I am a big fan of The Biggest Loser, and while I take it with a grain of salt, (anyone can lose weight if I had my meals prepared for me and my only job was to work out ) this season, in particular, should really hit home for Americans. They have some of the largest contestants they have ever had.  I was struck by one young girl, Ashley, who is 5'5 and weighed in at almost 380 lbs.  She is now down to around 317 lb, but, for the first time last night, I noticed she was wearing what appeared to be an OmniPod.  Anyone else notice it? Anyone have any comments regarding the show? Do you think it is a positive thing to watch or just another network reality gimmick?

I wonder if she's wearing a BodyBugg? I don't watch the show, but I hear about it all the time from my patients. They uniformly love it, and find it extremely motivating. One downside, however, is that they think they should be losing weight as quickly as the contestants on the show. It brings up a good discussion about realistic expectations, and also about expanding our goals to more than just a number of the scale.

There is also a lot of discussion among personal trainers about the potential for injury from some of the exerises the contestants do, and the intensity of their exercise. Folks at home think that they should be able to do the same types of exercises as the contestants, don't check with their physician first, and can possibly become injured - or feel so defeated that they give up.

One more downside:  I've had several people tell me they're actually trying to GAIN more weight so that they can apply to be a contestant on the show!

I also find the show motivating and I too question the degree of exercise these folks go through, then I remind myself that it is a television show and made to be very dramatic. We only see a very little portion of what goes on and the network chooses the portion that will keep our interest.  I have also heard patients say that they wish they could lose 12 lbs in a week like the contestants do and I remind them that those contestants are living in an EXTREME controlled environment and, for those contestants, their biggest challenge will be going back home and reintergrating back into their old lives and old routines, to me that is the real challenge.  We get to see a snippet of those contestants who are asked to leave, and return home, to see if they are meeting their weight loss goals.  I have to say its 50/50.  Some continue to lose weight, others either gain or stay stagnant and blame problems at home.  I like that part of the show because it helps me show my patients, who also watch the show, that things are totally different when you get home.   How we should not set unrealistic goals and think that we also could lose 64 pounds in 6 weeks like they do on the show.  I think as long as the viewer is based in reality (sometimes a challenge) it is an interesting look at the struggles of people desperate to lose weight.   This season what I did not like about the show is that the contestants did their preliminary "weigh in" in their home towns in front of their friends and family. I think that network gimmick was insensitive and hurtful.  Just my two cents!

Judy,
I don't routinely watch the show, but have already had two separate patients tell me that the weigh ins at home with family and friends around, were totally humiliating and very insensitive.

I do not like this television show because of the unrealistic messages people get from it. In Hope Warshaw’s thread Lose Weight, Keep it Off! Do We Over-promise? Give the Whole Story, I commented that it’s not RDs who over-promise, but books, magazines, diet programs and of course, TV shows like Biggest Loser. And this is what sets up so many people for failure. I hear about these contestants constantly while my patients berate themselves for not being equally successful. There are plenty of hugely successful people out there who are better (more realistic) role models than the people in this contrived setting. I can’t help but wonder if more people would be successful if they didn’t have false expectations and unrealistic goals. I think many people continue to seek out extreme dieting instead of a lifestyle change because of shows like this.

Jill,
I totally agree.  Basically, it is said that you want to lose only 1 pound/week, if you plan to keep it off.   We all would love a quick fix, but that's not getting anyone, any closer to their diabetes treatment goals any way.

Donna, you bring up two important points:  in general, our population wants (and believes they can get) a quick fix to their weight and often to diabetes; and that for many people, outward appearance is more important than health.

I often find it takes my clients years of trying diet after diet, searching for that quick fix, before they finally realize that the quick fix isn't going to happen. When they finally come to terms with that, they're typically very successful in improving their health profile, and lose some weight at the same time.

I wish I could come up with a way to bypass all those years of spending money, time, and energy chasing after a quick fix.

Another great conversation!

My relationship with Biggest Loser is love (not that's getting a bit extreme, perhaps like is better) / hate.

