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
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.
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.
Callahan, M. (2008). NutriSystem. Retrieved June 9, 2010, from http://eating.health.com/2008/
Gastric Bypass Surgery Lawsuits. (n.d.). Gastric bypass: Statistics. Retrieved June 9, 2010, from http://www.gastric-bypass-surg
Lippig, M. (n.d.). A maintenance weight loss program. Retrieved June 9, 2010, from http://www.idcon.com/article-m
Mueller, J. (2010). Eating habits of the biggest loser: Inspirational or a bad example? Retrieved June 9, 2010, from http://www.dailyspark.com/blog
Surgery.com. (2009). Gastric bypass: Normal results. Retrieved June 9, 2010, from http://www.surgery.com/procedu