CRIS76
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Evaluating the Biggest Loser success rates (long blog warning)

Wednesday, June 09, 2010

WARNING: This is a long one (longer than usual!!!!) so if you skip it, no worries. This is more my opinions on an article I read on the Daily Spark about the Biggest Loser. I won’t be upset…. I may shed a tear, but I won’t be upset *laughing*

I recently read a post on the dailyspark.com website entitled “Eating Habits of the Biggest Loser: Inspirational or a Bad Example. Here is the link: http://www.dailyspark.com/blog
.asp?post=eating_habits_of
_the_biggest_loser_inspira
tional_or_a_bad_example

If you haven’t read this article, I would suggest reading it and really thinking about what it is saying because I do feel it has some merit. I believe the author, Jen Mueller, has some rather valid thoughts on the premise of the show, Biggest Loser (BL) that need to be thought through. What does this show promote as far as health education? Is it realistic enough to be considered reality TV? Heck, is it unrealistic enough to be called reality TV? I believe the answer to these questions are YES and YES.

I left a lengthy comment on the article but I wanted to cover more of my thoughts here, specifically regarding the author’s blanket statement “Many of the contestants have said they didn't expect to maintain their entire weight loss once at home and some have gained back significant amounts of weight” (Mueller, 2010, para 6).

I know many individuals on Spark follow the Biggest Loser… or instead of making a blanket statement, I know many of the people I’m friends with on Spark follow the Biggest Loser. I think, as educated individuals, none of us take the show as a serious weight loss program. I have yet to read one blog from any of my friends about how great the weight loss program is and how they find it easy to spend 8-10 hours a day working out. In fact, it is quite the opposite. I believe that there may be some people out there who feel the only way to lose weight is to lose it like the contestants on the show; however, I think the majority of people feel more like I do: the show is there to prove that mass amounts of weight can be lost as long as you do not give up on yourself. Granted, this is my personal opinion – I haven’t ran any surveys to find out. Although, it would be interesting to find out what the general populace feels is the true premise of the Biggest Loser.

Truly, for me, what the show pushes is “eat healthy and exercise” as the only real way to lose weight. These people are transplanted into a “safe” area to do just that: eat right and exercise. And, unlike other programs or surgeries, the contestants are forced to face the mental/emotional factors associated to their obesity.

As I said in my comment on the original article by Mueller (2010), I cannot speak first hand on what happens at the ranch. I am sure contestants make a choice to do something unhealthy to shed an extra pound or two for weigh in – it is, in the end, a game… isn’t it? But shall we compare this to the number of people who do unhealthy things at home to lose weight? How many of you have been to Weight Watchers and saw women shedding all things ‘extra’ and lining up at the bathroom for one last pee-break before stepping on the scale? While taking a potty-break before hopping on the scale isn’t unhealthy, how many people are taking diuretics, purging, or starving themselves before they weigh themselves? All the Weight Watchers bathroom line proves is that people are aware and capable of doing things before weighing in. Weight Watchers isn’t responsible for what people do before weigh in – they only take the number. I have a feeling the BL producers feel pretty much the same way. They cannot make a contestant drink water that day or eat all meals before weigh in. They can only do the weigh in.

Is modifying yourself like this unhealthy? Absolutely. But really, if you think about it, what is worse: eating asparagus and jello the day of weigh-in worse than sitting around at 400 pounds with diabetes and fatty liver? These people ARE unhealthy. It’s a “damned if you do, damned if you don’t” situation. They are making their own decisions.

I have many other opinions about the article and what it says about the show; however, I want to move into the blanket statement about some of the folks having gained back significant amounts of weight. My first thought of this statement was that it was saying that BL contestants are unable to maintain, gaining back significant amounts of weight. Then I reread the statement again and realize the word “some” is quite a balancing act of a word – the word “some” is never defined. Does it mean 3 or 4? A little more than a handful? More than 25% but less than 50% of the people on the show?

I didn’t know.

My thoughts then went to the idea that so what – some people gained significant amounts of weight back. What is the success rate of the Biggest Loser contestants to other programs used to lose weight? Can we do a fair assessment simply because the number of BL contestants is so small compared to the number of people who get gastric bypass surgery or use programs like weight watchers or nutrisystem?

