Reality shows fail to portray realistic struggles of weight loss

Beth Bushnell Danielson of Elk Grove, Calif. never misses an episode of "The Biggest Loser."

A self-described fan of the show and weight-loss champion in her own right, Bushnell Danielson has drawn inspiration from NBC's dieting reality show. In fact, when she first starting watching, she would get on the floor and do exercises throughout.

"I can fully relate to those people," she says. "I watch that show avidly."

And yet, part of Bushnell Danielson knows that "The Biggest Loser" gives people trying to drop pounds unrealistic expectations of rapid weight loss and can even be medically dangerous. In her case, it took two years of steady, moderate exercise and smart eating to drop nearly 100 pounds. On "The Biggest Loser," however, contestants routinely lose 200 pounds over just 17 weeks.

"I do want people to know they can do it on their own - safely," Bushnell Danielson adds.

Some in the medical and fitness field criticize the physical and psychological tactics used in "The Biggest Loser." And they worry about its wide-ranging influence on the populace. The show has spawned best-selling DVDs and book, online community weight-loss boards and even a brand of exercise equipment.

Obesity - and the ways to shed the pounds and stigma - sells, apparently. "The show is not about obesity," counters outspoken "The Biggest Loser" personal trainer Jillian Michaels. "It's about human beings overcoming adversity. Anybody, across all human lines, can relate to that."

But with the Centers for Disease Control and Prevention issuing warnings about an "obesity epidemic" in the United States, and with 41 percent of Americans reporting that they are trying to lose weight (according to a Consumer Reports phone poll), the show's clear obesity angle hits people, well, in the gut.

The show's premise is to bring together a dozen or so morbidly obese people (between 300 and 400 pounds for men, 200 to 300 pounds for women) and hold a weight-loss competition, with the winner receiving $250,000. The contestants are put on strict diets overseen by a physician, work out rigorously for about five hours a day with a personal trainer and go to therapy sessions with a psychologist. The contestant who loses the least amount of weight weekly is booted off.

Helpful or harmful for dieters? Supporters of the show say it's a great motivator for people to start weight-loss plans. If only by osmosis, viewers pick up tips on healthier eating habits and exercise.

But detractors say that showing obese people losing 15 to 30 pounds a week is neither healthy nor realistic, since experts say the safe way to go about weight loss is to shoot for dropping 2 pounds weekly. Contestants also are often yelled at and humiliated by trainers - not exactly medical protocol. And because the show is compressed into a few months, what viewers don't see is what happens when these obese people hit weight plateaus, as nearly all dieters experience.

Plus, critics say, the average dieter at home is not afforded the luxury of leaving their homes, family and jobs to be whisked off to a ranch where they exercise for six hours a day and have someone overseeing every calorie consumed. "It's incredibly unrealistic and, frankly, a dangerous situation to put someone in," says Pat Manocchia, owner of the La Palestra Center for Preventive Medicine in New York City and a regular contributor for ABC's "Good Morning America. "The changes are not maintainable. But what they don't focus on is the process on how to change for the long run."

Michaels said she expected the backlash. "I would second the notion that the show is not realistic," she says. "In every book, DVD, interview and radio show I've ever done, I've made clear it's not realistic. The show serves as a means of inspiration, to say to people, 'Hey, if these people can do this, surely you can lose 2 pounds per week.'

"It also is a source of information, telling people about calories in, calories out. You don't need the lap band, you don't need to remove part of your stomach, don't need diet drugs. People come up to me on the street on a regular basis and say 'I lost 50 pounds because of your show.'"

But what about moderation? Most diet and nutrition professionals stress moderation even for the morbidly obese. Wendy Cunningham, a registered dietitian and professor at Sacramento State University, says volumes of medical science data show that losing weight quickly is not maintainable. And she doubts that the large amounts dropped by "The Biggest Loser" contestants constitutes "real" weight loss.

"It is not possible to lose the amount of fat weight in the amount of time," Cunningham says. "So they are being rewarded for basically losing water or becoming dehydrated."