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The pros and cons of weight loss reality shows, such as NBC’s The Biggest Loser, was the topic of my most recent post for WebMD’s blog Real Life Nutrition.  Hope you’ll check it out.

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Are you a fan of the show?  It certainly has its fans and distractors.  No doubt, The Biggest Loser pulls in the ratings, yet each episode sparks a flurry of online discussions — from tweets to blog posts — with each side passionately making their case on why the show is good or bad, inspiring or insulting.  One vocal critic as been physician Yoni Freedhoff, who has sounded off against The Biggest Loser’s approach on his blog Weighty Matters and on U.S. News, including this post  When Science Met The Biggest Loser.

The critics , including Dr. Freedhoff, have come out swinging even harder against the episodes featuring children.  Even though there’s a pediatrician working with the show, other pediatricians have expressed concerns about the humiliation and potential long-term harm inflicted on the young participants.

So what do you think, are these shows good or bad? I looked at what some recent studies have found and talked to a few experts to get their perspective of weight loss reality shows.

First, I think it’s an extremely good thing that a registered dietitian consults with The Biggest Loser. Cheryl Forberg has worked with the show from the beginning — providing behind-the-scenes nutrition consultation with each of the contestants.  She evaluates their food journals, monitors the nutritional adequacy of their diets, and is an on-going nutrition coach via weekly conference calls. Forberg thinks the biggest benefit of the show is inspiration. She hears from a lot from people who say: “If they can do, then so can I.” There’s always a lot of emotion expressed on the show, and the stories can be inspiring to others.  It also promotes the concept of accountability.  If you have a workout buddy, for instance, you’ll be more likely to stick with a new exercise routine. A friendly competition, or some type of incentive, has been shown to help people follow through on a commitment and reach a goal. Plus, there’s growing evidence that healthy habits are contagious.  So if you’re in a social network – whether online, at work, or in your own neighborhood – you may be more likely to adopt positive behaviors if others around you are doing the same.

The Biggest Loser has its own fan club, with lots of supporters, and there’s been a slew of best-selling books, DVDs and other products based on the show.  But there are also vocal critics of weight loss reality shows like The Biggest Loser, including nutrition researcher and advocate Linda Bacon, who thinks they humiliate the participants.

“I can’t find anything ‘pro’ or positive about shows built on shaming and self-hate,” said Bacon, who is the author of Health at Every Size: The Surprising Truth About Your Weight.  “The damage to the participants seems pretty obvious. For viewers, rather than inspiring people to care for themselves, weight-loss shows are more likely to inspire discomfort and fear: Even thin people can fear being judged by the harsh standards of reality TV.”

Boston-based registered dietitian Nancy Clark agrees.

“The messages in The Biggest Loser are all about deprivation, denial, starvation and punishment. Eating is viewed as cheating and food is  the fattening enemy,” said Clark, who is the author of Nancy’s Clarks Sports Nutrition Guidebook. Clark is especially troubled by how the show depicts exercise, which is akin to “torture,” she said

One recent study in the American Journal of Health Behavior suggests this type of intimidating, punishing approach to exercise could backfire. After viewing episodes ofThe Biggest Loser, participants in the study were less motivated to exercise because they anticipated it would be an unpleasant experience.

Clark told me

“The E in exercise should also stand for enjoyment. When exercise feels like punishment for having undesirable body fat, the day will come when that dieter no longer feels like whipping his or her body into shape and instead reverts to lazing on the couch. The Biggest Losers lose-out in the long run, because extreme diets (either on TV or in your life) teach nothing about sustainable eating and exercise practices that can be enjoyably maintained for the rest of one’s life.”

That brings me to another common complaint about The Biggest Loser, which is the lack of relevance to real-world situations.  The contestants move out of their homes and onto a “ranch” where their only focus is on losing weight.  Even Forberg admits that this set-up is unique because this is their full-time job.  It would be a mistake to expect the same results at home, she said.
Sports nutritionist Nancy Clark thinks the lack of reality in the weight loss reality shows is a major downfall.

“What happens in the long run, when the Biggest Losers return to the real world with no personal trainer to snap the whip, with no pre-made, pre-portioned food, and no ‘fat camp’ dedicated to full time weight loss?  Inevitably, without rigid vigilance, the weight will return with a vengeance. The physiological response to starvation is to overcompensate, commonly known as “binge eating” or “blowing the diet.” This desire to over-eat has little to do with willpower and lots to do with physiology. Just as a person gasps for air if oxygen has been withheld, the same person will grab for carbs if food has been withheld.”

Withholding food may also slow down your metabolism, which will make it even harder to maintain the weight loss.  That’s what Darcy Johannsen and colleagues found after studying 16 participants of The Biggest Loser. Published in the Journal of Clinical Endocrinology and Metabolism, the study found that some of individuals who lost weight had their metabolisms slowed by more than 500 calories – which is basically a meal’s worth of calories that they  no longer burn as a result of severely restricting calories on the show.

So what is your opinion of weight loss reality shows?  Do the benefits outweigh any potential harm?  Maybe these shows are far from reality, but do they inspire and motivate?  Are they getting people off the couch? Maybe the participants can’t maintain this extreme routine once they get home, but my hope is that they’re learning new habits. That’s the only way to sustain a healthier lifestyle.

image courtesy of DivaonaDiet on flickr

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A Few Other Things On My Plate

by Janet on October 24, 2011

Wanted to update you on some of my other projects and where you can find me. For starters, I’ve been busy working on a book with Cooking Light based on the 12 Healthy Habits series that’s been featured in the magazine throughout 2011. The Food Lovers’ Healthy Habits Cookbook will be published in April 2012. You can find me blogging over at Cooking Light’s blog called The Twelve.

I'm Blogging About Healthy Habits

I’m also thrilled to be one of the bloggers for a new WebMD blog called Real Life Nutrition. Please come check us out. I’m joined by some other dynamite registered dietitians. Hope you’re following their blogs as well:

Carolyn Brown: One Smart Brownie
David Grotto: Nutrition Housecall
Maryann Jacobsen: Raise Healthy Eaters
Elizabeth Ward: Expect the Best

Something else I’m thrilled to let you know about is Healthy Aperture. This is a new food gallery site that focuses on healthy foods, featuring various categories like vegetables, whole grains, gluten-free. Please come check us out, and if you’re a blogger, we’d love to get your submissions. We have an editorial board of registered dietitians evaluating the submissions. The new site is something I helped create with RD colleague Regan Jones, author of The Professional Palate.

my healthy aperture gallery

The other site I hope you’re familiar with now is the Nutrition Blog Network. This is another site I helped create that is the first aggregator of blogs written by registered dietitians. We now have more than 250 blogs featured on the site. Be sure to follow us on Facebook and Twitter too.

I think that’s all for now. Come back again soon.

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