So, I began to dig. First I wanted to find out what type of maintenance success rate BL contestants had. Surprisingly, it is a very successful “program” (for lack of a better word). I looked at articles discussing the ‘where are they now’ aspect of the show and dug up the reunion calculations. I did not use anyone beyond season 7 because I wanted the maintenance time to be greater than one year.

My results?

I found that of 53 contestants, only two (Ryan Benson and Erik Chopin) had gained over 50 pounds back. 11 contestants had gained between 25 and 50 pounds back; however, one of those contestants, Amy Wolff, had just had a baby, so does she really count? The remaining 40 contestants had either lost, maintained, or gained less than 25 pounds back. So this gives BL a 75% success rate of full weight loss maintenance.

So, to compare BL with other programs and methods, let’s look at the extreme first: gastric bypass surgery. The first thing that comes to mind is that no one has died on the BL yet. According to a website dedicated to gastric bypass surgery lawsuits (n.d.), the number of bypass surgery related deaths is grossly under-reported because the cause of death is normally listed as heart attack or another surgery related cause, not the type of surgery itself. For example, in Fresno California, 13 people were reported as dying from the surgery in January 2003. The quoted fatality rate is 1 in 200, which is much higher than other operations of similar complexity. It is believed that Fresno did not report the true number of deaths resulting from the surgery due to poor physician reporting (Gastric Bypass Surgery Lawsuits, n.d.).

I don’t really even want to go into all the other complications and likely issues that arise from the surgery like anemia, osteoporosis, hernias, gallstones, and malnutrition; however, I didn’t want to go without at least mentioning them. So there they are. The big concern is “do they keep the weight off?” According to surgery.com (2009), the long-term results of gastric bypass are that patients will have lost 58% of their body excess weight over five years. After 10, the loss (or gain) will be at 55% and after 10 years, the loss (gain???) is 49%. This is the average, according to a group of physicians. Of course, the same site states that diet and activity level after surgery plays a roll in how much weight the patient may lose and maintain. Funny – that’s what BL promotes too. Of course, the webpage title is “normal” results and they do not touch too much on the failures. But we can only assume that if the normal result is that a person will lose 58% of their excess weight, the average person does not lose the amount of weight they need to lose. But what about people like Carnie Wilson – she had the surgery and all the weight came back. What are the possibilities of that? No real statistics exist; however, many stories are out there. Apparently, the physician answer to this question is that it can happen.

So what about NutriSystem? Well, funny I should ask… there is no conclusive evidence that after a person loses their weight and exits the program. NutriSystem has been asked to prove it “works;” however, the company cannot point to a single clinical trial that validates the diet works and that people maintain after leaving the program (Callahan, 2008). And, to top it off – NS has been in business for over 30 years. What does this say about their program? All I know is the website says is that you need a counselor after you hit goal to help you integrate grocery foods back into your diet. Scary. It may work – but yea…. I don’t think I want to eat NS food for the rest of my life.

I’m still on a journey to find out the true statistics of various programs – but it seems all the famous programs rely on diet and exercise. The surgery experts state that you need diet and exercise… and so does the Biggest Loser.

But in my premature research phase, I have found something very interesting which may explain why the Biggest Loser, while still very early, is producing great long-term results. According to Michael Lippig (n.d.), The primary reason dieters fail is because of (1) reliance on one measure, (2) making temporary changes with no recognition towards the long-term needs, (3) overcomplication of the process, (4) lack of identification of balance, (5) over-reliance on technology or a ‘quick fix’ and (6) trying to do it on your own. Perhaps this is why the BL is doing so well – these individuals are being taught how to lose weight, even if their three month stay on the ranch is a whirlwind. They are taught to manage their exercise and food along with managing the emotional pitfalls of weight loss.

I think 6 was the trickiest for me, but then I think that while I am losing the weight by myself (I’m only one person), I’m not alone in my journey.

So to wrap this entire hot mess of a starting research project up (yes, I’ll be doing even more research), I think Dr. Hollly Wyatt, an obesity expert at the University of Colorado may have identified why the Biggest Loser, even though unrealistic for folks losing weight at home, and many of us on Spark will be successful in weight loss and management. She said, the “best predictor of the ones who are not going to regain are the ones doing the most physical activity.”

Think about it.



