Could "Psychological Stress" Explain The Biggest Losers' Metabolisms?

Seems extremely unlikely to me only in that there's no obvious pathophysiological mechanism that could help to explain why the show's psychological distress led to permanent and disproportionate metabolic adaptation.

And though that's what I told the reporter from the New York Post, she left out the "doubtful" proviso and left in the "possible".

The thing is, it's unclear why The Biggest Loser's contestants' metabolisms seem slower than would be expected simply as a consequence to weight loss. They're also slower than the metabolisms of patients who've had bariatric surgery and lost similar amounts of weight.

Could their greater degrees of metabolic adaptation be due to the nature of the show itself? Sure. But as I told the reporter Maureen Callahan, over and over again in fact, it's also possible that losing 40-50% of your body weight without surgery, regardless of approach, is responsible.

And yes, despite what the article misquoted me as saying, plenty of people have lost 40-50% of their body weights without surgery, but generally those losses occur with extremes of effort (like they do on The Biggest Loser). What I'd like to know is whether or not losing comparable amounts of weight slowly would lead to similar outcomes?

That'd be a challenging thing to figure out because losing that much weight slowly is a rarity. Of course that doesn't mean it doesn't happen, it just means that it's rare. It also means that randomizing people to lose 40-50% of their body weights with non-extreme efforts isn't feasible.

Lastly, though I think when it comes to weight loss The Biggest Loser's Dr. Huizenga is either deluded, unethical, or clueless, I never claimed to know him personally.

Bottom line. The Biggest Loser is a horror show (I've written extensively about it over the years), but so too is Maureen Callaghan's reporting on it for The New York Post.

The Lasting Damage of The Biggest Loser (Part II) - Lawsuit Edition

By Fayerollinson - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=17999473

Yesterday saw the publication of an unbelievably damning paper that unequivocally condemned The Biggest Loser as a show that permanently damages contestants' metabolisms, and that it does so in a manner far greater than would have been expected by mathematical models based on contestants' ages, heights, weights, sexes and body compositions.

Now I know from chatting with former contestants, the show requires them to sign massive indemnity and non-disclosure agreements, and while I'm no lawyer, I wonder what legal standing former contestants might have to launch a class action lawsuit in response to the show's trashing of their metabolic futures?

Certainly, for consent to now be informed, participants must be told to expect that as a direct consequence of the show, when they're done, their metabolisms will burn far fewer calories than expected, and will leave them metabolically far worse off than were they instead to choose bariatric surgery.

If such informed consent is not obtained moving forward, I've little doubt there'd at least be a theoretical legal case. But even looking back, I can't help but wonder whether, indemnity waivers or not, there are grounds for former participants to sue the show for their severe metabolic damages? Certainly the writing was on the wall back in 2011 with the first Biggest Loser energy expenditure studies. And even if those hadn't been done, is not knowing a fulsome defence vs. inflicting lasting harm?

The Lasting Damage of The Biggest Loser (Part I)

I've written a great deal about The Biggest Loser over the years - none of it good. Today you're bound to read a lot of headlines about The Biggest Loser and its dramatic, devastating, and likely permanent damage to contestants' metabolisms (more on that from the author of the recent study in a few days), but that's not what I'm writing about today. Today I want to talk to you about a different sort of lasting Biggest Loser damage, and to illustrate, the story of Ali Vincent.

Vincent is The Biggest Loser's first female "winner". Back in Season 5 she lost 110lbs, and now they're back, and so is Vincent - she's been on a media tear and she's joined Weight Watchers in a bid to again lose weight.

Now Vincent regaining really isn't that much of a story. If your weight loss methods are not only a misery, but a misery that trashes your metabolism, go figure there's a good chance you'll regain. The story here is that apparently The Biggest Loser's brainwashing is so great that "once burned, twice shy" doesn't seem to apply.

And I'm not talking here about putting herself out there. While I do think it opens a person up to incredible scrutiny to lose weight publicly, that's clearly a personal choice, it's likely motivating while it's happening, and I've little doubt that in Vincent's case, it'll directly or indirectly earn her some modicum of further fame and or fortune. But where Vincent doesn't seem shy is to be once again adopting The Biggest Loser's competitive suffering to lose narrative.

Vincent has joined up with a website called DietBet, whereby she's leading online challenges that have people put up cash as part of a weight loss pledge that in turn allows them to win it back if they lose 4% of their weight in 4 weeks.

4% in 4 weeks is certainly doable. For a woman Vincent's age, height, and weight, it would probably require her to consume in the neighbourhood of a tightly controlled 1,000-1,200 calories daily. What's not doable though is living an enjoyable and normal life on 1,000 calories, and by the contest's very nature, no doubt the competition and prize money will inspire people to adopt non-sustainable approaches.

Pretty sure Vincent has some experience with what happens in the long run when you undertake a non-sustainable approach.

The Biggest Loser's philosophy embodies the very worst of modern day weight loss efforts. It teaches viewers that suffering is crucial, that you're a failure if you don't want to suffer forever, and that scales measure health and happiness. And sadly it would seem, while weight lost by way of The Biggest Loser doesn't seem to last, those toxic lessons do.

[Thanks to Nutrition Wonk for letting me know about Vincent's competitions on DietBet]

More on Why The Biggest Loser Contestants Are Doomed To Fail

I've written a great deal about The Biggest Loser.

I've covered the fact that according to previous contestants the vast majority gain their weight back, I've covered the metabolic slow down that occurs consequent to the show, I've covered the cruelty of the show's inclusion of children, I've covered how watching the show actively discourages viewers from exercising, and I've covered the ethics of being a physician involved in its production.

Today I'll leave you with this tidbit.

In a study published early online last week in the journal Obesity, when compared with matched gastric bypass patients, following their respective losses, contestants on The Biggest Loser had 5x less circulating leptin in their bloodstreams.

Leptin, in case you aren't aware, is one of the body's primary satiety (fullness) hormones.

With 5x less circulating leptin, and metabolisms that are slowed down twice as much as their gastric bypass counterparts', it's no small wonder the majority of The Biggest Loser's contestants are reported to have gained their weights back as it's tough to be a metabolic slug and be hungry.

Biggest Loser Pediatrician Joanna Dolgoff Still Misinforming Nation Regarding Childhood Obesity

On The Biggest Loser, pediatrician Dr. Joanna Dolgoff promoted weight losses so rapid that prior to her involvement with the Biggest Loser she herself had cautioned they were unhealthy, and while thankfully there are no kids on The Biggest Loser's upcoming Fall season, that isn't stopping her from using her influential platform to further misinform a nation about childhood obesity.

Her current project is called, "Rally for Recess", and it's a Dannon initiative designed to increase the sale of three of their products - Danimals Smoothies, Danimals Crunchers and Dan-o-nino drinks. It's charitable healthwashing in that with every product purchased schools, parents and kids are encouraged to mail their labels into Dannon and the school sending in the most is awarded a $30,000 playground makeover.

