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The Biggest Loser study<\/strong>\u00a0Is it impossible to sustain weight loss in the long term?<\/strong>\u00a0By Helen Kollias\u00a0<\/strong><\/p>\n What happens to the body weights and metabolisms of\u00a0The Biggest Loser<\/em>\u00a0contestants after they appear on the show? Why? And what does this mean for everyone else who wants to lose weight and keep it off?<\/strong><\/p>\n Nine in 10 people want to lose weight.<\/strong>\u00a0So it\u2019s no wonder the NBC reality show\u00a0The Biggest Loser<\/em>\u00a0has become wildly popular.<\/p>\n -this-happened-to-you montages set to emotive music.<\/p>\n And successful contestants who\u2019ve lost significant weight \u2014 sometimes hundreds of pounds Competitors running on treadmills with tears streaming down their faces.<\/p>\n Trainers screaming motivational slogans\u2026 or just screaming.<\/p>\n How \u2014 holding their \u201cbefore\u201d jeans next to their new bodies.<\/p>\n The Biggest Loser<\/em>\u00a0is pure TV gold.<\/p>\n But is it gold for the contestants themselves? A just-released study \u2014 shedding not-so flattering light on what happens after the show \u2014 suggests not.<\/p>\n Here\u2019s the media narrative of what happened:<\/p>\n But is this story true?<\/p>\n What does the study prove? And is it\u00a0really<\/em>\u00a0impossible to sustain weight loss?<\/strong><\/p>\n Let\u2019s dig a little deeper.<\/p>\n Research questions:<\/p>\n What happens to the body weights and metabolisms of\u00a0The Biggest Loser<\/em>\u00a0contestants in the years after they appear on the show? Why? What does this mean for regular folks who want to lose weight and keep it off?<\/strong><\/p>\n Fothergill E, Guo J, Howard L, Kerns JC, Knuth ND, Brychta R, Chen KY, Skarulis MC, Walter M, Walter PJ, Hall KD.\u00a0Persistent metabolic adaptation 6 years after \u201cThe Biggest Loser\u201d competition<\/a>. Obesity (Silver Spring). 2016 May 2. doi: 10.1002\/oby.21538.<\/p>\n To explore these questions, this study looked at three key indicators in 14 men and women who participated in season 8 of\u00a0The Biggest Loser<\/em>\u00a0(2009):<\/p>\n Now, in case you\u2019re not caught up on your reality TV watching, here are a few important things to know.<\/p>\n Methods & Initial assessment<\/p>\n Before their first appearance on the show in 2009, contestants went through a battery of tests that assessed things like:<\/p>\n Follow up<\/p>\n In 2015, six years after their run on the show, subjects returned to the laboratory for a complete follow-up. Two weeks before the study officially started, participants weighed themselves on a special digital scale that transmitted their data to the researchers.<\/p>\n This early start helped ensure that people didn\u2019t try to change their weight before the study began, which would skew the results. Once in the lab, researchers again measured the subjects\u2019 RMR, total energy expenditure, and physical activity expenditure. They also performed bloodwork. They then compared the results of their 2015 testing and their 2009 testing. Here are the results\u2026<\/p>\n Results: Weight<\/p>\n Average weight before filming\u00a0The Biggest Loser<\/em>: 328 lb.<\/p>\n Average weight after 30 weeks on\u00a0The Biggest Loser<\/em>: 199 lb.<\/p>\n Average weight six years after final on camera weigh-in: 290 lb.<\/p>\n This means that, on average, participants regained 70 percent of the weight they\u2019d lost. (Although they did keep off 30 percent of it.)<\/strong><\/p>\n Resting metabolic rate<\/p>\n Average RMR before filming: 2,607 kcal burned \/ day.<\/p>\n Average RMR after 30 weeks on the show: 1,996 kcal burned \/ day.<\/p>\n Average RMR six years after final weigh-in: 1,903 kcal burned \/ day.<\/p>\n Surprisingly, despite their weight regain, participants were burning 700 fewer calories per day at rest vs. when they started the show. This is about 500 fewer calories than we\u2019d expect them to burn based on predictive equations that take into account their body weight.<\/strong><\/p>\n Lean body mass (an indication of muscle mass)<\/p>\n Average lean body mass before filming: 167 lb.<\/p>\n Average lean body mass after 30 weeks on the show: 142 lb.<\/p>\n Average lean body mass six years after final weigh-in: 155 lb.<\/p>\n Participants lost 25 lbs of lean mass during the filming of the show. They did end up gaining about 13 lbs of it back. However, that didn\u2019t help to elevate their RMR, as we might have expected.<\/strong><\/p>\n Leptin<\/p>\n Average leptin before filming: 41.14 ng\/mL<\/p>\n Average leptin after 30 weeks on the show: 2.56 ng\/mL<\/p>\n Average leptin six years after final weigh in: 27.68 ng\/mL<\/p>\n As you\u2019d expect, participants\u2019 leptin levels went down when fat decreased, and went up again when fat came back.