A Dietitian’s Take on the Biggest Loser and Weight Loss

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THE BIGGEST LOSER — ‘Live Finale’ Episode 1713 — Pictured: (l-r) Roberto Hernandez, Stephen Kmet, Colby Wright — (Photo by: Trae Patton/NBC/NBCU Photo Bank via Getty Images)

With a headline suggesting that it’s almost impossible not to regain pounds after weight loss, this New York Times article shook up the diet world this week. The article is based on a study being published next week in the journal Obesity that examines the long-term weight-loss success of contestants who appeared on Season 8 of The Biggest Loser. Having followed the contestants for six years since their televised weight loss, researchers report most have regained weight and still struggle (possible more so now) with keeping weight off.

The headlines were disappointing to say the least. At first glance, even I wondered momentarily what the point of weight loss is if it’s seemingly impossible to keep off. But once I got past the headlines and was able to digest the full article, I couldn’t help but feel that the story’s buzz was a little misleading in terms of long-term, weight-loss success.

The words extreme, intense, crazy, and unrealistic kept popping in my mind as I reviewed the article and compared it with my nutrition knowledge. While not the most scientific of terms, they perfectly summarize why we shouldn’t take the headlines too seriously just yet: findings like these that are the result of extreme weight loss at a crazy-fast rate, using unrealistic, intense methods can’t be applied to healthy dieting approaches. And while it would be poor practice to not research this further, it’s also poor practice to apply these findings, caused by an extreme weight-loss game, to all weight-loss pursuits without more knowledge.

Are the article’s initial impressions discouraging? Yes, they were to me and probably to most others. Do the results suggest there’s a need for more research? Definitely. But are the findings really surprising? Not really and here’s why:

Start by looking at the dieting methods. Each season the now-cancelled game show picked a new group of obese, sedentary individuals to compete against each other for the highest weight-loss percentage in a seven-month period. Contestants left their families, lives, and jobs to move to The Biggest Loser Ranch where they transformed their bodies through hours of daily exercise, coaching from personal trainers, and a controlled food environment. The physical transformations that occurred were amazing. Most contestants lost over 100 pounds (some even lost more than 200), and the gains in self-confidence and fitness were inspiring to watch. I’ll confess that when my children weren’t around, I’d tune in to an occasional episode; there was something motivational and compelling about the show, even though I knew the practices weren’t healthy or maintainable. And while they may have generated great ratings, the intense methods used in this weight-loss bubble aren’t what research has suggested is best for an individual’s physical or mental health or long-term success.

Then examine the rate at which weight loss occurred. The Biggest Loser created a controlled environment where extreme weight-loss methods created weekly drops on the scale so intense and fast, they’re nearly impossible to replicate. Take Season 8 contestant Danny Cahill, who’s featured in the article. He went from 430 to 191 pounds in seven months. This is an average of 34 pounds per month and a 56% loss in body weight. Now, compare that to what research suggests is the ideal rate to maintain health and to keep it off long-term: ½ to 2 pounds per week or 10% of body weight in six months. As breath-taking and exciting as the weekly weigh-ins were to watch, The Biggest Loser rates of loss were not only unhealthy, but also not supported by science.

Now look at the long-term effects. Six years after the dieting game show ended, researchers find most of the contestants have gained weight, all struggle to keep weight off, and several seem to have a permanently decreased metabolic rate. While a small decline in metabolic rate is normal and expected, a long-term and significant decline (those tested averaged around 500 calories below what would be expected) is not. Add in hunger, cravings, and the body’s perceived “urge” to want to gain weight back, and you’ve got a metabolic mess.

Photo: GK Hart/Vikki Hart/Getty Images

All weight loss causes a slight decline in metabolism, so incorporate strength-building activities two to three times per week to help combat this. Photo: GK Hart/Vikki Hart/Getty Images

The Real Reality of Weight Loss
So where does all this leave those of us struggling to lose or maintain weight? I’ll be the first to admit that there’s a lot we don’t know about the body and weight loss, particularly hormones, brain chemistry, and metabolic changes associated. And, I think the NYTimes article illustrates just how much we still have to learn.

But, it’s not all doom and gloom and what’s not mentioned in the article is that there is good research suggesting that significant, long-term weight loss can be maintained. In fact, the National Weight Control Registry (NWCR) is a research organization set up with the sole purpose of tracking people who’ve lost significant weight (usually ≥10% of body weight) for long periods. With data on over 10,000 people, the NWCR has identified key characteristics or habits of successful maintainers. People who’ve successfully maintained significant weight loss:

– stay on top of their weight by weighing on a regular basis
– get an hour of exercise per day;
– eat breakfast
– consume a lower calorie meal plan
– plan meals ahead of time
– eat 4 to 5 times per day
– watch less than 10 hours of television per week
– have developed coping techniques for emotional eating.

What You Can Do Now
While I’ve downplayed the article’s hyped headlines, there are some key insights that can be taken it. Here’s what I think the bigger picture of the findings says we should do:

– Set a realistic goal. No, it’s not going to grab TV ratings, but the rate at which research has shown weight can be successfully lost and kept off is ½ to 2 pounds per week. Until we have better research suggesting a different rate, this is what we need to stick with. Another way to look at this is setting a goal to lose 10% of body weight in six months.

– Be active every day. Whether it’s through exercise or daily steps, research is clear that activity is a key component in weight loss success and, possibly even more so, in maintaining loss.

– Moderation, moderation, moderation. If there’s anything that jumps out at me, it’s this: moderation in calorie reduction, diet, and exercise is essential. We gain weight and make our bodies unhealthy by being on one extreme of the pendulum, but, as this study shows, being on the other extreme isn’t healthy either.

– Address the real issues. Something made us gain weight, and it’s likely tied to emotions like stress, sadness, or excitement. Until an individual addresses his or her own emotional eating triggers and develops coping skills, long-term success is difficult.

– Incorporate strength training weekly. Aside from the benefits it offers bone health and overall strength and mobility, building lean body mass or muscle is one of the few safe ways we know of to increase metabolism. All weight loss causes a slight decline in metabolism, so incorporate strength-building activities two to three times per week to help combat this.

– Settle in for the long-haul. If you’ve struggled with weight, acknowledge that diet and activity is something you have to stay on top of for the rest of your life. I’ve seen too many people reach their goal weight, only to then resume their previous eating habits and lifestyle. But good health and maintenance don’t work like that. Don’t think of it as a life-sentence; instead consider it a choice to live a healthy lifestyle. I like to use the 90/10 approach to stay on track: make healthy, smart choices with diet and exercise 90% of the time, and then it’s okay to make not-so-healthy choices 10% of the time.

– Focus on what’s been proven, not headlines. Too often news headlines are centered around one snippet of research that may (or may not) have been taken out of context. Do your research, check it out, or ask a health professional about it. Be careful about forming decisions based on headlines and media buzz.

– Remember we’re talking about a gameshow. The study suggests that the contestants’ weight loss has had some detrimental effects on metabolism. But remember these effects occurred from an extreme weight loss scenario on a gameshow – not from a healthy eating and exercise routine and not from weight loss at the recommended rate.

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