So what are these products?

Here are some photos:

Before I get into their nutritional breakdowns, for perspective, I want you to know that the percentage of calories coming from sugar in Ben & Jerry's Chocolate Fudge Brownie ice cream clocks in at 41%. These products? Of the Danimals Cruncher's 120 calories, 60% of them come from its 4.5 teaspoons of sugar, of the Danimals Smoothie's 60 calories, 66% of them come from its 2.5 teaspoons of sugar (crammed into a serving that's barely larger than a third of a cup with nary a raspberry to be found in its ingredient list), while Dan-o-nino drinks' see an astonishing 80% of their 70 calories coming from their 3.5 teaspoons of sugar.

Of course Dannon's Rally for Recess is a brilliant move for Dannon. It directly encourages the consumption of their products in the name of charity, and by tying it to physical activity and school recess the program perpetuates the myth that childhood obesity is a consequence of inactivity and that childhood obesity can be treated or prevented by means of kids just running around a little bit more. In turn that may lead parents to not notice (or not care) that the yogurt based sugar-spiked desserts they're feeding their kids have a substantially greater percentage of calories coming from sugar than does Ben and Jerry's Chocolate Fudge Brownie ice cream.

And what of recess? A wonderfully objective 4 year study that utilized accelerometers to measure kids' actual activity levels found that even a ten fold difference in physical activity did not protect against obesity.

So what did Dr. Dolgoff have to say about Dannon's products and physical activity in regard to childhood obesity? The "sponsored by Dannon" TV news segment (embedded below) opens with scary childhood obesity statistics, and then a direct tie to decreased physical activity, and then to Dr. Dolgoff who explains that she's teamed up with Dannon because kids weren't getting much P/E at school so she's championing their rally for recess campaign. She doesn't mention that energy intake matters far more than energy output when it comes to childhood obesity. In fact her only real mention of intake involved her pointing out how committed Dannon is to kids that they've quietly cut the sugar in their product lines (apparently they were 25% worse before), and that,

"Dannon is very committed to the health and wellness of kids"

Because what could be healthier than yogurt desserts with chocolate candies or drinks where 80% of their calories come from sugar, or an expert physician spokesperson supporting a marketing initiative that by its very nature encourages those products' excess consumption, or that same expert physician helping to perpetuate the myth that childhood obesity and inactivity are tightly linked and that the problem, or the solution, lies with more recess or simple play?

I'm all for kids running around more, and I'm all for more recess, but to infer simple running around will help with childhood obesity (or that not running around led to childhood obesity) and to help to sell kids and parents dessert as a healthy snack isn't something I would expect from a pediatrician whose specialty is childhood obesity.

Former Biggest Loser Contestant Sued For Weight Regain

That I'm not a fan of The Biggest Loser won't come as a shock to anyone. I think it's a hideous spectacle of every toxic attitude society has ever had regarding weight that teaches a nation that self worth is measured in pounds and that people who struggle with obesity are truly just lazy gluttons who don't want it badly enough.

Regarding those Biggest Losers who do manage to keep off their weight (and according to the former contestants I've interviewed that's a very small number) I've always said that the Losers who keep it off may well do so consequent to having translated their weight losses into careers as product spokespeople, celebrity trainers and motivational speakers.

Well maybe even that's not enough to help maintain the severity of a Biggest Loser lifestyle as one such Loser, Tara Costa, is apparently being sued because she'd gained back enough weight (according to news reports she had regained 29% of her Biggest Loser losses) that one of the companies for who she was a paid spokesperson felt that they could no longer use her in their advertising and that her weight gain in turn was in breach of her contract which specified that she needed to, "maintain her current level of fitness and conditioning".

Biggest Loser Pediatrician Joanna Dolgoff Promotes Unsafe Weight Loss to 7 Million Viewers?

Screencap above and show transcript down below courtesy of Shannon Russell

This story will be told primarily in tweets. Not mine, but rather Dr. Dolgoff's.

So is rapid weight loss in children safe?

Not according to Dr. Dolgoff.

Here's her tweet from January 7th where she appropriately cautioned a 15 year old that losing 36% of her body weight in just 29 weeks and 3 days was not safe.

It's a message reiterated regularly and appropriately by Dr. Dolgoff in her recent Twitter stream.

Here she cautions that weight loss should be "slow and steady",

Here she reiterates that rapid weight loss in children isn't safe,

And here she explains that the Biggest Loser approach, one that sees adults losing between 25% and 50% of their weights in 22 weeks (there's no clear answer as to exactly how long the show is. Best guesses out there are somewhere between 20 and 24 weeks and The Biggest Loser executive producer Dave Broome, when I asked him on Twitter, ignored me) is extreme and unrealistic,

The reason Dr. Dolgoff cautions against rapid weight loss in children is twofold. Firstly the only way to lose weight rapidly is to take on extremes of effort - dramatic under-eating and massive over-exercising - neither of which represent a sustainable strategy for anyone at any age. More importantly though, when it comes to rapid weight loss in children it's thought that rapid weight loss potentially risks negative effects on pubertal development and on lean tissue, while simultaneously putting children at greater risk of developing eating disorders.

But don't take my word for it, here's Dr. Dolgoff's own website from back in 2011 on the subject of rapid weight loss in children (the admonition is still on her program Red Light Green Light's page, but thanks WayBackMachine for providing a version that can't be altered by the site's owners),

"Child weight loss is very different from adult weight loss for many reasons. First and foremost, children need a sufficient number of calories to support their growth and development. We cannot limit fat as much as we do in adults because children need fat for continued brain development. We also don’t want to limit carbohydrates which are essential for growth and energy. In fact, most studies show that low carbohydrate diets are neither safe nor effective for children.

It is not safe for children to lose weight too quickly. Weight loss in children must be closely monitored by a doctor to make sure that no nutritional deficiencies are developing and that growth and development is appropriate. We recommend that all patients see their pediatricians routinely while following our program.

We aim for a slow, steady, and healthy rate of weight loss, approximately one half pound to one pound per week. It is not safe for children to routinely lose weight more quickly than that. Of course, there may be some weeks when your child loses more than one pound but in general, sticking to a half pound to one pound per week is ideal.

Remember, your children are still growing. So even if they don’t lose a pound (but rather maintain their current weight) and continue to grow, they will get thinner. We call this “growing into their weight”. In fact, for younger kids, we don’t aim for any weight loss; we aim for weight maintenance and continued growth.

"Ok, so Dr. Dolgoff really isn't a fan of rapid weight loss in kids.

Or isn't she?

