Pros, cons of reality TV’s approach to weight loss

These days, the only people who don’t seem to mind a few extra pounds are the executive producers of reality TV shows that center on weight loss. Series such as “The Biggest Loser” and its various spinoffs and copycats, including “Losing It With Jillian,” “I Used to Be Fat” and “Heavy,” fill the small screen with the travails of America’s flabby majority.

The programs speak to the fact that obesity has become an overriding cultural obsession, but some experts see them as an unhealthy influence. They fret that the shows’ emphasis on body image can encourage eating disorders and other dangerous behaviors. With participants losing as much as 30 pounds in a single week, they run the risk of heart problems, bone loss and electrolyte imbalances, among other problems. Some contestants on “The Biggest Loser” have admitted to fasting or dehydrating themselves to drop weight, and at least two had to be hospitalized after they collapsed during a one-mile race.

On the upside, these shows have the potential to inspire millions of viewers to hoist themselves off the couch and into the gym, and perhaps cut back on junk food and prepare healthier meals as well. Such changes would help reduce the risk of diabetes, heart disease and stroke.

Do the benefits of these reality shows outweigh the risks? Read on for two views on the topic.

Reality weight-loss shows perpetuate stereotypes and encourage unhealthful behaviors

Lynn Grefe is the chief executive of the National Eating Disorders Assn.

I do not think these shows are a good idea in any way. When people are as large as the contestants on these reality shows, they are not well. I have a problem with treating their condition like some kind of game: How much weight can you lose? And how quickly?

Those on these television programs clearly are obese, but they are afforded medical supervision. The person viewing at home who says, “I’ll do those jumping jacks and turn my life around” could have a heart attack.

Frankly, the idea of everyone simply losing weight is also questionable. There are people who are heavy but remain healthier than people who are slim or who are “yo-yo” dieters. Weight is an individual thing and weight loss is not the best option — or even necessary — for everyone.

We should focus on our health, not size or weight. If it was a show about “Let’s be healthy,” it probably wouldn’t have as many viewers, but it would at least be sending a positive message to viewers.

Diets are multibillion-dollar marketing campaigns that people buy into. I believe it’s about a lifestyle change, not a diet. Since 95% of the people who diet will regain their weight within five years, this TV dieting is just setting people up for failure.

Some weight gain is also an anxiety-driven, binge-eating disorder, and that’s not something I’m hearing discussed. While people on these shows may temporarily lose weight, in the case of eating disorders, they are not addressing the underlying causes of their weight problem. Eating disorders have the highest death rate of any mental illness — more than depression or schizophrenia.

Finally, many people who have eating disorders probably do watch these shows and are impacted by them. That just furthers the unhealthy focus society has on weight and size. It’s like forcing an alcoholic to live in a bar. When I talk to people who had eating disorders, I tell them never to talk about what their weight once was as that creates competition, which can trigger unhealthful behaviors. Clearly these shows are the ultimate competitions.

Reality weight-loss shows can have a positive impact

Lorette Lavine is a nurse and clinical social worker who treats obese patients in the dialysis center at Loyola Medical Center in Maywood, Ill.

I really think that the weight-loss reality TV shows inspire people. I am both a nurse and a social worker, and I see an enormous amount of obesity, including morbid obesity, in the dialysis center where I work. The show I particularly like, “The Biggest Loser,” emphasizes support and competition to keep people going.

On “The Biggest Loser,” the trainers seem to be really involved with the contestants on the show. They have a huge team and are quite clear that it is not just about dieting but also about maintaining a healthful lifestyle and educating people. They push them to exercise. They work with chefs skilled in healthful cooking. They try to get them to reach their maximum health potential. I think the teamwork is just right on the show.

They also recognize the possibility of failure. They have shown a fair amount of people regaining weight on follow-up shows. It’s an ongoing battle.

Many of the contestants on the show suffer from hypertension and diabetes, which actually have been known to improve as they move through the program. Some of the contestants have been told that they will not live very long if they do not lose weight. Presenting these realities can act as a wake-up call to obese viewers. People watching at home are told that medical personnel are watching over the weight-loss program, and they can find legitimate programs in their area to help them lose weight in a healthful manner and keep it off successfully.

In my experience, I haven’t seen people with obvious eating disorders on these shows. The shows promote a healthful lifestyle as opposed to binge eating and dramatically losing weight fast without the exercise component and without the diet education component. They are putting the whole picture together, and I don’t see them going down so thin that it’s not healthy. Of course, you are going to have people watching the show who may have an eating disorder, but they need more help than just a weight-loss program.

health@latimes.com