<\/strong><\/p>\n So, why did they regain the weight?<\/p>\n That\u2019s a complicated question. But the study\u2019s findings give us big clues, and new discoveries for our understanding of metabolism. Many people assume that weight loss \u2014 and sustaining weight loss \u2014 is purely\u00a0psychological<\/em>. If you don\u2019t have the mental strength and willpower to\u00a0pass on the chili cheese fries<\/a>, then you\u2019re essentially choosing to gain back the weight, right?<\/p>\n But the\u00a0Biggest Loser<\/em>\u00a0data illuminate the important\u00a0physiological<\/em>\u00a0roadblocks contestants face.<\/p>\n Metabolic adaptation<\/p>\n We already know that\u00a0when you lose weight, your metabolism slows<\/a>.\u00a0This is called metabolic adaptation, and it\u2019s normal.<\/strong><\/p>\n Metabolic adaptation is a natural defense mechanism against starvation. When you\u2019re dieting, at a certain point, your body will send up a red flag.<\/p>\n Starvation alert! There\u2019s not enough food to go around! Hold onto the fat reserves!<\/em><\/p>\n At that point, your RMR slows.<\/p>\n Metabolic adaptation can make things more complicated (and frustrating) for dieters who hope to continue or maintain their weight loss. Once their body\u2019s red flag goes up, calorie restriction no longer has the same effect it did at the beginning of their diet. Suddenly, they need to cut\u00a0more<\/em>\u00a0calories just to maintain the same weight. While this is sometimes framed as\u00a0metabolic damage<\/a>, it\u2019s really just your body\u2019s way of trying to keep you alive and well.<\/p>\n What was interesting about this study? It showed that participants\u2019 RMR stayed low despite:<\/strong><\/p>\n In the end, as you can see in the following graph, participants\u2019 metabolisms were just as low after six years (and after regaining almost 100 pounds) vs. the end of the show, when they were their lightest.<\/p>\n Leptin<\/p>\n As expected,\u00a0The Biggest Loser<\/em>\u00a0participants experienced a huge drop in leptin when they lost weight in 2009. When they regained weight, leptin rose accordingly. But there are two sticking points here:<\/p>\n Putting all this together, in order to sustain their weight loss,\u00a0The Biggest Loser<\/em>\u00a0participants would have to:<\/p>\n Or<\/em>\u2026<\/p>\n All while<\/em>\u2026<\/p>\n Yea, that sucks. No wonder these folks have trouble keeping the weight off. Does this mean it\u2019s impossible to sustain weight loss? It\u2019s clear that, when you lose a lot of weight, you\u2019re up against a lot of very real physiological changes if you want to maintain the weight loss.<\/p>\n But there\u2019s a lot of important information we don\u2019t have about\u00a0The Biggest Loser<\/em>\u00a0contestants.<\/strong><\/p>\n What goes on behind the scenes?<\/p>\n The Biggest Loser<\/em>\u00a0is a television program. It\u2019s not itself a controlled research group or scientific experiment. With this study, researchers are trying to make sense of what happened after the fact. The initial conditions themselves are mostly a mystery. That means all kinds of factors could have influenced the outcomes.<\/p>\n We just don\u2019t know. But all of these factors could affect the contestants\u2019 ability to sustain weight loss.<\/p>\n What are the participants\u2019 lives like?<\/p>\n The participants reported maintaining the\u00a0Biggest Loser<\/em>-approved nutrition regimen and exercise level over the six-year period.\u00a0But<\/em>: Self-reported data are notoriously unreliable. It\u2019s not a flaw of these particular people, it\u2019s just how humans work. Some of the participants were able to keep weight off for years before it returned. So questions arise like:<\/p>\n Here again, we don\u2019t have answers, and all of this can affect a person\u2019s ability to maintain their weight.<\/p>\n Did they regain the weight because they lost it so quickly?<\/p>\n The Biggest Loser<\/em>\u00a0program helps contestants lose weight at a rate you rarely see elsewhere. Many people are speculating that this is the reason for the participants\u2019 persistent metabolic adaptation and weight regain. That\u2019s a convenient explanation, but not necessarily an accurate one. Another study compared\u00a0The Biggest Loser<\/em>\u00a0participants\u2019 weight loss with gastric bypass (Roux-en-Y) patients about six months after surgery and found something surprising.<\/p>\n Feeling full, anxious, lethargic, foggy-headed, heavy, or extremely thirsty are signs of overeating that warrant an 80-percent experiment. Next time you eat lunch, eat slowly, take a good break after each bite, and ask yourself, \u201cAm I still truly,\u00a0physically<\/em>\u00a0hungry?\u201d If the answer is yes, take another bite, chew slowly, and repeat. If the answer is no, end the meal and start monitoring fullness\/hunger cues until dinner.