Hate first: I hate for for many of the reasons stated - unrealistic weight loss, unrealistic environment that nearly no one can replicate on their own or, even more importantly forever which is exactly what is needed, and a lot of emphasis is put on exercise (endless time in the gym) and very little time spent talking about/preparing/eating food. Yet, what does research time and time again say - food (calories in) is the most important piece of weight loss. Yes exercise is important and plays a "supporting role" but isn't the key factor in weight loss.

I like the show because I enjoy watching the transformations. In fact I enjoy the show more as the season goes on. In fact watching the show early in the season is simply disturbing....how can people get SO overweight. It is amazing to me. The transformations I enjoy watching most are the ones at the end of the show of the contestant that has just been sent home. I think these most realistically portray how hard it is to lose weight and keep it off. 

I'll likely keep watching, especially towards the end of the season!

Hope Warshaw, MMSc, RD, CDE

Nutrition Section editor, www.presentdiabetes.com

Hope, I share your love/hate relationship with the show for the same reasons.  I hate the beginning because I feel it is demeaning what they do to the contestants, I agree that it is not totally based in reality and I love it for the same reasons too.  Dont you find yourself really rooting for them all to lose weight, especially towards the end? You hope that they really learned something valuable that will be life changing for them.  As we have seen in previous seasons some go home and put all the weight back on, plus some.  That is very sad, but also very realistic (probably the only really realistic part of the show). I think it is funny how the show can actually manipulate our emotions, from anger to sadness, to hope and to joy, and that is exactly what the network wants. At the end of the day it is just another reality tv show, and if we keep that in mind when we watch it, and when we discuss it with our patients, if it is a topic that comes up, I think as long as we recognize its just another reality show we can provide sound advice, while still enjoying the program and can only hope our patients realize the same things we do about the motives of the program!

I have watched The Biggest Loser but tend to find it very disturbing at times. It makes me so sad and frustrated to see people weighing in at 400-500 pounds! I can't help but wonder why this is happening. What makes people become that overweight. There has to be a reason for why people eat that much. I have a psychologist friend who believes that people who are morbidly obese almost always are dealing with major rejection issues in their lives. That makes we wonder if the problem is much bigger than just diet and exercise. What role do you think the psychosocial issues play in the obesity epidemic?

Roxy

Roxy,
I think you've hit the nail on the head.  People who are that morbidly obese do have other issues, be they rejection, disappointment, poor self image, etc, etc, etc.

It is very sad and something that I think is a critical part of any weight loss program, and yet rarely addressed.  I'm actually somewhat surprised that the Biggest Loser hasn't gone into that arena.  That could make for some VERY interesting, albeit, sad, television.

I agree I have in the past worked as a psych nurse and Psychological issues run deep and contribute to all kinds of eating disorders.
During the AADE convention in Atlanta I had the pleasure of working out with Bob Harper. One of the things that he tells his contestants is that there is something eating away inside of you and you must find out what the issue is and deal with it in order to permanently change your eating habits.He said that was something that they tried to help the contestants with as well as the weight loss. I thought that was great..His book gives you better insight into behind the scenes.Not what you are seeing on screen.
I thought how great that he understands more than the physical challenge.

You're right that we only see a small part of what people on the Biggest Loser experience. Obviously they edit it for TV, and leave out parts that we may think are most important.

I estimate that 75% of the people I work with on weight loss overeat because of emotional reasons. Motivational interviewing and coaching techniques are a really big help for me in addressing these issues. I'm also careful to refer clients on to counselors and therapists when they identify issues that are beyond my expertise. I wonder if the Biggest Loser employs psychologists for their contestants?

As mentioned, a lot of things go on behind the scenes of the Biggest Loser. They may have a psychologist or psychotherapist. They have a registered dietitian. I wish they brought her on the show because her role is so important, and viewers should know what she does.

I agree that they probably have psychologists or psychotherapists on the show to help the contestants.  Instead of watching the contestants go through a grueling workout I would like to see a group session where they talk about what makes them overeat. I think people would really relate to that and maybe even do a little bit of their own soul searching.

What a great idea to have the RD and the psychotherapist as part of the show. That would be so much better than just watching the exercise and the tears. I think you two should submit that to the Biggest Loser team. Roxy

Thanks Roxy, I may just do that. I think it helps to see people getting to the root cause of their overeating, not just watching them try to lose weight.  I guess it all depends on what makes for better tv!!

Hmm, maybe we should contact the show.