Lessons from the Biggest Loser

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Dr. Phillip Chang

Dr. Phillip Chang

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The diet and exercise regimens were not based on any professionally accepted nutritional and health programs. And in fact, the lessons learned from the Biggest Loser TV show are that extreme diet and exercise can be physically and mentally harmful.

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What was the Biggest Loser?

The Biggest Loser was an extremely popular reality TV show that ran on NBC for 17 seasons between 2004 and 2016. The show featured obese and overweight contestants who competed against each other to see who could achieve the highest percentage of weight relative to their original weight.  The contestants were encouraged and counseled by nutritionists and physical trainers who helped them along their weight loss journeys.

The tremendous popularity of the show was based in part by the spectacle of obese contestants sharing their weight loss journeys with an overweight American population who could not help but to partially relate to the contestants.  There is the subconscious or conscious encouragement that if these extremely overweight people could lose hundreds of pounds, maybe we can lose at least ten.

The problem was that The Biggest Loser was a contrived reality TV show created to provide entertainment and ratings.  The diet and exercise regimens were not based on any professionally accepted nutritional and health programs. And in fact, the lessons learned from the Biggest Loser TV show are that extreme diet and exercise can be physically and mentally harmful.

What happened to the first contestant to win the Biggest Loser?

Ryan Benson was the first winner of the The Biggest Loser in 2005.  Benson, who was 300 pounds, lost 122 pounds and won $250,000. The reality TV star has since regained all of his weight back.  After spending five grueling months exercising and dieting as a “Biggest Loser” contestant, the first thing Benson did to celebrate his accomplishment was order a burger and fries.

In an interview with the Business Insider, he states, “In my mind I just thought I’ve been training so hard I want to eat something I craved for a few months — a burger, fries, some ribs; That was one of the things that propelled me to the finish line. I thought, when I’m done I’m going to get this. It was a reward.”

What is wrong with extreme caloric restrictions?

Researchers studied 14 of the contestants 6 years after they participated in the 30-week competition.  The contestants averaged 328 pounds at the start of the competition and and 200 pounds by the end of the show. The research study that was performed by the National Institute of Health ( NIH ) showed that all the patients except for one had gained almost all of their weight back.

NIH Study about The Biggest Loser: What is Persistent Metabolic Adaptation?

The graph below shows the following findings

  • 13 out of 14 contestants regained all of their weight back
  • Percent body fat increased from 28% just after the show to 45% after 6 years
  • Metabolic rate decreased during the show; and decreased even more after 6 years ( 2,607 calories per day at rest before the competition, dropped to about 2,000 calories per day after the show;  and 1,900 per day after 6 years )

When the show began, the contestants, though hugely overweight, had normal metabolisms for their size; this means they were burning a normal number of calories for people of their weight.  The problem is that by the end of the show, their metabolisms had slowed radically and their bodies were not burning enough calories to maintain their thinner sizes.

The fact that the contestant’s metabolic rate would decrease with caloric restriction was not new.  What shocked the researchers was that the metabolic rate AFTER the show slowed down even further. Slowing of your metabolism means that you would have to restrict caloric intake even further just to maintain your weight;  and if you don’t, you will actually gain more weight over time.

Danny Cahill, one of the contestants who won Season 8 of the Biggest Loser was one of the worst off;  he regained more than 100 pounds after the show. His metabolism slowed so much that, just to maintain his current weight of 295 pounds, he now has to eat 800 calories a day less than a typical man his size. He states that anything more than that turns to fat.

Caloric Restriction also increases your Hormonal Drive for Hunger

Slower metabolisms are probably the major reason why the contestants regained their weight;  but it is not likely the only reason. The researchers also found a dramatic decrease in a hunger hormone called Leptin. High Leptin levels make you feel satiated while low Leptin levels make you feel hungry.  The contestants started out with normal levels of leptin. By the season’s finale, they had almost no leptin at all, which would have made them ravenous all the time. As their weight returned, their leptin levels drifted up again, but only to about half of what they had been when the season began, the researchers found, thus helping to explain their urges to eat.

Leptin is just one of a cluster of hormones that control hunger.  In a one-year study funded by Australia’s National Health and Medical Research Council, Dr. Joseph Proietto of the University of Melbourne and his colleagues recruited 50 overweight people who agreed to consume just 550 calories a day for eight or nine weeks. They lost an average of nearly 30 pounds, but over the next year, the pounds started coming back.  The study also reviewed 4 other hunger hormones. Levels of hormones that make you satiated went down while hormones that make you hungry went up.

So what are the lessons from the Biggest Loser?

  • Metabolic rate decreases with severe caloric restriction
  • A decrease in metabolic rate makes it even harder to lose weight as you have to eat even less calories to maintain existing weight… which decreases your metabolism even further

Hunger hormones such as Leptin ( high levels cause you to feel full ) decrease dramatically with caloric restriction.

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