References:
Callahan, M. (2008). NutriSystem. Retrieved June 9, 2010, from http://eating.health.com/2008/
04/18/nutrisystem/

Gastric Bypass Surgery Lawsuits. (n.d.). Gastric bypass: Statistics. Retrieved June 9, 2010, from http://www.gastric-bypass-surg
ery-lawsuits.com/pgs/gastr
ic_bypass_statistics.html

Lippig, M. (n.d.). A maintenance weight loss program. Retrieved June 9, 2010, from http://www.idcon.com/article-m
aintenance-weightloss.htm

Mueller, J. (2010). Eating habits of the biggest loser: Inspirational or a bad example? Retrieved June 9, 2010, from http://www.dailyspark.com/blog
.asp?post=eating_habits_of
_the_biggest_loser_inspira
tional_or_a_bad_example

Surgery.com. (2009). Gastric bypass: Normal results. Retrieved June 9, 2010, from http://www.surgery.com/procedu
re/gastric-bypass/normal-r
esults
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Member Comments About This Blog Post
  • MRS-DUTCHER
    great research! Thank you for another terrific blog
    3181 days ago
  • NADJAZZ
    Wow, thanks for all the data! This is the first season that I watched every single episode. I do think the producers made some effort to have contestants and former winners discuss the challenges of real life as compared to being isolated on the ranch. Most important for me was the obvious hard work and dedication that went into the workouts, challenges, meal planning, and personal obstacles, both on and off the ranch. No matter whether they won or not, they were all WINNERS at the finale, and such an inspiration to little ol' me sitting at home.
    3208 days ago
  • CULTURECHIC
    You're really a terrific writer, and I appreciate you sharing your research and thoughts.
    3209 days ago
  • GINA7249
    love love love ur blog. one person mikes dad had surgery before the ranch. on jillians new show the first fam had 2 people the dad and the daughter had surgery jillian helped them. obviously bl is doing it somewhat right. 8 hrs of doing things is possible but for us norm people do it by working and other things there. i include walking anf doing erronds like mall shopping or whatever.my husband includes all of that.
    3209 days ago
  • TEENY_BIKINI
    Wow. Totally interesting. Great blog.

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    3209 days ago
  • no profile photo IMATALOSS
    Interesting read. Thanks!!! Though it's interesting to see how successful different programs can be (if there are stats...yeah I'm talking about NutriSystem!) it still comes down to the same thing. Eat healthy and move more. You summed it up best with Dr. Wyatt's quote, the “best predictor of the ones who are not going to regain are the ones doing the most physical activity.” and your statement, THINK ABOUT IT. Yep, I am. Thank you, CRIS76, I am..... emoticon
    3212 days ago
  • FOOFIT1
    This was very interesting! I think it's awesome that BL has 75% success rate. That's amazing! Thanks for all the info. Great blog today!

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    3212 days ago
  • FITNHLTHYMONICA
    Great blog! I found it very informative. Thanks for sharing. I look forward to seeing your future research.
    3212 days ago
  • LOPEYP
    I think the more simple the process is the better change you have of repeating it over time. For example, if you have a list of do's and don'ts that you have to refer to before eating then you are going to get frustrated and fail. That's why I like the Spark lifestyle. You can eat ANYTHING in moderation.

    Thanks for doing all the research. I was surprised by the maintenance rate of the BL contestants. I thought the failure (regain) rate was higher.

    3212 days ago
  • ELYMWX
    Great blog, Cris!
    3212 days ago
  • KARVY09
    Thanks for sharing. Informative!
    3212 days ago
  • CRISPINI
    I enjoyed this blog! I should add that I have recently been watching the Australian version of BL via You Tube / RealityTVFan.org -- and I actually like their version of the show much better. In the most recent season they've started showing informational classes about cooking, exercise, and attitude, which is one thing I think the American version could really use.
    3212 days ago
  • TALLYCAT13
    that was fantastic! and i'm such a research nerd that i was literally leaning forward, nose 6 inches from the screen, while reading this. I cannot wait for more from you on this:)

    again, that was a really awesome read:)
    3212 days ago
  • WYND10
    Nice job Cris. I am not sure I processed it all, but I look forward to hearing more as you research progresses.
    3212 days ago
  • ICETHISTLE
    This was a great blog, but I really could have used more information. (Yes, that is sarcasm! Haha!) emoticon I think it was wise of you to look up the success rates of other diet programs. Every time you see a Jenny Craig or Nutri System commercial the fine print always says, "Results not typical." This doesn't seem to be the case with the BL show. And you're right - normal people cannot work out 8-10 hours per day so hopefully they are smart enough to realize they cannot lose these huge amounts of weight in one week like their favorite BL contestant.

