Thanks for posting this, Alex.
First, 26 is a pretty small sample size to draw conclusions from. I would be interested in knowing if the choice of 13 Biggest Loser contestants is truly randomized. I suspect that the quality of the evidence in this particular study would be considered low.
I'm trying to figure out how I would be able to commute and work and still be able to exercise or even watch TV 4-6 hours per day (which I don't). If I needed to do that under the supervision of a Biggest Loser trainer, I certainly would have to work to afford it.
I find it really funny that Dr. H is, in essence recommending one surgery over another in the form of an orthopedic surgery when the participant becomes injured.