I'm the poster child for what a Biggest Loser contestant could be. Once upon a time, I weighed more than 300lb. For more than a decade, I've healthily, happily maintained a 150lb weight loss.
So maybe it's somewhat surprising that when The New York Times published a story on research showing that those who had success on the show usually gained everything back, and sometimes more, I thought, "Yep. Makes sense."
What researcher Kevin Hall found startled him: when people lose that much weight that quickly, their metabolism gets thrown out of whack, making them unable to burn the calories necessary to maintain their new weight. It's a classic catch-22: you need to burn calories to lose a bunch of weight, but losing a bunch of weight makes you burn fewer calories. One successful contestant burned 800 fewer calories per day at his new weight than would be expected of someone who hadn't formerly been obese.
In short, the deck is stacked against overweight people before they step foot on a treadmill, not to mention the mental and emotional toll of these physiological effects. Yet here I am, a great example of the results that contestants on The Biggest Loser could (and should) be getting.
Why am I still the exception to the rule?
"Eat less, exercise more" doesn't really work
From the start, I was the biggest kid in every school photo. While other kids in my neighborhood dreamed of going to Disney, I dreamed of going to fat camp. By the time I was 10 I'd already lost and gained weight a dozen times.
No matter where I turned, the message was clear: eat less, exercise more, and you'll lose weight. Then, just stick to a reasonable maintenance plan, and you won't gain it back. But no matter how hard I tried to eat less and exercise more, I just couldn't seem to lose weight. The few times I did, I couldn't maintain it.
In fact, until I started focusing on why and how I made certain food- and other self-care-related decisions, every time I tried to lose weight I ended up heavier on the other side. In fact, before I shifted my focus, the more intense my effort to lose weight, the quicker I gained it back.
And I was in the process of proving that for the last time in 2004, the same year The Biggest Loser started airing.
Not even weight-loss surgery is a guarantee
In early 2003, I had weight-loss surgery, arguably the biggest effort one can make to lose weight. I bottomed out at 140, and wouldn't you know it, I immediately started gaining it back.
I admit that I wasn't exercising -- yet -- but food has a much bigger impact on weight than exercise ever could. Since my stomach was the size of an egg, you'd think I would've been immune to putting on all the weight I lost.
But even folks who have weight-loss surgery are likely to regain their lost weight, so long as there are calories in liquids and pre-masticated processed foods around every corner.
This might be the most damaging aspect of The Biggest Loser: It fuels the fantasy so many of us have that if we could just eat small portions, and exercise like a beast every day for some magical number of days or months, those behaviors would become habitual. We would never revert back to our old habits. We would never gain back the weight.
Fast weight loss is good TV.
Life lasts way longer than a reality show
Really, the study was simple in that it merely followed the progress of Biggest Loser contestants for six years. The findings, though of course there's a level of scientific complexity to them, can be boiled down to an equally simple statement: once a body is obese, it will fight to gain back any weight it loses.
And it won't just fight for days to gain it back. Not for months. But for years.
Hall's study shows what many overweight people have felt but were embarrassed or ashamed to say: ours is a disadvantaged population. Losing weight and keeping it off is a harder prospect than anyone who insists we should eat less and exercise more can appreciate. Like any group that faces more than their fair share of obstacles, we need additional support.
Additional support is antithetical to the very concept of The Biggest Loser, so it's not surprising that the contestants didn't receive the years of follow-up they needed -- fast weight loss is good TV, and has to start fresh each season. Would you rather watch a show about people struggling to maintain their weight loss, or magically dropping hundreds of pounds in a matter of months?
What a more effective program would include
Obese and formerly obese people have more needs than The Biggest Loser can offer. We need more than the controlled diets contestants received; we need help to develop love for nutritious food, and serious support to practice coping with stress in ways that don't involve food.
We need more than a few intense months with a trainer; we need to feel genuinely cared for by exercise and fitness professionals who can patiently help us accept where our bodies are at and hold us accountable for being active every single day.
We need more than a goal weight; we need to develop daily goals and healthy boundaries that allow us to feel the deep pleasure the results when we make healthier choices every time we're faced with a choice.
We need more than 15 minutes a year with a primary care provider whose focus is disease management; we need access to empathetic, experienced doctors who know if or when to suggest medications and medical interventions.
We need more than a quick chat in the dorm about how our abuse histories informed how we think about and treat our bodies; we need ongoing mental health support from folks who understand the power of shame and self-sabotage, and who have direct experience healing both.
We need more than four months on the ranch; we need years of ongoing, daily support from peers vested in our health and success.
We want to think The Biggest Loser was this great resource, but the truth is that once most of us have crossed the line into obesity, we need a helluva lot more than any contestant on that show ever got.
Like any underprivileged population, we are capable of reaching our goals, we just need more support to get there -- especially love, patience, time, and each other.
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