Last week on The Biggest Loser Dr. Dolgoff was shown congratulating 13 year old Biingo on losing 25% of his body weight in just 11 weeks! Now to be fair, TV is a manipulated media so perhaps that segment was shot past the 11 week mark, but certainly it wasn't presented to viewers as such. Instead it was presented to them as Biingo's 11 week accomplishment. Here's a transcript of what she said to Biingo (and to America),

"I have here a body mass index curve, it's a way to measure levels of body fat, and when we first met you, you were in the purple and at a real risk for medical problems. In just a few months of making healthy choices, you have gone from the purple all the way down to the yellow. Biingo has lost 25% of his body weight."

And here's her excited tweet:

Then at the finale this past Monday we found out that 13 year old Biingo lost 43lbs in the 22 weeks, 13 year old Lindsay 47lbs and 17 year old Sunny 51lbs and though they didn't announce percentiles I'd venture that each and every one of their losses represented somewhere in the neighbourhood of losing near 30% of their body weights in just 22 weeks. For the show's children to lose 30% of their body weights in just 22 weeks puts their results right in line (and even in some cases exceeding) those of the show's adults, especially when considering not fully grown 13 year olds' resting energy expenditures are likely less than those of fully grown, taller, heavier, adults. What that means to me is that the kids, while not living on the ranch but while under Dr. Dolgoff's supervision and oversight, were as or more extreme in their weight loss efforts than the show's over-the-top, run till you puke, never eat a cookie, competing for $250,000/$100,000 adults.

And while these massive weight losses in barely pubertal children may have put the kids at personal risk, what of the viewers' children? Roughly 7 million people watch The Biggest Loser, which means 7 million people have just been taught that children, if pushed hard enough, if they just want it badly enough, can lose dramatic amounts of weight in truly rapid fashion and that pediatricians support that degree of loss. I wonder how many parents who watched The Biggest Loser this year are going to start riding their overweight children and forcing them to undertake incredible amounts of exercise while simultaneously severely restricting their diets thinking that's their kids' tickets to slim?

Sigh.

So are there any thoughts out there as to why Dr. Dolgoff's caution against rapid weight loss for the 15 year old hoping to lose 36% of her body weight in 29 weeks didn't apply to the three children she regularly reports on Twitter that she "loves" whose care she was responsible for overseeing while on The Biggest Loser? Or why she's comfortable serving as a cheerleader for a show that teaches America that rapid weight loss in children is awesome when she clearly appears to have at least once thought differently? Has she simply changed her mind?

American Academy of Pediatrics - would still love to see some actual leadership from you on this one. You need to speak up about kids on this show. You're failing them on this.

Guest Post: How a 7 Year Old Boy Came to Ask, "Do I Look Fat?"

One of my Facebook readers sent me a message telling me about the experience she had after allowing her son to watch a few episodes of this season's The Biggest Loser. I asked her if I could repost it as a guest blog.

Meet Tara Newman.  She is a mom, fitness enthusiast, and an advocate for healthy living. She has a Master's Degree in Organizational Psychology and works full time as a Human Resources Manager. She spends most of her time trying to keep up with her active family.

How a 7 Year Old Boy Came to Ask, "Do I Look Fat?"

My son recently told me he wants to be 100 pounds so he can be on TV. You’re probably thinking “What an odd comment,” or “Where did that come from?” Well, you see, I allowed my seven-year-old child to watch The Biggest Loser this season – the first to feature kid participants.

I am not writing to critique the show, give advice, pass judgment or claim to have any answers. I am not a doctor, nutritionist, registered dietitian, exercise physiologist or even a personal trainer. I am simply sharing my experience as a mother, fitness enthusiast, and health-conscious individual.

I know some of you started judging me the second you realized I allowed my son to watch The Biggest Loser. That’s okay, I have thick skin. However, I think you will see that I am a fairly rational being who meant no harm. I might even be a bit like you.

I am a working mom with two kids. Like many of you, my life gives new meaning to the word busy. Aside from my own activities, my husband competes in triathlons, and my kids have their fair share of athletics. Family fun day is always an active experience.

We are conscious eaters. Our diet consists of loads of plants and limited prepackaged items. We steer clear of preservatives as much as possible. And absolutely NO high fructose corn syrup or hydrogenated oils. We participate in a CSA (community supported agriculture) program, which allows us to show the kids where our food comes from. If they’re at a birthday party, they eat the cake. We strive for balance without instilling any body image issues or phobias.

When I let my seven-year-old watch The Biggest Loser, my goal was to expand his worldview by observing people who live differently, have him hear what it’s like to be an overweight child, and (hopefully!) help him understand why Mommy and Daddy work hard to ensure we live the healthiest lifestyle for us. I am not an over-analyzer and have a pretty positive personality; it didn’t even cross my mind that allowing my son to watch the show might have any negative outcomes.

Having kids on the show made it seem more appropriate. Otherwise I would have deemed it adult content. I don't usually watch the show. It’s not representative of our lifestyle or beliefs. It seems strange now that we watched this season at all, let alone as a family.

As my son watched these episodes, he did what I expected. He expressed empathy for the contestants as they shared their life stories. He cheered them on as they faced their challenges and weigh-ins. He was angry when these children spoke about being bullied. He spoke about how he felt lucky to grow up in a house where everyone was “healthy” and had active lifestyles.

What I didn't expect were the random “Do I look fat?” or “Am I getting fat?” or “Can I step on the scale?” questions that started creeping into our daily dialogue. I was blown away the day he said he wanted to be 100 pounds or more so he could go on TV. (For reference, my son is about 58 pounds, medium height with a muscular build.)

I didn't dwell on his desire to gain weight so he can be on TV. Not that I didn't take it seriously, I just didn't think it was something I wanted to “play up.” As a mother, my wish to do right by my children trumps all. I do believe when you pay too much attention to something, it begins to grow into something greater than it might really be – kind of like the boyfriend you kept around too long because your parents despised him.

I like to focus my kids on what they CAN do instead of what they can’t do. As the situations above came up, I continued to redirect him (and my daughter) to our family’s healthy habits: we get plenty of sleep, we drink water, we eat lots of fruits and veggies, we try new things (especially foods), and we get our hearts pumping.

Before writing this post, I spoke to my son about his experience watching The Biggest Loser. Did he really want to gain weight just to be on TV?

My son talked about healthy habits but admitted he didn't learn them from the show, he learned them from Mom and Dad. He also admitted that while he knows he shouldn't want to be over 100 pounds, being on TV would be “really cool.” Alas… the mind of a seven-year-old.

I don’t regret my decision. I take full accountability for my actions. I was able to reinforce the importance of positive body image and discuss healthy weight loss with my son. Building healthy, fit, well rounded, and emotionally well adjusted kids starts in the home and has nothing to do with mass marketed ‘reality’ TV.

Be confident in the life you lead, be present in the decisions you make, and be cautious of how you go about trying to expand your child’s worldview.

8 Year Anorexic's Mom Cites The Biggest Loser as Potential Contributor to Daughter's Illness

In 2008 The Cutting Edge did a documentary on Dana, an 8 year old anorexic and recently a friend on Facebook sent it my way.

