Many ‘Biggest Loser’ Contestants Leave Show with Slower Metabolisms and Regain Their Weight

Published in May Issue             

A new study found that many contestants on “The Biggest Loser,” NBC’s long-running reality show known for its extreme weight loss measures, leave with slower metabolisms, making it that much more difficult to maintain or continue their weight loss once they leave the show. In fact, after six years, most regain a significant amount of the weight they lost.

The study, which was funded by the National Institutes of Health (NIH) and published in the journal Obesity, followed 14 (six men, eight women) of the 16 contestants who competed in the show’s eighth season. All but one regained much of the 100 pounds or more they lost through The Biggest Loser’s intensive dieting and exercise regimen, and five had returned to within 1 percent or above their original weight. Contestants also had slower metabolisms, which is expected after a diet ends, but was not expected to stay that way years later.

"It is frightening and amazing," lead study author, Dr. Kevin Hall of NIH’s National Institute of Diabetes and Digestive and Kidney Diseases told The New York Times. "I am just blown away."

When people lose massive amounts of weight, it is well known their resting metabolic rate slows down and they burn fewer calories while at rest. This phenomenon is known as metabolic adaptation. After a period of time though, resting metabolism generally rises, but not in the case of “The Biggest Loser” contestants -- it remained at the lower rate for the entire length of the study (6 years). As a result, contestants had to consume about 500 fewer calories per day than other people their size to avoid gaining weight.

Interestingly, the researchers wrote that in their study the magnitude of metabolic adaptation increased six years after “The Biggest Loser,” while a matched group of gastric bypass surgery patients who experienced significant metabolic adaptation six months after surgery had no detectable metabolic adaptation after one year, despite continued weight loss. “It is intriguing to speculate that the lack of long-term metabolic adaptation following bariatric surgery may reflect a permanent resetting of the body weight set-point.”

In a statement to ABC News, producers from “The Biggest Loser” wrote, "We have comprehensive procedures and support systems in place which we routinely re-evaluate to ensure all contestants receive the best care possible. The lead medical doctor on the show, who has worked with the National Institutes of Health on initiatives in the past relating to ‘The Biggest Loser,’ has been made aware of this most recent study and is in the process of evaluating its findings."

Nonetheless, headlines through the country had people talking about the show’s methods and the difficulties people face maintaining weight loss because of factors that go far beyond will power and lifestyle choices, and include biological and environmental factors. Also, when the show’s over, contestants return to their daily lives, and lose the supervision of personal trainers, doctors, nutritionists and psychologists and are unable to sustain the intensity and pace they kept on the program. In other words, real life sets in when the cameras are turned off and the public isn’t watching.

Samer Mattar, MD

“The Biggest Loser, as with most non-surgical programs, fails to take into consideration the underlying physiologic and metabolic mechanisms that are promoting and perpetuating this chronic disease known as obesity,” said Samer Mattar, MD, ASMBS Secretary/Treasurer and Professor of Surgery at Oregon Health & Science University. “Ultimately, the inevitable return of weight to baseline breeds feelings of despair, contempt and failure on the part of the contestants who are so exposed in the public eye; and by association, plants despondency in the minds of many struggling with issues of excessive weight.”

“The Biggest Loser” has been very critical of bariatric surgery over the years with one of the show’s medical experts at one point telling one contestant after he lost weight on the program, “You did it in a safe, effective manner, much better than those distasteful weight-loss surgeries that everybody wants to turn to.”

Pam Davis, RN, CBN, MBA, bariatric program director for TriStar Centennial Medical Center in Nashville has been a long-time critic of the show.

Pam Davis, RN, CNB

“I abhor their methods,” said Davis. “Screaming, yelling and belittling people does not make for an effective or positive long-term end result. During filming, contestants do not work, they do not live their normal lives; instead, during the show their existence revolves around exercise, which is unrealistic for anyone to maintain when they return to a normal life.”

The authors did not report all bad news. They said that while “The Biggest Loser” participants regained significant weight, they were overall more successful at long-term weight loss when compared to other lifestyle interventions.

Eric J. DeMaria, MD

“Progressive recurrence of morbid obesity remains the rule and not the exception. Only bariatric surgery has been shown to provide substantial weight loss in the long term for patients with morbid obesity,” said Eric J. DeMaria, MD. “In a head to head competition, bariatric surgery makes the biggest loser approach, the loser.”

The show has been on the air for 17 seasons since 2004. Ratings have dropped significantly over the years, but nearly 4 million watched this season’s finale. No word yet if “The Biggest Loser” will be back for another season.