    You hit the nail on the head about WW! I joined a group for a (very short) while and I used to think people were pathetic for taking off their jewelry, belt, shoes, etc. I was like, "Seriously? Why don't you just strip?!" At least on BL they truly teach you about nutrition and exercise, whereas the WW points system allows you to eat CRAP so long as it falls within your daily alowance. Don't get me started on how many of those 1-point lemon cakes I ate every day! emoticon (I have a friend who was very successful thanks to WW, so I know it works for some, just not for me. Not all groups are the same, but the group I joined was not my style.)

    I like BL in small doses - I watch the 2-minute recaps online. I just am not interested in the drama, only the end results. The show has its faults and I would like it better if they simply eliminated the person who lost the least amount weight each week, or if they had the two lowest losers compete against each other to see who stays. That would be more fair, but then there would be no drama, which would be perfect for me, but would probably make viewership go down.
    3212 days ago
  • ADIPOSEROSE
    The X factor in all that you address is CONSISTENCY. Programs that "don't work" in the long run are programs that are little more than "bandaid fixes"--they change current behaviors temporarily ("gotta lose 10 lbs. before the reunion!") but not psychoemotional relationships with food, and not attitudes toward exercise and nutrition. Biggest Loser is still a "quick fix" in one sense: no one can *consistently* spend as many hours in the gym and in various other forms of exercise as the contestants do, once he or she has returned to the real world, and as soon as the successful exercise+diet formula is unbalanced, weight gain inevitably follows. I've experienced similar pressure from my doctor--"a woman your age needs to spend an hour a day in the gym *just to maintain*, so if you want to lose, you need to do more than that!" Well--this woman CAN'T spend that kind of time, and doesn't want to--if I did, I'd have no life outside of working, sleeping, and working out at all--so setting such a goal is unrealistic. It's not something I can do consistently. Right now, because I can, I do 90 minutes to an hour every other day. I'm comfortable with that, and though I won't be able to do it when I return to work (because of the commute times around here), I *will* be able to break it up into 30-45 minute bouts of either cardio or weights five days a week without a problem. I'll get the same amount of exercise spread over more (and shorter) sessions. I won't enjoy it as much, I guess--I like having a day totally "off" in between--but it's doable. Let me admit, to clarify, that I don't *enjoy* working out: I do it because my appreciation for its benefits is greater than my aversion to sweating. If I push myself too hard to do more than is reasonable for my life circumstances, I will feel overwhelmed and quit. But I can do what I'm doing now indefinitely, because I *don't mind it.* Maybe that's not as good as "I'm loving it," but it works--for me. Consistency is everything!
    3212 days ago
  • LOSINGJESS
    Wow, that was a really long blog.... but wow that was a really well thought out and informative blog too.

    I watch the biggest loser and I definatly dont think that the way they do it there is the way you should do it at home... Of course the trainers (expecially in the last few seasons) have also stressed that the way the contestants lose on the ranch is not the way you should do it at home... they are just showing that it can be done with hard work and lifestyle changes.... You know showing us at home that if that person can lose 10 pounds in one week...then I can lose 10 pounds in a month.

    I Just want to let you know I read the whole thing, dident just skim over it and it was really very interesting. Your a really great writer & I highly enjoyed it. :-) Thanks for posting and I look forward to reading more long blogs in the future.

    ~ Jess
    3212 days ago
  • JOKNOWS
    I agree with you in that I don't think the premise of the show is practical for the average person. Losing 20 pounds a week and working out 8-10 hours a day would not suit the average person's schedule. As to your prelim research -- it is spot in comparing the success of various weight loss programs. I'd be interested to learn more (from your research, of course!)
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    3212 days ago
  • CINDY1TWO3
    Well - great work on all the research. I must admit I am a fan of BL, but had not watched the first few seasons. So I had looked at the "where are they now" pictures and articles. I know this is not realistic to do at home - unless you are unemployed and have 6 hours a day to exercise - but I am in no rush at home. No one is going to pay me - or kick me out - if I do not lose enough this week. It is a great show, we just have to look at our own journey differently.
    3212 days ago
  • SSCHULTZ59
    Awesome. i enjoyed reading all of your comments.. and to sum it all up.. each person is an individual.. and each person needs to find what works for them. if the will to do it is there and the support is there anything can be done..

    Thank you for you longer blog.. but not boring..
    3212 days ago
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