In it they cover the rising rate of eating disorders among ever younger children where according to the show in Britain between just 2006 and 2008 the number of children under 10 admitted to hospitals with eating disorders rose by 50%.

Dana did well in treatment and was discharged home and in the wrap up interview her mother pondered the genesis of her daughter's struggles,

"I always feel it was just a few things that clicked together like a jigsaw.  One, she started watching this program called America's Biggest Losers, it's a weight loss challenge. I did see her watching it. I just didn't really consider it dangerous. I didn't you know, she's never been a kid that had even mentioned dieting. It just clicked into place. If you don't eat, you lose weight and watching this weight loss challenge program about how they're all trying to give up food, it was just a combination of things that happened together".

The documentary is frightening. The residential eating disorder treatment home's director had this to say on their increasing number of under 10 year old patients,

"I worry very much that we're so many younger and younger children. They are being robbed of their childhood these days. Children as young as 5 and 6 are sitting in the playground discussing the shape of their bodies, talking about the fat that they've got and the fat bits that they would rather not have. You can't underestimate how serious it is."

If you'd like to watch the documentary, click here or watch below, and please, don't let your children watch The Biggest Loser and better yet, don't watch it yourself:

How Does a Biggest Loser Teen Celebrate her Birthday?

Who knew, but according to Wikipedia we've associated birthdays with birthday cakes since as far back as ancient Rome, while archaeological digs have us celebrating with food for at least the past 12,000 years.

Food isn't just fuel. As a species we celebrate and comfort with food, and when we undertake efforts that deny food those roles in our lives, well those are called diets, and generally in the long run they fail. Human nature simply isn't built to suffer unnecessarily in perpetuity, and while thoughtfulness regarding dietary choice is certainly a requisite for a healthy life, being overly strict surely isn't thoughtful.

I've been highly critical of the inclusion of teens on this year's The Biggest Loser. My two main concerns can be boiled down to:

1) The teens are going to be taught that success requires a lifetime of sacrifice and suffering.

2) Being portrayed as lazy gluttons on prime time television, and being taught that if you just try hard and sacrifice enough you'll succeed, when coupled with the almost statistical certainty of regain in at least one, if not all the teens, puts them at huge risk of both increased future bullying, and tremendous damage to their own personal self worth and esteem.

Now the Biggest Loser has made it very clear - the kids are going to be treated more gently than the adult contestants, but of course the kids will be watching the show and are in fact being managed by the same team that the adults are - are they going to absorb the show's ultimate messaging - that weight is the only determinant of health and that there's no amount of suffering too great to get to some artificial number on a scale?

Sure looks that way.

One of the contestants, 16 year old Sunny, recently blogged about her seventeenth birthday in Seventeen magazine. Did she have cake? Well of course not, the show has taught her that she doesn't deserve cake if she wants to be "healthy". Instead her trainer, after an "exhausting workout", gave her, "a tiny, sweet mandarin orange with a birthday candle stuck into it" which according to Sunny, "was, hands-down, the best birthday cake I’ve ever tasted".

Honestly I wish Sunny and the other teens on the show all the luck and kindness in the world. I hope they prove my concerns to be entirely unfounded, me a blowhard idiot, and that their weight losses are permanent and their lives only blessed by their involvement with the show.

But I can't help but worry about the 17 year old girl who's been taught to think that birthday cakes are tangerines with candles in them.

Go Figure - New Study Reports Watching The Biggest Loser Discourages Interest in Exercise

(Original Source:  The Soup TV)

By my count during the first week of this season's The Biggest Loser, three contestants lost consciousness, two threw up, one suffered a stress fracture in their knee and a thirteen year old boy fractured his foot.

Watching that - who wouldn't want to hit the gym?

And that's a question that Tanya Berry and colleagues wanted to answer. Their thinking was straightforward. Since they felt that the Biggest Loser portrays exercise as "work and not fun", and that it's often incredibly extreme in its depiction, it may follow that viewers watching The Biggest Loser rather than be motivated to exercise, will in fact be motivated not to. Their study was published this month in the American Journal of Health Behavior.

So what'd they do?

They took a common viewer demographic (undergrads believe it or not - of who nearly 30% reported watching the show at least once a month) and from it recruited 138 students from an undergraduate psychology class to watch one of two video clips - a Biggest Loser clip or an American Idol clip.

The Biggest Loser clip was 7.5 minutes long and involved a typical Biggest Loser training session replete with crying, screaming, complaining and the clear message that it was very difficult.

The American Idol clip was 5 minutes long and according to the authors it was chosen because it too depicted a reality show competition. The American Idol clip had no mention of exercise and showed highlights of the top 12 contestants along with some judge's comments.

Researchers then used a Go/No go Association Task to measure "implicit" attitudes towards exercise (unconscious attitudes) which basically involved using a computer to rapidly cycle through exercise and non exercise related words with the participant as quickly as possible choosing from a good or bad word association. They also evaluated "explicit" attitudes (conscious attitudes) by rating this statement about exercise,

"For me to exercise for at least 30 minutes each day in the forthcoming month is..."

They then looked at the following 3 items along a 7 point scale: 1. Pleasant to unpleasant. 2. Enjoyable to unenjoyable and 3. Pleasurable to painful.

Controls were put in place for the pretest activity level and mood of the participants and with those variables controlled the team found that watching the Biggest Loser led to a statistically significant decrease in explicit attitudes towards exercise - meaning watching the show led viewers to report that the notion of their exercising regularly for the next month as less enjoyable. Implicit attitudes were not shown to change.

And guess what? When looking at correlations between implicit and explicit attitudes towards exercise and actual exercise it's the explicit attitudes that matter which is why the authors of this study suggest the possibility that watching The Biggest Loser,

"may result in lower motivation to participate because of the anticipation of an unpleasant experience"

The study wasn't perfect. As the authors themselves noted, in their methodology they should have identified the show's regular viewers as their responses and attitudes may differ from non habitual viewers. It was also a small study and only involved a short segment of show, but ultimately I don't think it's a stretch to think that the depiction of successful weight management as being dependent on an exercise regime that is much more readily described and depicted as a painful punishment than a pleasure would make the thought of exercising that much less enticing.

How Do 3 Biggest Loser Alumni Feel About The Show's Inclusion of Kids?

Who better than the folks who've been there to weigh in (sorry) on whether or not The Biggest Loser by its very nature puts kids in harm's way?

Last week I interviewed three former Biggest Loser contestants - Kai Hibbard and Ken Coleman from Season 3, and a third contestant, who placed either first, second or third in their season, who wishes to remain anonymous but who I'll be calling Linda for the sake of this post.

