Lessons of the Biggest Loser: From Science to Nonsense

The study published last week on metabolic adaptation in participants from the Biggest Loser reality show has captured the imagination of both the public and the media. The results are not pretty. Some elegant science with a simple message – human metabolism resists an extreme weight loss scenario – has been twisted in some disturbing ways.

An optimistic view would be that this story has been helpful to inform the public about the power of metabolic adaptation. And indeed, in the ongoing tracking of public attitudes toward people with obesity by ConscienHealth and the Obesity Action Coalition, we are seeing a significant drop in blaming people with obesity for their condition. The latest data was collected on May 9, just one week after this story began running.

But a more negative view comes from a steady stream of stories that talk about the futility of weight loss. The Atlantic puts it this way:

According to a devastating new study published in the journal Obesity and written up in a widely shared article by the New York Times last week, only one of the 14 Biggest Loser contestants studied weighs less today than when the competition wrapped. Four of them are now heavier than before they went on the show.

This is a rather obvious distortion of the actual outcomes. On average these people maintained a 12% weight loss and 57% maintained at least a 10% weight loss. These outcomes compare favorably to the 27% who maintained a 10% weight loss after eight years in the Look AHEAD study. They just don’t compare well with the Biggest Loser’s premise of weight loss miracles.

Another view can be found in the New York Times, where Sandra Aamodt uses this study to promote her view that “you can’t lose weight on a diet.” Her solution is to recommend mindfulness, a trendy concept that many people find helpful. She has a forthcoming book on the subject to sell you. But mindfulness has a relatively thin evidence base for helping with health outcomes in obesity.

The biggest lie of the Biggest Loser is the idea that it’s a reality show. In fact, it has nothing to do with the reality of obesity. The opposite extreme is the suggestion that there’s no hope for people living with obesity.

Perhaps the public can let go of both hype and blame without giving up on hope for better health. We hope so.

Click here for more from the New York Times and here for more from the Atlantic. Click here for the original study.

Science Club, illustration © Philip Bond / flickr

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.

May 12, 2016