The Real Biggest Losers? The Show's Audience

Dear American Academy of Pediatrics (AAP),

Last week, reinvigorated by some fresh young blood, season 14 of the prime-time weight loss extravaganza known as The Biggest Loser enjoyed its most watched premiere in its nine-year history. And when I say young blood I mean it, as this season marks the first time that The Biggest Loser has included children in the mix -- two 13-year-olds and one 16-year-old round out the cast.

While I personally find the show to be an emotionally and physically abusive, misinformative, horror show, it's clearly beloved and trusted by many -- that record premiere was reported to have been viewed by over 7-million people. And while my personal opinions shouldn't concern you, the peer-reviewed medical literature stemming from The Biggest Loser, as well as the AAP's implicit endorsement of the show, should.

Perhaps not surprisingly given what appears to be the overarching theme of the show -- that obesity is the individually controlled consequence of gluttony and laziness -- a study published in the journal Obesity this past May demonstrated that watching even a single episode of The Biggest Loser dramatically increased hateful weight bias among viewers -- an effect that was heightened among non-overweight viewers.

Given this season's causal billing as a "big, bold mission: to tackle the childhood obesity epidemic head-on," no doubt viewers are going to be looking to the teachings of The Biggest Loser to help with their children's struggles. Therefore along with being taught that obesity is treatable by means of incredible amounts of vomit-inducing exercise, severe dietary restriction, and never-ending servings of guilt and shame, the medical literature suggests viewers will also be taught that failure is an obese child's personal choice -- something that their bullies have been saying forever. Indeed increasing hateful weight bias is the last thing America's already over-bullied overweight children need as a recent study on bullying published in the journal Pediatrics found that the odds for being bullied for an overweight child were 63 per cent higher than their lighter peers.

The metabolic impact of The Biggest Loser's weight loss formula of exercising a minimum of 4 hours a day while enduring a highly restrictive diet has also been studied. Using indirect calorimetry and doubly labelled water researchers determined that by week 30 participants' metabolisms were decimated -- they had slowed by 504 more calories per day than would have been expected simply as a consequence of their losses. This led the study's authors to conclude (emphasis mine):

"Unfortunately, fat free mass preservation did not prevent the slowing of metabolic rate during active weight loss, which may predispose to weight regain unless the participants maintain high levels of physical activity or significant caloric restriction."

This finding may help to explain why according to the three Biggest Loser alumni I recently interviewed, 85-90 per cent of participants regain their weight, and where more often than not those who do sustain their losses have translated those losses into careers as personal trainers or motivational speakers.

The fact that The Biggest Loser trainers have gone on record this year and formally reported that they won't yell at the show's children is a testament to the ugliness of the show as a whole. And regardless of how the children are treated, it doesn't change what seems to be the show's ultimate message: that happiness, self worth, success, and pride are wholly determined by the numbers on a scale and that people, now including children, who remain obese are lazy gluttons who just don't want it badly enough. As horrifying as that message is, more horrifying that it's being promoted under the AAP's own banner as the show has recruited Dr. Joanna Dolgoff as their pediatrician and new on-screen character. Reading her biography on NBC's The Biggest Loser page reveals just six words in that she's also an, "official spokesperson for the American Academy of Pediatrics."

The biggest losers each and every season aren't in fact the contestants, they're the viewers. By watching The Biggest Loser and basing their devoted adoration only on the proverbial "after" pictures, but not the "after-after" pictures, viewers are being taught non-sustainable approaches to weight management that in turn the medical literature suggests promote hatred of those who struggle with their weight, and potentially of themselves.

That children are involved in the show this year will likely increase the number of children watching and in so doing increase already rampant school-based weight-related child bullying. It may well also lead young overweight or obese viewers to feel even more guilt, shame and self-loathing than they already feel which in turn might heighten their risks of developing body image and eating disorders. Truly, if guilt, shame or self-loathing were sufficient for weight loss the world would be skinny as those who struggle with their weight, especially children, have no shortage of those particularly painful emotions.

Please do the right thing. Speak up about The Biggest Loser. I would argue that it's poisoning an already sick nation and right now it would appear that you're in fact fully and officially on board.

Sincerely,

Yoni Freedhoff, MD

Assistant Professor, University of Ottawa

Faculty of Medicine

Medical Director, Bariatric Medical Institute