Kai, known to be an outspoken critic of the show, is concerned,

"I think putting children in this position is super, super, harsh.",

and she wonders what their parents were thinking in allowing them to be included on the show,

"Putting your child in that psychological position to be picked at, to be analyzed, to be mistaken for somebody else and to have a level of fame, but not a level of protection from it that money and power might provide is irresponsible, so even without the weight loss, reality TV is dangerous."

Next I asked her if the show's pressure to lose led her as an adult to struggle and what impact it had on her and her fellow contestants,

"I know my own self-image suffered extensively. I felt, and I know that two of the other female contestants on my season alone felt the same, the more weight we lost, the less we liked ourselves. The less we liked looking in the mirror because it wasn’t enough, and it didn’t look good enough."

To this day, 7 years later, Kai still reports being scrutinized by strangers and that she worries it'll be worse for this season's kids,

"I think it’ll be 10 times worse because they’re adolescents. I’m a grown adult, and it’s been almost 7 years and literally less than a month ago I had a complete stranger come up to me in the grocery store, look at my cart, and ask me whether I should be buying the ice cream that’s in it. I can’t imagine what they’re going to endure and let’s be honest, beyond the regular every day being picked on, they’re going to get the, “oh you think you’re so special, you think you’re so cool, because you’re on reality TV - adults even do that so kids will be 10x worse."

Ultimately Kai feels that the show teaches participants (and viewers) that it's just about willpower,

"Not only are you instilled with “if you just want it bad enough you can lose weight”, but that the only barriers are that you don’t want it enough and hey, you’re lazy. That’s honestly the attitude",

and at the end of the day she doesn't think that attitude, or this show is a place for children,

"I see this show doing harm both physically and psychologically. It scares me, it scares me for the kids."

Kai's former teammate Ken isn't on the same page. Ken isn't worried about the kids getting picked on more consequent to their involvement,

"kids are already being picked on, it’s a living hell for them",

but he readily agrees with Kai in that the scrutiny from strangers even long after the show is very, very real,

"I still have that happening today. Yes, 7 years and it doesn’t change. I do speaking engagements, I have people that come in to speaking engagements and the only reason they came, they don’t want to hear what I have to say, they just want to see if I gained the weight back"

Ken feels the kids on the show will be kept safe by the show's psychologists and psychiatrists who'll be there to help them through the journey, though when I asked him whether or not that support would still be there for the kids once the cameras stopped rolling, or once the next season's children were the stars, here's what he had to say,

"Well none of the contestants from NBC have been that lucky"

All told, Ken does think the show will be a positive experience for the children, but only if NBC steps up and provides these children with far more extensive and longer term supports than have been offered to the show's adults to date.

The last call I made was to Linda. Right off the bat she didn't mince words,

"It is a horrible idea. A horrible idea. I have professional experience working with children near to the ages of those on the show, and they are in such a fragile mental emotional physical state at that age that kind of rigorous workout and body change and self reflection I think is damaging"

When I pointed out to her that it'll be different for the children, that they won't be facing elimination or regular weigh ins she was unfazed,

"regardless of if they’re doing weigh-ins both that kid and the producer and their family and their trainer know exactly how much they weigh, exactly how much they need to lose and that’s always in your head."

And what does having that in your head do?

"It was a total mental battle, all of the time. It’s so much pressure that you put on yourself. I was taking sleeping pills to get through the night because I was so freaked out weighing myself daily. It was so much pressure. It was unbelievable"

And echoing Kai and Ken, Linda reports the pressure and scrutiny consequent to being on The Biggest Loser simply doesn't end,

"You are constantly scrutinized. I remember after the show aired I was in the grocery store and somebody was looking in my cart and scrutinizing, and still to this day, even though my show was a bunch of years ago, I am still worried about what is in my cart because god forbid if somebody recognizes me"

Going back to the safeguards being put in place for the children, Linda couldn't be reassured,

"remember, regardless of whatever safeguards they’re putting in for children this is a TV show, and they do this for ratings, and they want a reaction, and the only way you’ll get a reaction is if you get an extreme results. So these kids are going to go to be one day 50lbs overweight, and they’re going to wake up 6 months later at a normal weight and they’re not going to recognize themselves. So what is that going to do to an already fragile psyche?"

She even recounts bullying consequent to her success where people said things to the effect of

"Oh what, you had to go on a tv show to lose weight? It was a lot of why go to this extreme, what’s wrong with you that you had to go on national tv to do this?"

Linda also validates Ken's comments on the lack of long term support. In fact she goes further in that not only did the show not offer support, but according to her they also ignored her cries for help,

"One of the things that hurt the most through this whole biggest loser process is I gave the show everything and they dropped me. After the show was over, when I reached out, when the weight started to come back on I reached out and I begged and I pleaded and I said help me and they wouldn’t even respond to me. I felt terrible. I don’t think there are words to describe the defeat and the rejection I felt after the show."

Linda gained all of her weight back, as did other finalists from her season. I asked her how regaining has affected them consequent to their show created visibility,

"We still know that people look at us, people who know the show and we feel such shame because we had this opportunity that everybody wants, and we didn’t keep it off"

What I also learned interviewing these 3 former contestants is that The Biggest Loser alumni, perhaps due to their shared trial by fire, keep in fairly close touch. Consequently I asked each of these three what percentage of folks from the Biggest Loser keep the weight they lost off.

Kai answered,

"I’d say one quarter to one third - and not all of it"

Ken stated,

"85-90% of the contestants on the show have regained all their weight"

And Linda,

"Maybe 10-20% are keeping it off"

Linda summed up her experiences succinctly,

"If I would have known where I would have ended up after the show I would have stayed 300lbs"

And regarding kids, again, she didn't mince words,

"Kids are cruel and kids will take any opportunity they have to berate and belittle each other, that’s what kids do, and I think they're setting these kids up to be bullied relentlessly.

I’m so appalled and disgusted with it. It’s one thing to mess with our heads, but then they go to kids. I’ve been battling with this for many years, and I can’t even imagine, I can’t even imagine what it’s going to do to kids."

Are you also appalled? If you are, feel free to sign the petition, and/or better yet, join and promote the advertisers' products boycott.

[If there are any other former contestants who'd like to go on record, pro or con, anonymous or with attribution, feel free to contact me at yonifreedhoff over at gmail, or in a comment on this post]

"First Do No Harm" and The Biggest Loser's Children

The Hippocratic oath is the oath physicians either literally or figuratively take when embarking on their careers in medicine. The original of course is rather old and is written in Greek but I found a line from its translation to be especially apropos to The Biggest Loser's inclusion of just barely teenagers on this season's show,

"I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice."

It's the latter part I'm interested in, the "harm", and, "injustice".

So there are 3 children on the Biggest Loser this year. Two 13 year olds and a 16 year old, and before I type anything else I want to make it exceedingly clear - I hope they find the healthy lifestyles that they're looking for through their involvement with the show and that the show's teachings help them to live long, happy, and healthful lives where the only outcomes of being on the show are incredibly, unbelievably and undeniably positive.  I imagine that's what they're hoping.  Probably their concerned parents too.