<\/p>\n The Biggest Loser study authors didn\u2019t look at the stress hormone cortisol, which is a shame. When you experience psychological stress, cortisol shoots upward. Research has linked increased cortisol with weight gain, likely due to poorer food choices and physiological changes. It\u2019s conceivable the\u00a0Biggest Loser<\/em>\u00a0participants experience considerable psychological stress: Undergoing an intense weight-loss program on national TV; airing their traumas to the world; regaining the weight when everyone knew they\u2019d appeared on the show; feeling the shame of \u201cfailure\u201d. Every day, take steps to\u00a0reduce your stress level and recover from all the hard work you do<\/a>\u00a0\u2014 physical and otherwise.<\/p>\n Some ideas:<\/p>\n Of course, what you find rejuvenating might be unique to you. Just be honest with yourself: Some activities that have the reputation for being relaxing \u2014 say, watching TV or throwing back shots at the bar \u2014 may be more escapism than true stress reducers.<\/p>\n Change is hard for most people, and it\u2019s partly due to our hardwiring. Research shows that most of the decisions we make are automatic, based on patterns and brain shortcuts as opposed to rational thought. We react to what\u2019s in front of us, and our actions are often impulsive and\/or the result of motivations we\u2019re not fully conscious of.\u00a0That means our environment powerfully shapes our decisions \u2014 including food decisions \u2014 more than we realize.<\/strong>\u00a0We eat whatever\u2019s in front of us, finish all the food regardless of portion size, consume more when we\u2019re multitasking\u2026 and more. Tough to change your eating habits when those habits are based on thoughts you didn\u2019t know you were having, huh? But you can use this hardwiring to your advantage by putting your environment to work to control your energy intake:<\/p>\n What to do next.<\/p>\n Shifting your mindset from \u201cthis is impossible\u201d to \u201cI can do this\u201d will take time. But there are steps you can take today to get on the path to achieving \u2014 and sustaining \u2014 a healthy weight.<\/p>\n Let it be.<\/p>\n So you\u2019ve struggled to lose weight, or you\u2019ve struggled to keep it off. So what? For many people, a sense of shame, failure and fault is caught up in weight gain. When we can remove these from the equation, we can have a better experience, and possibly better results. Don\u2019t beat yourself up. Losing weight and keeping it off is challenging and complicated \u2014 especially\u00a0in the context of real human life.<\/a>\u00a0Each day is a clean slate. It\u2019s yours for the taking.<\/p>\n Aim for healthy, not ripped.<\/p>\n The Biggest Loser<\/em>\u00a0participants lose enough weight to appear on the cover of\u00a0People<\/em>.<\/p>\n For the vast majority of people,\u00a0getting magazine-cover ready is a goal neither realistic nor worthwhile<\/a>\u00a0\u2014 and luckily, you don\u2019t have to turn yourself into a reality TV marketing machine. More realistic expectations usually mean better long-term adherence to healthy eating and movement and help mitigate your stress response to a weight loss program. Telling yourself yet again that \u201ctoday is the day\u201d you\u2019re going to start eating and looking like\u00a0Jessica Biel<\/a>\u00a0\/\u00a0Brad Pitt<\/a>\u00a0\/ whoever?<\/p>\n Dial it back. Pick one, simple health-supporting habit you want to concentrate on and put your effort towards that for 2-3 weeks before adding anything else to your list.<\/p>\n Talk to your people.<\/p>\n What we do know about\u00a0The Biggest Loser<\/em>\u00a0participants\u2019 lives? They went from 30 weeks of intensive support to\u2026 zilch. Research shows that a supportive social environment makes weight loss and maintenance more likely. Of course, as you probably already know,\u00a0getting family, friends, coworkers, and others \u201con board\u201d with any new lifestyle habits<\/a>\u00a0comes with its own challenges and doesn\u2019t happen overnight. A great place to start? Connect with them. Talk to them about what you\u2019re trying to do with your focused nutrition and exercise practices. Listen to what\u2019s going on it their lives. Understanding and compassion with yourself and the people around you will become the foundation of a healthy lifestyle that lasts.<\/p>\n","protected":false},"excerpt":{"rendered":" Here are notes from a great article from the team at Precision Nutrition looking at some of the effects of rapid weight loss and not developing a longer term plan. Research Review: The Biggest Loser study\u00a0Is it impossible to sustain weight loss in the long term?\u00a0By Helen Kollias\u00a0 What happens to the body weights and<\/p>\n\n
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