“Biggest Loser” Versus Bariatric Surgery: New Research from Dr. Huizenga

[Alex Brecher 10,498]

Love it, hate it or ignore it completely, the “Biggest Loser” on NBC is one of America’s favorite shows. Millions of viewers tune in each week to watch contestants weigh in as they shed pounds during this inspirational weight loss competition. If you are a bariatric surgery patient or candidate, however, this inspirational show can be bittersweet.

You root for each contestant because you understand their fight against obesity. But if you have been a long-time viewer, you may also cringe regularly. That’s because of the show’s history of devaluing weight loss surgery as a legitimate weight loss aid. More than once, Biggest Loser trainers and the head doctor, Dr. Robert Huizenga, have stated Biggest Loser methods is a better way to lose weight than surgery, which they imply is dangerous and an inappropriate solution in all cases.

New Study: Biggest Loser versus Bariatric Surgery

Are these obesity experts right to discourage weight loss surgery in the national spotlight? Or should they acknowledge bariatric surgery as a possibly beneficial weight loss approach? A lot of us would love to know more about the weight loss program on the Biggest Loser competition and how its results are compared to weight loss surgery.

Now, we can. Dr. Huizenga has published a study comparing Biggest Loser to weight loss surgery – in particular, gastric bypass. It answers a lot of questions…and raises a lot, too! Here are the basics of the study.

The Study Groups

The study compared 13 contestants on the Biggest Loser to 13 roux-en-Y gastric bypass patients. The weight loss surgery patients followed their surgeon’s standard program, including the weight loss surgery diet and any required post-surgery follow-up care and support.

Biggest Loser contestants were on the Biggest Loser Ranch until week 13 or until they got voted off and were at home until the finale. While on the ranch, they exercised for 90 minutes 6 days a week under supervision and were encouraged to exercise up to three additional hours each day on their own. Their diet included lean Protein, fruits, and vegetables, and limited sugars, fats, and processed grains.

The Results

By seven months, or the time between the start of the Biggest Loser season and the show’s finale, Biggest Loser contestants were ahead of bariatric surgery patients. The average Biggest Loser weight loss was 108 pounds while weight loss surgery patients averaged a loss of 78 pounds. By the end of the year, weight loss surgery patients got to an average loss of 89 pounds.

In addition, Biggest Loser contestants lost less muscle and more body fat. However, they also had a lower resting metabolism – that is, they burned fewer calories per day than the weight loss surgery patients. That means they are more likely to put the weight back on.

These are the key findings.

• Biggest Loser contestants lost more weight at 7 months, but the gap narrowed by 12 months.
  
• Biggest Loser contestants lost more body fat.
  
• Weight loss surgery patients had a higher metabolism.
  
• Weight loss surgery patients had lower levels of leptin, a hormone related to hunger.
  

Dr. Huizenga’s Conclusions…Leading to More Unanswered Questions?

Dr. Huizenga believes this study is a compelling argument against bariatric surgery. He refers to the risk of death (1 in 1,000) from bariatric surgery, as well as the high cost of surgery. He acknowledges the high injury rates of contestants but believes these can be treated with orthopedic techniques and surgery. Hopefully, you know a good orthopedic surgeon and have good medical insurance!

Do You Watch TV for Four to Six Hours a Day?

The Biggest Loser includes 90 minutes per day of exercise under the watch of Biggest Loser trainers, plus contestants are encouraged to exercise up to another three hours a day on their own. Do you have a spare four and a half hours each day?

Dr. Huizenga has a solution. He says most people spend 4 to 6 hours per day watching television. He suggests you could spend that time exercising instead. Indeed, a Nielsen survey backs him up. However, while the numbers may sound reasonable, can that be true in real life?

• Do you really watch TV for that many hours each day?
  
• When you “watch” TV, are you just watching TV (and are, therefore, available to do exercise instead), or are you already doing something else, like folding laundry or cooking dinner?
  
• Are you willing to exercise that long each day?
  
• Are you physically able to exercise that long each day?
  

To sum it up, this is an interesting study. Certainly nobody actually wants bariatric surgery – but is there an alternative? Can you follow a Biggest Loser lifestyle and get the results you want? Dr. Huizenga thinks so, but we have our doubts. Coming up, we’ll have an easy-to-read comparison of Biggest Loser and bariatric surgery. Then, we have a few final questions to raise about the study. Stay tuned!

If you’re interested in reading the original research article by Dr. Huizenga and his colleagues at the National Institutes of Health, Vanderbilt University, and Pennington Biomedical Research Center, you can go here.

[LipstickLady 25,682]

On top of the 3-4 hours of time during the day, which I don't have (nor do I watch TV most days much less for that long on any day), I would potentially need:

• a hard core trainer which I really can't afford
• a dietician to plan my meals
• the desire to potentially cause serious damage my knees, my back, my ankles by continuing on program if an injury occurs
• time off work to heal from any injuries incurred as my job is pretty demanding physically
• a complete lifestyle change to accommodate my new schedule to not only lose the weight but maintain it.