I just worry that they won't be.

But for a moment let's assume only the very best. That the show's incredibly gentle, ethical and evidence based. That none of the nonsense (both in terms of messaging and in terms of approach) the show typically  throws at their adults trickles down to the kids. That all of the kids lose weight, improve their self-esteem, and develop healthy relationships with food.

I'd still be worrying about the "harm" and "injustice" of their inclusion on a weight loss reality show. Having spoken to more than one adult contestant I know that simply being on the show opens them up to a world of criticism, scrutiny and unbelievable pressure. The kids may well have it worse as their worlds will include the harsh and often exceedingly cruel realities of adolescence.  Given the horror stories the former adult participants have recounted to me about the judgments and comments they experienced with adult strangers and even loved ones directly consequent to their involvement with the show, I shudder to think of the taunts, pressure and pain that the show's children will face as this season progresses, let alone if they, like the vast majority of the show's contestants, regain once it's done.

And most do regain.  According to the multiple Biggest Loser contestants I've spoken with (who keep in touch with one another through private social networks), the show's success rates for long term weight maintenance run from a low guess of 10% to a high guess of 33%.

Which brings me back to the involvement of pediatrician Dr. Joanna Dolgoff. While Dr. Dolgoff and I have publicly disagreed before on the merits of formally putting children on diets, here we're at odds on whether or not putting children on an incredibly popular and heavily watched weight loss reality show is really in the children's best interests. I'd posit that simply being on the Biggest Loser puts these kids, regardless of their short and long term weight loss outcomes, at incredible risk of harm due to the pressures of simply being so completely in the public's eye, an eye which isn't kind to adults, let alone the public eye of young teenagers - an eye that's quite frankly is too often, and in the specific case of weight regularly, dramatically and inherently cruel. Add to that the incredible statistical likelihood of regain and I'd say their involvement represents one hell of an injustice.  Consequently I think Dr. Dolgoff has failed to uphold her seminal obligation to protect her patients.

[If you're appalled by the Biggest Loser's inclusion of children - do something about it.  Visit my blog post from the other day and join the advertiser boycott]

[Stay tuned on Monday (though it may be over on the Psychology Today blog), when I'll be posting some of the thoughts conveyed to me by former Biggest Loser contestants, including at least one winner, on why they're "horrified" by the show's inclusion of children.]

So Long as the Biggest Loser Exploits Children, I'll be Boycotting Its Advertisers' Products

If you haven't already heard, this Sunday's 14th season premiere of the Biggest Loser will see the show's latest twist unveiled - the inclusion of children. This year there will be two 13 year olds and a 16 year old losing weight before a prime-time audience. They won't be competing for any prize money, they won't be weighing in, and they'll only be on the ranch periodically, but they will be part of a television series which assuredly will be watched by all of their friends and relations.

No doubt many will see this as something laudable, something along the lines of, good for the Biggest Loser for helping out those poor kids.

But is it really a good deed?

As far as the treatment of obesity in the pediatric population goes we know that there has yet to be a behavioural weight management intervention proven to have a long lasting benefit. As far as the the Biggest Loser itself goes we know it cultivates hateful weight bias, and we know that the rapid weight losses it generates destroys participants' metabolisms in a manner far more dramatic than would be expected by the losses themselves.

And as far as the Biggest Loser's approach to the kids goes - assuming it's roughly the same approach provided to the adult participants - it will involve a huge amount of exercise (4 hours a day minimum is what the adults are doing), coupled with highly restrictive diets, and the pervasive insistence that if you just want it badly enough, you'll be able to make it happen - the corollary of which of course is that if you aren't successful it's your own damn fault you lazy, weak, loser.

To their credit, many of the Biggest Losers' past participants have maintained dramatic losses, but according to one former contestant, the majority have not. We might then fairly presume that one or more of the children involved will regain the weight that they're about to so publicly lose, and given the nature of the show's teaching, will likely hate and blame themselves for doing so. They may even gain back more than they lose in the first place consequent to the impact the show's approach will undoubtedly have on their metabolisms.

And here's where my knickers are in a knot. The adults - well it might be argued that they have the maturity and insight to know what they're getting themselves into. The same can't be said to be true about the children and I would imagine that the psychological devastation of weight regain in any of these children will be far more damaging to them, and far more likely to be ridiculed by their peers and even complete strangers, than regain in any adult participant.

As far as blame goes - I don't blame the children for wanting to be involved (their parents I'll cover tomorrow) - the show's messaging is incredibly seductive. I do however blame the producers as no doubt they understand the implications of these kids being in America's cold, hard, spotlight and however well intentioned they might claim to be, ultimately what they're doing is exploiting children for the sake of viewers, and I believe, putting children in true harm's way.

A few days ago I signed a petition calling for the Biggest Loser to not include children, but I don't expect it to actually have any impact. On the other hand, what might have an impact is a boycott of the Biggest Losers' advertisers products.

Consequently so long as children appear on the Biggest Loser, and so long as their parent companies continue to buy advertising time during the show, I will not be purchasing the following products:

Quaker Oats

Brita water filters

Wrigley's Extra gum

Yoplait yogurt

Subway

Jennie-O meats

Bodymedia (they make FIT exercise trackers)

Cybex exercise equipment

Planet Fitness

Weight Watchers

Sprint

Ford

And as I watch the show this season, I'll be adding advertisers to the list, and periodically reblogging this.

If you'd like to come on board with this boycott, please share this post with your Twitter feeds, Facebook pages and personal email lists. The greater the number of people who've shared this post, the more likely it is that the Biggest Losers' advertisers will take notice. Moreover, if you'd like to send an email to a member of the sales or PR teams of the aforementioned products, click here and an email will be generated for your approval - I imagine if they were to receive hundreds or thousands of emails, it might at least give them a moment of pause. Ultimately if anyone has the power to stop this madness it's the show's advertisers - money always talks.

[Click here and you can read my thoughts as to why regardless of outcomes or approaches, The Biggest Loser is putting children in harm's way and why I think the show's paediatrician is breaking her Hippocratic oath.]

Biggest Loser MD Deluded, Unethical or Clueless?

Take your pick, but I think he's got to be one of those three.

His name is Dr. Robert Huizenga and last week he presented a Biggest Loser themed report at the 21st Annual Scientific and Clinical Congress of the American Association of Clinical Endocrinologists in Philadelphia.

The presentation detailed what an overly excited press release called a "pioneering study" whereby Huizenga found that when looking at 35 contestants from seasons 11, 12 and 13 of The Biggest Loser, severe dietary restriction combined with insane amounts of exercise dramatically improved metabolic outcomes including diabetes and hypertension.

That's "pioneering"? Is it really news that weight loss and exercise improve diabetes and hypertension? The only outcome related to hypertension and diabetes that would have been surprising to me would have been if they didn't markedly improve.

