'Loser' not a winner with some experts

November 17, 2008|By Jeannine Stein | Jeannine Stein,Los Angeles Times

On The Biggest Loser, contestants arrive fat and leave thin. And, in between, they go through an intense fitness regimen that is, to put a good face on it, grueling.

The hours-long, athlete-level routines take place from the get-go. Some contestants have completed a quasi-mini-triathlon consisting of a 250-meter swim, a 2-mile bike ride and a climb up 42 flights of stairs. Others have pulled airplanes down a runway or climbed up and down a hill as many times as they could from sunup to sundown - not just sweating copiously but sometimes feeling dizzy, vomiting and crying.

With the show taping its seventh season and continuing to spawn an ever-larger assortment of books, videos, online clubs and forums, The Biggest Loser has made uber-boot-camp-style training sessions seem a sure-fire ticket to weight loss for sedentary, morbidly obese people. And the success of its contestants suggests there's little risk - contrary to common advice that such programs should be undertaken only with a physician's seal of approval.

Mainstream physical health experts are appalled by such extreme workouts. "This is another example of taking a serious health condition and almost mocking it," says Jeffrey Potteiger, kinesiology professor and director of the Center for Health Enhancement at Miami University in Ohio. "I find it deplorable."

For starters, he points out that overweight people may have undiagnosed medical conditions such as high blood pressure, heart disease and diabetes.

"If you go out and do this type of workout," Potteiger says, "you are going to dramatically increase your risk for some abnormal event and possibly exacerbate the condition. People could certainly have a heart attack, a stroke or become hypoglycemic. People need to be aware of these kinds of things."

Second, the truly obese need moderate workouts that help them gradually build up their strength and stamina, he says, not ones that send them sprinting out of the blocks, risking injury. "This is not the way we deal with this kind of weight issue," Potteiger says. "At the end of the day, you're talking about behavior change - nutritional, psychological - and that's hard to change. ... A program like this ... isn't a scenario that will help people change their behavior and become healthy."

Nicki Anderson, named trainer of the year by IDEA Health & Fitness Association, criticizes the show's portrayal of exercise as an almost Herculean effort. "All the show does is reinforce to those who are overweight and inactive "See how hard [exercise] is?' ... For most people, exercise is going to be hard, but it doesn't have to be that hard."

Co-creator and executive producer J.D. Roth says the show is simply redefining what is realistically possible.

Most people - including doctors and fitness professionals - still cling to the idea that standard recommendations of moderate exercise and moderate weight loss are right for almost everyone, including the morbidly obese, he says. And some heavy folks have convinced themselves they can't do one push-up, let alone 10.

"Bob and Jillian had so much conviction about how much more these people could do," he says of the show's trainers, Bob Harper and Jillian Michaels. And as for the contestants: "In a way, these guys are trained like special forces. They're tired, they're overworked, but they're changing their food and exercise habits."

"People are watching the show to be inspired and not to feel hopeless anymore," he says.

If the show has a true believer about the power of abundant, intense exercise, it's Dr. Rob Huizenga, associate professor of clinical medicine at the University of California, Los Angeles, and the show's medical consultant.

"One of the big selling points of the show," he says, "is that people learn things no one has taught them before, like how to exercise. People have no idea what they're capable of, and they don't understand that there are different exercise programs for heart health, for weight maintenance and for weight loss."

Huizenga scoffs at the notion that minimal amounts of low to moderate exercise, even done every day, will make a serious dent in a large weight-loss goal and advocates longer, tougher workouts - providing they are done with a doctor's OK and supervised if necessary. (Contestants on The Biggest Loser get rigorous health screenings - something viewers may not know - including a stress test, plus tests for diabetes and high blood pressure. An emergency medical technician is always on the set.)

About half the contestants had stayed within 5 pounds to 10 pounds of their "finale" weight at a two-year follow-up, he says, a percentage far higher than in most clinical research that typically results in far less weight loss, usually 8 percent to 10 percent of total body weight.

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