Does Reality TV Go Too Far?

By MEGAN SENGER

The Biggest Loser. Heavy. Fat March. I Used to Be Fat. Each of these television reality shows feature morbidly obese participants exercising several hours per day during an intensive, multi-month period. Certain shows encourage previously sedentary clients to work out for five or more hours daily. The results? Some participants shed more than half of their body weight in less than six months by losing as much as 10 to 20 pounds in a week. 

Virtually unheard of a decade ago, the concept of filming overweight, previously sedentary people on ambitious fitness programs is now commonplace (see sidebar, “Reality Roundup”). Although each show format is unique, some fitness pros feel strongly that they depict unreasonable practices, while others see value in their ability to motivate the masses to get moving. Regardless of industry opinion, these shows attract millions of viewers—and potential training clients—who may take the often-staggering levels of weight loss depicted to heart.

What technical information do you need to counsel clients who admire—and aspire to—the rate of weight loss depicted on reality TV? What should your approach be if these shows make your clients feel like they, too, should be losing 10 or more pounds per week? Our experts weigh in on the physiological changes that allow such huge drops in weight to help determine where reality shows end and real-world weight loss begins.

 What Should Trainers Recommend to Their Clients?

First, consider the industry standard for suggested rates of safe weight loss: ACE recommends 1 to 2 pounds per week, says Fabio Comana, M.A., M.S., an exercise physiologist and spokesperson for the American Council on Exercise. And dropping only 1 pound per week may still be challenging, he adds, noting that 1 pound of weight loss per week can occur with a 3,500-calorie deficit in seven days, or about 500 calories per day (see sidebar, “The Mathematics of Weight Loss”).

It is rare for an obese person to successfully adopt many sound lifestyle changes all at once in real-world situations, agrees Jonathan Ross, author of Abs Revealed (Human Kinetics, 2010) and a fitness expert with a background in training obese clients. More likely, it will be a gradual process, regardless of what is hypothetically possible. “A weight loss of 1 to 2 pounds per week ensures that the body has time to adapt to the changes,” he adds.

In contrast to this 1- to 2-pound recommendation, consider the weight-loss rates seen on programs like The Biggest Loser, an NBC show currently in its eleventh season where obese contestants compete to lose the most weight and win a $250,000 cash prize. On some weeks of the program, participants may lose 10, 20 or upwards of 30 pounds in a single week, raising the question of how reality TV can be considerably different from reality.

Reality TV versus Real-world Fitness: What’s the Difference?

Apart from capturing everything on film, most TV weight-loss shows share three common factors that differentiate them from real life: an unusually prioritized environment, the presence of medical supervision, and an unwavering focus on a relatively short-term goal.

1. The Environment Is Different: No Distractions

Some weight-loss shows remove real-world financial constraints, responsibilities and motivational challenges. Certain programs go so far as to literally take people out of their real lives, providing food, accommodation and training at a facility dedicated to weight loss. Examples include The Biggest Loser and Heavy, a non-competitive show on the A&E channel featuring clients living at a dedicated weight-loss facility for part or all of a six-month weight-loss program.

“I think that people need to understand that [our] participants were in a controlled environment for weight loss, without any outside interruptions,” says Lorrie Henry of Phoenix, Ariz. Henry starred as a trainer on ABC’s Fat March, a 2007 reality series in which obese participants walked 575 miles over 10 weeks for cash prizes and weight loss while camping in tents along the way.

If your clients have their sights set on reality TV–style weight loss, this training truth may be a real eye-opener. For example, you could surprise your clients by saying you can help them drop drastic amounts of weight (which you might not think is safe), using a mock scenario such as this: “Sure, I can help you lose X pounds like on reality shows. We’d have to book an eight-hour session tomorrow, ask for a leave of absence at your work and find someone to watch your kids for a few weeks…” Hyperbole aside, support your clients by noting that the unique circumstances of reality TV may not be translatable to everyday life.