But where I'm truly left dumbfounded is Huizenga's reported consequent belief that the Biggest Loser modality of weight management - literally a minimum of 4 hours a day of exercise coupled with a highly restricted diet - is, "a better mousetrap".

I'm not sure what world Dr. Huizenga comes from, but in the one where I live people, even if they want to, don't have four spare hours a day to exercise. You see in my world people have jobs, families and other real-life-actual-human-being things that regardless of their weight or health intentions, are going to supersede any misguided physician's recommendations that in order to be healthy they need to spend every third waking hour of their lives in a gym. I'm thinking if 4 hours a day of exercise is his "better mousetrap", he'd best be prepared not to catch any mice.

And there are more differences between our two worlds. For instance in mine virtually everyone knows how incredibly unrealistic and perhaps even unethical it would be to suggest a better mousetrap had been built if it's build was based on Biggest Loser contestant outcomes without looking at whether or not those outcomes were preserved when the show turned off its ever present cameras. Not so apparently in Huizenga's world where his conclusions are indeed based on Biggest Loser participants' outcomes recorded only at the end of their 24 week contest. An end where his subjects were all still competing for huge sums of prize money, and where they were still being followed by television cameras, millions of viewers, and the potential to turn their experiences into careers. Hardly an end that's clinically applicable to the general population.

There's one other piece that's really bothering me. Why did Huizenga's study only include 35 contestants? By my count that's only 59% of those seasons' contestants. A pretty terrible loss to follow up in a venue where as is evidenced by each season's finale, there's virtually no loss to follow up.

Huizenga's apparently applied for a grant to compare outcomes between bariatric surgery and  Biggest Loser contestants. If funded let's hope that his study design doesn't include subject cherry picking, and that his follow up period is at the very least a clinically useful few years long, though given what he's done here, I won't hold my breath hoping for an ethical and appropriate methodology.

As to Huizenga's motives - well aside from supporting his show and television career I can think of two: Cognitive dissonance and confirmation bias.  Those two?  They're like the bed bugs of science, except instead of spreading disease, they spread delusion.

Someone ought to fumigate that guy.

The Biggest Loser Destroys Participants' Metabolisms

[This is an updated and edited version of a post originally published in February 2011. I'm updating it as the original post referred simply to a poster presentation but yesterday the full article was published ahead of print in the Journal of Clinical Endocrinology and Metabolism]

Talk about setting people up for long term struggle.

The term metabolic adaptation is given to the phenomenon whereby when a person loses a certain percentage of weight, their metabolisms slow by greater amounts. This process may be theoretically accelerated with more rapid weight loss as a consequence of the rapidly losing body metabolizing calorie burning muscle along with fat to make up for its massive energy deficit.

And as far as rapid non-surgical weight loss goes, there's probably no weight loss program more rapid than that of the television show The Biggest Loser, where it’s not uncommon for contestants to lose upwards of 150lbs at an averaged pace of nearly 10lbs a week.

Of course what’s different about the Biggest Loser as compared with most other non-televised rapid weight loss programs is the incredibly large amount of exercise concurrently involved, along with an almost certainly severe degree of stress, peer pressure and dietary restriction given the team and competitive nature of the show (where the team who loses the least weight has a member voted off, and where the last man or woman standing wins $250,000).

So is the weight lost on the Biggest Loser, a show now formally endorsed by the First Lady as an inspiration to the nation, healthy? Does the huge amount of exercise protect contestants against the show doing marked damage to their metabolisms?

The answer to both of those questions certainly appears to be, "No".

In an article published yesterday ahead of print, Darcy Johannsen and friends studied the impact 7 months of Biggest Loser weight loss had on the resting and total energy expenditures of 16 participants. They used all the latest gadgets to do so including indirect calorimetry and doubly labeled water. So what happened? By week 6 participants had lost 13% of their body weight and by week 30, 39%. More importantly by week 6 participants metabolisms had slowed by 244 more calories per day than would have been expected simply as a function of their weight loss and by week 30, by 504 more.

That's basically a meal's worth of calories a day that Biggest Loser contestants no longer burn as a direct consequence of their involvement. How do you think you'd do at maintaining your weight if you ate an extra meal a day?

But maybe that's typical. After all, metabolic adaptations are a known consequence to weight loss - couldn't that be all we're seeing here? I guess it's too bad there's no control group the study could have used for comparison.

Actually there kind of is. Bariatric surgery patients lose massive amounts of weight in a hurry as well, and they generally do so without the inane extremes of lifestyle endorsed by the Biggest Loser. If there were a study on the impact bariatric surgery losses had on resting and total energy expenditure, that would certainly offer some insight as to the healthfulness of Biggest Loser's weight loss program.

Good news! There is such a study. Published in 2003 in the American Journal of Clinical Nutrition researchers looked at the impact bariatric surgical losses had on the resting and total energy expenditures of 30 men and women whose pre-operative average BMIs of 50 were within 1 point of the Biggest Loser contestants' averages of 49, and who lost a Biggest Loser style average of 117.5lbs. And guess what? While resting energy expenditure indeed was shown to slow, it didn't slow down in excess of what would be expected by weight loss alone. In other words? Looking at these two studies, Biggest Loser style weight loss destroys metabolisms dramatically more than does bariatric surgery and does so in huge excess of what would be expected simply as a consequence of losing weight (though I suppose to be fair, the study on the surgical patients was done at 14 +/- 2 months, while the Biggest Losers' was at 7 - perhaps the Losers' metabolisms will improve with time)

That's a rather ironic finding given that one of the Biggest Loser study's authors, Biggest Loser's TV doctor Dr. Robert Huizenga, regularly trash talks bariatric surgery on the show as a terrifically unhealthy way to lose weight. Metabolically speaking, it would seem to me that his own study would suggest bariatric surgical weight loss is far healthier to a body's metabolism than is Biggest Loser style loss.

The study concludes,

"Unfortunately, fat free mass preservation did not prevent the slowing of metabolic rate during active weight loss, which may predispose to weight regain unless the participants maintain high levels of physical activity or significant caloric restriction"

Gee, ya think? "May"?

Here's how I'd spell it out. While some contestants of the Biggest Loser will translate their new lifestyles into careers as product spokespeople or fitness trainers and hence have new external motivators to maintain their extreme behaviours, those who don’t are doomed by the show itself to regain their weight, as the lifestyles promoted by the reality television show The Biggest Loser are only "realistic" to those whose livelihoods and/or fame depend on them.

Case in point? That picture up above, that's Eric Chopin. He was the winner of the third season of the Biggest Loser. He lost just over 200lbs. A few years later he was on Oprah to talk about his massive regain. Think Eric dropped the ball? Not me. I think the Biggest Loser provided him with a nonsensical and metabolically dangerous approach to weight management, and in the process, stacked his deck entirely against him.

