret to this day I did not have the courage to tell the world at the finale just how sick I was from the weight-loss methods on that show,” she says.

Crazy Expectations

The level and intensity of exercise, combined with the highly restricted diets, can set the viewer up for some pretty unrealistic expectations — and that’s without seeing the ounce-shaving tricks that go on behind the scenes. Hibbard describes how contestants would wring every ounce of sweat from their bodies before the weekly weigh-ins: wearing up to four layers of clothing on both the top and bottom, then hitting the gym — no air conditioning, and doors and windows closed — for two hours without water. “Some contestants wouldn’t wear a tampon to the weigh-in if they had their period,” she says. “You become a little crazy.”

After her Thintervention contestants produced weekly weight losses of 1 to 3 pounds — widely accepted as a healthy, sustainable weight loss — trainer Jackie Warner blew up and accused them of cheating on their weight-loss program. That sort of response can have a demotivating effect on ordinary viewers struggling with their own weight-loss goals.

“People on [The Biggest Loser] are in a fantasy, unrealistic environment, where everything is optimized for weight loss,” Michael Dansinger, MD, a consultant for season two of The Biggest Loser and a physician at Tufts Medical Center in Boston, told MSNBC. But viewers can have a hard time understanding that what they’re watching isn’t applicable to real life. “I have clients who tell me, ‘I only lost 1 pound this week. I may as well give up,’” says Nutting. “They compare themselves, even though they shouldn’t.”

The Real Recipe for Success

The best advice to the average overweight viewer, it seems, is not to try to mimic reality-TV weight-loss methods, but rather to mine the shows for whatever positive inspiration they happen to provide. And if you’re not inspired — or if you’re inspired to do things that aren’t good for you and your self-esteem — it may be best to just tune such shows out entirely.

As Nutting points out, people can make long-term lifestyle changes only if, 1) they believe it’s worth it, and 2) they have confidence they can succeed. By showing contestants digging down to the roots of their size issues and getting fit, weight-loss shows can help support both goals for viewers. But whether or not they actually do help depends entirely on the mindset and personal experience of the viewer in question.

What even the reality-TV contestants ultimately discover is that the most challenging component of weight loss isn’t the measuring out of vegetables or the pushing through another 15 minutes on the elliptical: It’s identifying and resolving the reasons they became overweight in the first place.

“People expect me to talk about diet and exercise, but that’s really only 10 percent of the whole weight-gain equation,” says Ali Vincent, the first female winner of The Biggest Loser. “It’s really about how you process your thoughts, your self-image and what issues you have.”

And although what they display on TV might be another story, the trainers and contestants on weight-loss shows do at least pay lip service to the fact that weight loss isn’t just a quick fix. “The Biggest Loser taught me that getting healthy and holding a steady weight isn’t a one-time thing,” says Vincent. Warner tells her Thintervention charges: “This is a lifestyle choice. Every day, you have to make the right choices.”

In other words, the work goes on long after the cameras stop rolling. So, go ahead and enjoy your favorite weight-loss show, if you like. But then get up and go for a walk. Enjoy a healthy meal. Because remember: Reality TV isn’t reality. And this life — your life — is the show that really matters.

Be The Biggest Winner

Most of us don’t have four hours a day to work out, a self-stocking kitchen and a personal trainer at our disposal 24/7. Instead of getting frustrated because you can’t replicate the hyped-up outcomes of TV weight loss, create your own better reality:

Make sustainable changes. You may long for dramatic results, but most people who experience lasting success start much more gradually. “In my 31 years as a personal trainer, I’ve only had one client who successfully changed everything — diet, exercise, drinking, smoking — all at once,” says Mark Nutting, CSCS*D, NSCA-CPT*D, founder of Ensemble Fitness Club in Portland, Maine. “Most folks can’t expect to sustain that.” Instead, experts recommend changing one or two habits every few weeks. “For the first change, just drink eight glasses of water a day,” recommends John Berardi, PhD, CSCS, president of Precision Nutrition.

Be accountable. Find a trainer or buddy who will encourage and challenge you — but not belittle or shame you — into working a little harder than you otherwise might. (Contrary to what you see on the small screen, yelling and crying isn’t a mandatory part of the process.) For those new to fitness, find a group of coworkers, friends or family who are aware of the changes you’re choosing to make, who will encourage you and help you hold yourself accountable. “There’s a real strength that comes from a supportive community, particularly when you are just starting to integrate new healthy habits,” says Adam Naylor, EdD, CC-AASP, director and sport psychology coach at the Boston University Athletic Enhancement Center. He notes that after about six months of consistent action, healthy changes will become more habitual. Even then, though, “having a workout buddy can be invaluable,” he says. “They make you show up for a workout, and push and encourage you during it.”

Safeguard your metabolism. Extreme calorie restriction isn’t a good long-term weight-loss strategy. In fact, research indicates that it tends to backfire, setting you up for more weight gain down the road. First, your energy and mood flag, making it challenging for you to exercise or think about anything but food. Then, “your metabolism starts to slow down, which prevents further weight loss, and you risk not getting enough nutrients,” says Michele Olson, PhD, FACSM, professor of physical education and exercise science at Auburn University Montgomery in Alabama. Rather than focusing on eating an absolute minimum of calories, strive for maximum high-quality nutrition. Eat a diet of whole, real foods that includes a balance of proteins, healthy fats and unprocessed carbs. Couple that with an hour of activity most days of the week, and you’ll start seeing results. If not, you may have an underlying medical condition, such as a metabolic or hormone imbalance, that should be investigated by a professional. Extreme dieting can make such conditions worse and put your health at great risk.

Like what you’re doing. Strive to establish a challenging but doable workout routine that you actually enjoy — and that you can build on over time — rather than going in for all-out measures that leave you dreading your next workout. Not everyone enjoys running or biking or weightlifting, so try out a wide range of activities; increase intensity, frequency and volume gradually; and focus less on max calorie burning than on building your fitness and enjoyment of exercise.