2. The Team Is Different: Presence of Medical Supervision

Risks of rapid weight loss include headaches, fatigue, menstrual irregularities, hair loss, constipation, gallstones, electrolyte imbalances, decreases in bone-density, malnutrition and even death, says Irv Rubenstein, Ph.D., an exercise physiologist and president of STEPS, Inc., a personal-training center in Nashville, Tenn. How do television shows deal with this harsh reality?

“Medical supervision was readily available to each [of our participants on Fat March] throughout the entire project,” says Henry. “There was a medic onsite as we trained, and he checked out the clients every day,” concurs Britny Fowler, an Austin, Texas–based personal trainer who coached participants on a segment of Heavy.

Medically supervised weight loss through restricted caloric intake occurs at places like the Johns Hopkins Weight Management Center in Baltimore, Md. “When medically supervised, [rapid weight loss] has little in the way of dangers,” says Lawrence Cheskin, M.D., FACP, an obesity researcher and the Center’s director. So what exactly does medical monitoring entail?

Doctors supervising weight-loss programs measure metabolic markers in patients’ blood, breath and urine, explains Comana. These can include ketones, which are present in the blood and urine when fat is incompletely metabolized, or enzymes such as creatine that signal protein (muscle) breakdown. “Those are red flags,” cautions Comana, because “next thing you know, [these participants] are not just losing fat, but they’re losing muscle tissue, too.” Comana notes that such monitoring highlights needed diet-and-exercise adjustments, something a person without medical support may not realize are necessary.

While some reality shows assemble a team of doctors, dietitians, exercise experts and psychologists, most real-world clients obviously don’t have the luxury of benefiting from such a support team. Not only is it farfetched, it’s expensive. “If the average person had to pay for four or five medical professionals [to monitor his or her progress] all day long, how much would that cost?” questions Comana.

3. The Goal Is Different: Short-term Intervention Versus Long-term Modifications

Even with medical supervision, physical and psychological health risks of rapid weight loss still exist. Kai Hibbard, a Biggest Loser Season 3 contestant in 2006, spoke out publicly to ABCnews.com in 2010 about experiencing hair loss, menstrual irregularities, disturbed sleep and a distorted body image that she claims stemmed from rapid weight-loss practices learned while on the show.

Hibbard’s experience might cause some fitness pros to wonder if the risks of being obese and losing weight slowly are less than the risks of dropping pounds very quickly to reach a lower body weight. Proponents of rapid weight loss may counterargue that, for some people with severe obesity-related health problems, entering a reality-show environment may be a life-saving experience, and losing poundage rapidly to reach a more reasonable weight is what will boost their health.

But while tactics in reality television are often extreme and short-term, some reality trainers do aim to inspire lifestyle change in contestants. “Think about this in terms of a long race and not a short sprint,” says Martin. “So many factors go into weight loss: age, height, weight, gender. I would really stress to someone that it’s not sustainable to go on a crash diet and exercise excessively for the long haul,” he adds.

While the environment, team and goals of a TV show may be unusual, the physiological changes that participants experience are very real. Therefore, the metabolic mechanisms behind a 10-plus pounds-per-week weight loss should be carefully considered for both safety and reality.

How Do Cast Members Experience So Much Weight Loss in the First Few Weeks?

Some reality shows air remarkable weight-loss results very early in a new season. For example, The Biggest Loser’s week-one weight-loss record was set in Season 11 (which began airing in January 2011) by contestant Moses Kinikini, who started the show weighing 440 pounds. He lost a whopping 41 pounds in his first week on the program (9 percent of his body weight).

On The Biggest Loser in particular, a first-week weight loss of 10 or 20 pounds is not uncommon. How do cast members on shows like The Biggest Loser achieve such rapid results? The key is extreme caloric deficits: increased calorie burn from activity and decreased calorie consumption with food.

And there is a science to cutting calories. “American Dietetic Association [ADA] guidelines tell us we should not drop below 1,000 to 1,200 calories per day for females and 1,500 for men,” says Comana. So what makes caloric deficits work for reality show cast members? For one thing, they might have been eating far more than the average person does before they got on the show. “Someone who weighs around 300 pounds might be consuming 3,500 to 4,000 calories per day,” says Comana.