Instead, because of weight loss surgery I have been able to:

• go to the gym on my own time and take group classes
• visit the NUT that was included in my follow up care after surgery
• go easy on my body if an injury occurs
• take just a few days off work while I got over the initial surgery
• lose weight and maintain while still spending time with my family, friends, and doing the things I love to do instead of spending every free moment at the gym
• and most importantly, live a lifestyle that I can easily maintain for the rest of my life, into my 60s, 70s, 80s.

[4MRB4PHOTO 3,899]

I have a great idea, instead of watching this show for (1 hour?, I don't know, I don't watch it), we should exercise in our own homes, the gym or walk that additional (hour?) each week.

Edited April 14, 2015 by 4MRB4PHOTO

[Mariew24 51]

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.

[James Marusek 5,244]

I recently came across a program on TV called "My 600-lb Life" on TLC. It is about individuals weighing 600 pounds or more who undergo bariatric surgery to loss weight. It is something to watch.

[JamieLogical 8,684]

The main thing we are lacking here is a comparison of weight maintenance 5+ years out. That's the info that actually MATTERS. And I love how he lists the costs and risks of WLS as arguments against it and then advocates orthopedic surgery! The mortality rate for Gastric Sleeve is lower than the mortality rate for knee replacement.

Still everyone can lose weight in a million different ways, so comparing weight loss between WLS and Biggest Loser's extreme exercise plan is completely meaningless. What we really need to know is what the maintenance stats are.

[Babbs 14,680]

Got it. So to to have a little bit better muscle mass and achieve a little more weight loss, I just need to exercise 6 hours a day.

Excuse me while I tell my husband that being at the gym is now my full time job. I'm sure he will understand.

[mrs kaje 347]

Got it. So to to have a little bit better muscle mass and achieve a little bit more weight loss, I just need to exercise 6 hours a day.

Excuse me while I tell my husband that being at the gym is now my full time job. I'm sure he will understand.

Second full-time job, for me! Except I don't get paid for this one - instead, I actually have to pay for the privilege.

Ain't nobody got time for dat.

[Babbs 14,680]

[LipstickLady 25,682]

Oh and I forgot!!

Unlike Biggest Loser, once I have WLS, I CANNOT be "voted off the island".

[MBM1Forever 107]

Very interesting and in the end, I just don't care what he thinks. For me, it boils down to him trying to justify the show. The show's contestants have continually regained their weight. I chose WLS for many reasons and all personal to me. I have watched BL and seen the way they treat each other and the dog eat dog mentality. Pretty sad and I would not buy one of their products. Their method isn't proven. The only thing they prove is that if you take someone out of the environment and keep them moving and control their food, they lose weight. Again, they don't keep it off. They lose it.

[Katcloudshepherd 630]

This doctor can pound sand as far as I'm concerned. My knees and back are so bad there is no way in Hades I could physcially execise that hard. The surgery gave me my life back. I want to see those contestants several YEARS away from the show! Without the restriction of surgery, how well did they keep the weight "lost" off? If you loose something you sure can find it again! I "released" my excess weight through the tool of surgery and the work AFTER surgery. Only through continuing to use the tool and do what I'm supposed to can I keep the fat released---otherwise it sure will find me!

[Bobby46 327]

Even if I had that kind of time to exercise everyday, there is no way I could do it! I exercise 45 minutes to an hour at the gym and I am so done and so ready to take a shower and get on with my life. Within a week if I didn't have Jilian Michaels, Bob Harper or the "flavor of the day" trainer, screaming at me to keep going, I wouldn't. That is a ridiculous amount of exercise for the average, non-athletic, person to follow through with. I also guarantee those contestants on that show are not continuing with that kind of rigorous exercise plan once they are back home without the screaming trainers in their faces everyday. And....what kind of doctor would even suggest that over weight, out of shape, potentially, very unhealthy people get up and exercise 3 to 4 hours a day?! Was he even slightly serious? Good grief!

[BackSpin81 350]

I'm still pretty new post surgery (week 4) and used to be an avid Biggest Loser fan many years ago when it first started. After watching the show and going through my own weight loss battles, I realized the differences between the contestants and me. Some include TIME (away from work, home, hours in the gym, etc.), having personal trainers, personal chefs, and lastly being on television. I'm not losing weight to win money. I'm losing weight to save my life! And that is all the motivation I need. Plus, the new tools that I continue to learn are set to keep me motivated and keep me fit for life!

[VSGAnn2014 12,992]

Honestly, I'm amazed lawsuits by ex-contestants haven't been filed yet against The Biggest Loser.

Obviously, contestants are required to sign away ALL their civil rights when they agree to submit to the BL "treatment."

And that research design is ridiculous. A sample of 13 participants per treatment? One year's follow-up? Gimme a break.