[UPDATE: Received a thoughtful email from obesity researcher Dr. Jennifer Kuk who wondered whether or not the Biggest Loser subjects had their energy expenditures measured in the week or days leading up to the finale. If so, she feels (and I'd agree) that given the competition they might have all been severely under eating so as to increase their chances of winning, and that it therefore might have been their temporary under feeding that led to their abysmal energy expenditure results.]

Darcy L. Johannsen, Nicolas D. Knuth, Robert Huizenga, Jennifer C. Rood, Eric Ravussin, & Kevin D. Hall (2012). Metabolic Slowing with Massive Weight Loss despite Preservation of Fat-Free Mass The Journal of Clinical Endocrinology and Metabolism : 10.1210/jc.2012-1444

Das SK, Roberts SB, McCrory MA, Hsu LK, Shikora SA, Kehayias JJ, Dallal GE, & Saltzman E (2003). Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery. The American journal of clinical nutrition, 78 (1), 22-30 PMID: 12816767

Life after the Biggest Loser

I'm not a big fan of the Biggest Loser.

For those of you who aren't familiar with it the Biggest Loser is a "reality" television show that features extremely overweight folks living on a ranch for 6 months and undereating and overexercising in order to lose weight and potentially win $500,000.

Not exactly the reality that most of my patients face.

In terms of the show's participants life post-show is a mixed bag. Some will parlay their weight loss into new lifestyles and in some cases, new careers.

Unfortunately others won't fare as well.

Now while it's certainly true that there is recidivism with all weight loss programs my beef is not that contestants regain weight, it's what they're taught. Watching the Biggest Loser I can't help but feel that the message it ultimately teaches is that all weight is bad and the scale is the only determinant of how you're doing.

Me?

I think scales tell you what you weigh whereas you tell yourself how you're doing, where how you're doing depends on what you're actually doing. Are you eating in a manner that is both healthy and enjoyable? Are you exercising as much as you can happily include into your busy life?

I came across this article and video online detailing the struggles of a former runner up on the Biggest Loser - Kai. It's well worth the read. Here's a snippet,

"The philosophy of the show -- to radically change diets and exercise patterns of obese people -- seemed to have a hidden message about her character, Zwierstra said. It seemed to say that weakness made people fat. If they just had discipline, if they weren't lazy, they could be thin."

There was a video too - I've included it below. Sadly it's a lot more real than the Biggest Loser will ever be.

Reality Weight Loss Lies - Biggest Loser Edition

So at the end of last week's show the exiled player was shown completing one of his dreams - running a marathon with his wife. It was an idyllic ending - running hand in hand past the finish line. The somber text following the shot, complete with Biggest Loser music in the background, read that Dane finished the 26 mile marathon with his wife in 3 hours and 53 minutes - a pace that if true would have had Dane placing 14th overall.

Inspirational or impossible?

Dane, though much slimmer than his starting Biggest Loser weight, weighed in on race day at 280lbs. A sub-four hour marathon for someone who's only been training for 6 months who weighs 280lbs to me sounded impossible.

Imagine my lack of surprise when the truth actually hit the net. According to a report out of Runner's World magazine's blog, not only did Dane not complete the marathon in under 4 hours, he didn't actually complete it at all. Apparently when it became clear that he would be unable to complete the marathon in the 6 hour time limit of the Arizona Desert Classic Marathon a Biggest Loser show SUV picked Dane and his wife up and gave them a lift.

Oh, and even with the lift they didn't finish in 3:53, they finished in 5:53:48.

The Biggest Loser's production company Reveille LLC reportedly put out a press release detailing their "error" (I can't find the press release) suggesting there was a problem with the time readout. Certainly I can read 5:53 in the video below and you think that maybe, just maybe the camera guys knew how long it took and that Dane's run included an SUV ride?

Looking at the Biggest Loser website I couldn't find anything that suggested they lied to their viewers, nor did I see mention of it last night.

Dane, the guy whose incredible weight loss and commitment to changing his life I'm not knocking, isn't planning on giving back his finisher's medal because "in his mind" he finished the race.

Now as you might imagine, I don't espouse the ridiculously non-sustainable approaches the Biggest Loser broadcasts as helpful, but that said I've always felt the show was useful for that last two minutes. That's the two minutes where the incredibly dramatic weight loss is juxtaposed with the incredibly dramatic lifestyle changes that contestant has made. I've often said, "the more weight you want to permanently lose, the more things in your lifestyle you'll have to permanently change". I guess I'll have to take some of those changes with a grain of salt too as clearly lying is something the show espouses.

To watch a video of last week's last two minutes, click on below.

[Hat tip to Twitter's @stepank ]

The genetics contest called The Biggest Loser

It has become one of NBC's flagship shows.

Dozens of Americans meet at a ranch vying for half a million dollars during a weight loss contest.

The first 4 months they spend working out on the ranch all day long under the supervision of trainers and eating prepared low calorie meals.

Contestants compete in the requisite competitions, many of which involve the ridiculous "food temptations", but most of which involve feats of physical strength or endurance.

After 4 months on the ranch the remaining folks (people get voted off each week) go home and spend I believe an additional 6 months trying to lose weight on their own until finally they all return and get weighed and the person who lost the most weight (as a percentage of their initial weight) wins.

Perhaps the most dramatic part of the show are the weekly weigh ins on the incredibly over-sized scale that builds suspense by displaying the contestants' weights bouncing around for some time before finally displaying how much they've lost that week.

Weigh-in wise, week after week the numbers are dramatically fluctuant with some weeks folks losing more than 5% of the previous week's weight and others, virtually nothing. Those variations are simply a reflection of different degrees of hydration and they don't really interest me - what interests me is the fact that consistently, season after season, some people simply lose faster than others with a cadre of contestants usually losing weight twice as fast as another cadre of slower losers.

So the fast losers - do you think they're eating half as much and working out twice as hard? Do they have double the "willpower" of the people who simply don't lose quicker? Are they twice as motivated?

Of course not - as is clearly evidenced by the television show, everyone on that ranch is busting their butts exercising and eating low calorie meals as they all have the added motivational benefits of unlimited time and resources, millions of national viewers and let's not forget the $250,000 carrot dangling in front of them.

So what's the difference?

Genetics.

Weight loss is not simply a one to one relationship between how many calories you eat and how many calories you burn. The body's a big black box with food going in the top and coming out the bottom but in between there are dramatic between person differences in how calories are handled. The result of course- some people lose weight far easier than others.

My conclusion therefore?

The show's all about genes.

Oh, and there are two winners on the show by the way. There's the "Biggest Loser" from the folks who don't get voted off earlier on and then there's the person from the folks who were voted off who loses the most.

The two winners from last year?

Identical twins.

UPDATE: A reader pointed out that in fact the contestants cook for themselves on the ranch - certainly this would allow for more variability, but still not enough to account for such wide divergences in weight loss.