Because an overweight individual likely consumes more calories than is recommended, the morbidly obese can afford to cut calories to a greater extent, notes exercise physiologist Rubenstein. The result: They can lose weight more quickly than the average, slightly overweight client would.

However, Ross—the 2006 ACE Personal Trainer of the Year—points out that not all obese people eat enormous amounts. “The majority of obese people overeat, but there are [some] who under-eat [and] have compromised their metabolisms,” says Ross. Comana agrees that cutting calories from food by more than 15 percent at one time may induce a starvation state (i.e., metabolic slowdown) in some individuals, regardless of how many calories are consumed overall. So if large caloric cuts are needed, this process should be progressive, taken in small steps and supervised by a doctor or registered dietitian.

Despite the importance of caloric planning, most TV shows focus on the visually exciting aspect of participants struggling through boot camp–style workouts, and not on the rather mundane task of a supervising dietitian charting out food plans. Thus the caloric restrictions used on reality shows remain mostly low profile and largely misunderstood by viewers. That’s one reason why your clients might come to you confused about how they, too, might lose 10 pounds in a week.

However, there is more to first-week weight loss than just caloric deficits—water losses are also a huge factor.

Drastic Weight Loss by the Numbers

Of the 11 men and 11 women who competed on Season 11 of The Biggest Loser, five obese men lost more than 25 pounds in the first week, and six obese women lost 15 to 20 pounds in the same time period. Some metabolic mathematics will assist your clients to see how this works.

The exercise required to lose even 10 pounds (35,000 calories) in one week is drastic, notes Rubenstein. “This would require the equivalent of running [approximately] 50 miles per day (at 100 calories per mile and a 15-minute mile).” Because this is farfetched, Rubenstein notes that water weight—not just simple energy stored as fat—likely accounts for some of the initial poundage lost.

The mechanism for this water loss rests with glycogen, says Comana, because it is the first fuel depleted in the body upon beginning an exercise program. Every gram of glycogen used correlates to 2.4 to 2.7 grams of water concurrently lost. This drives the initial rapid weight loss in the first week to 10 days, he says.

For participants who lose large amounts of water weight quickly, safety may be a concern, cautions Rubenstein. Unusually large water losses via sweating can potentially lead to kidney overload and rhabdomyolysis (an increase in blood-borne myoglobin due to the breakdown of muscle fibers). “If not treated properly and quickly, this could cause kidney failure or even death,” says Rubenstein. He notes that medical supervisors on reality programs likely weigh contestants pre- and post-workout to monitor levels of water loss and replenish them as needed. However, if this does occur it is off-camera.

Weight Loss After the First Few Weeks

Fluctuations in weight loss become more apparent as various reality TV shows continue through their seasons. “As the weeks go by, the numbers tend to slow down and weight loss becomes more challenging,” says ACE-certified Personal Trainer Jimi Varner of I Used to be Fat, a youth-driven MTV show featuring teenagers losing weight at home during the summer before college.

A listing of individual rates of weight loss on the Season 11 The Biggest Loser Web site indicates that the vast majority of the weight loss that occurred after the first week was between 1 percent and 3 percent of total body weight per contestant. And Martin reports that on Heavy most obese participants lost, on average, 1 percent to 2 percent of their body weight per week (e.g., 2 to 4 pounds lost for a 200-pound person; 4 to 8 pounds lost for a 400-pound person.) Preparing clients mentally for weight-loss slow-downs and fluctuations is therefore important to maintaining their sense of motivation.

Reality Hitting Home

Fitness industry opinion may be divided on the value of weight-loss shows. Nevertheless, with audiences numbering in the millions, some viewers may find within such programs the motivation to take the first step into your gym. Build on this forward momentum with a supportive reality check: Ensure that clients have the guidance and education needed to succeed within their real-life circumstances for real-world success.

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Megan Senger is a writer, speaker and fitness sales consultant based in Southern California. Active in the exercise industry since 1995, she holds a bachelor’s degree in kinesiology and English. When not writing on health and lifestyle trends, techniques and business opportunities for leading trade magazines, she can be found in ardha uttanasana becoming reacquainted with her toes. She can be reached at www.megansenger.com.