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The Biggest Loser? For How Long?

Since “The Biggest Loser” first aired on television, there have been several studies on how the original 16 contestants fared in the years afterward. I was curious about this because I was highly suspicious of the of the premise of the show (which is not to say that I think I’m too intellectually superior to indulge in reality TV – I admit to being a loyal watcher of Say Yes to the Dress. I have no explanation for this).

Anyway, it turns out that about half of the contestants kept off a significant amount of weight that they lost, but the other half did not. It seems that the biggest difference between the two groups is that the people who sustained their weight loss were the ones who remained more physically active (1).

This comes as no surprise. Without regular exercise, most people who lose weight gradually regain the weight (and often end up weighing more than they did in the first place) over a period of one to five years (2,3). 

Why does this happen? There are many explanations, based largely on the body’s physiologic response to weight loss (and not on all the reasons people give for blaming others and blaming themselves for regaining the weight). As the body adapts and needs fewer calories to maintain the lower weight (4), the pounds creep back on unless you rev up your metabolism with exercise. While physical activity doesn’t have a large role in initial weight loss, at least compared to ingesting fewer calories, it is essential in maintaining weight loss. (4,5). 

 

And Now Back to The Biggest Loser

A few months ago, Ellen Gray, a journalist at the Philadelphia Inquirer, wrote a terrific articleabout what happened to former contestants of The Biggest Loser. She interviewed a local Philadelphia radio disk jockey, who did, in fact, gain back much of the weight she had lost. She also said, “Weight loss can make some things better. You can fit in a plane seat, you can ride in a roller-coaster. But other things don’t change. You have to really love yourself, no matter what, at the start.”

She’s absolutely right, but that’s really hard to do in our fat-shaming culture. In fact, there are studies showing that reality weight-loss TV shows actually increase the stigma against obesity (6) and contribute to the stereotype of obese people as not taking enough personal responsibility for their weight (7). Yes, one’s own behavior is a factor. But there are other factors, too, like genetics, hormones, and ubiquitous unhealthy food (8). Unless you’re a permanent contestant on one of these shows, there’s no way you’re going to sustain the incredibly low number of calories a day they feed you, not to mention the three hours a day of exercise (9). It’s very complicated – but here’s something that’s not complicated at all:

 

You Don’t Lose Weight by Thinking of Yourself as a Loser

 

References

(1)Kerns JC et al. Increased physical activity was associated with less weight regain six years after “The Biggest Loser” competition. Obesity 2017; 25(11):1838-43.

(2)Santarpia L et al.  Body composition changes after weight-loss interventions for overweight and obesity.  Clin Nutr 2013; 32:157-61.

(3)Anderson JW et al. Long-term weight-loss maintenance: a meta-analysis of US studies.Am J Clin Nutr 2001; 74 (5):579-84.

(4)Rosenbaum M et al.  Long-term persistence of adaptive thermogenesis in subjects who have maintained a reduced body weight. Am J Clin Nutr 2008; 88 (4): 906-12. 

(5)Pronk NP. Combined Diet and Physical Activity Promotion Programs for Prevention of Diabetes: Community Preventive Services Task Force Recommendation Statement. Annals  Int Med 2015; 163(6):465-8. 

 (6))Domoff SE et al. The effects of reality television on weight bias: an examination of The Biggest Loser. Obesity 2012; 20(5):993-8.

(7)Yoo JH. No clear winner: effects of The Biggest Loser on the stigmatization of obese persons. Hlth Commun 2013; 28;3:294-303.

(8)Ludwig DS, Ebbeling CB. The carbohydrate-insulin model of obesity: beyond “calories in, calories out.” JAMA Intern Med 2018; 178(8):1098-1103.

(9)Hall, KD. Diet versus exercise in ‘‘The Biggest Loser’’ weight loss competition. Obesity 2013; 21: 957-9.