Keeping Weight Off: Lessons Learned from The Biggest Loser

Posted: Jul 18 in Clinical Nutrition Center News by Dr. Lazarus

A recent study published in April received a lot of press last month in an editorial in the New York Times. In this study, 14 competitors from the “Biggest Loser” TV show participated in follow-up measurements 6 years after completing the competition.

We have long told people that if you lose weight and keep it off, your body over time will recognize a new, lower set point. This study suggests that this simply is not true.

Of the 14 contestants, the average amount of weight lost during the competition was 39% of each individual’s total body weight. Note that this was lost in 30 weeks. Contrasting this to gastric bypass surgery (the most aggressive medically-acceptable treatment), the average loss at 2 years is 35%. So, the extreme competition is taking off significantly more weight than any acceptable medical approach.

6 years later, the average contestant has maintained weight loss, albeit not as dramatic. The average amount of sustained weight loss is 11%. Thus, ¾ of what was lost has been regained. Compared to gastric bypass surgery, the retained weight loss is 25% of the total body weight.

Even though 75% of the weight was regained, there was virtually no recovery in metabolism – it remained suppressed 6 years later.

What can we learn from this study?

1. Sustained weight loss IS possible.
2. When losing a lot of weight (>20%), some regain is normal and expected.
3. The methods used on this TV show DO yield some weight loss, but it is not nearly as dramatic as the short-term televised results would suggest as the majority is regained.
4. We need to remember that these contestants weigh LESS 6 years later than the original weight by 11%. Without treatment, obesity is progressive – most of these contestants would have had a significant weight gain! 11% is enough sustained weight loss to offer significant health benefits.
5. Instead of losing weight for a competition, we should focus on sustainable treatment strategies.
6. FDA approved anti-obesity medications or bariatric surgery remain the preferred treatments for patients with class III obesity (BMI > 40). These treatments are not offered or recommended on this TV program.