When Dr. Jeffrey Levine and I first met more than a decade ago, our professional paths seemed unlikely to converge. He, a medical doctor and family physician, and I, a psychologist, found ourselves discussing a crucial topic with first-year medical students: weight and weight loss. As far as I could tell, this was their only three hours of training on the subject.
Levine’s perspective emerged from his time as a contestant on season 2 of “The Biggest Loser.” During his time on the show, he remained on the Ranch for 12 weeks and lost 153 pounds. While he achieved significant weight loss, like so many of the show’s contestants, he eventually regained most of the weight he lost.
[READ: Factors That Contribute to Weight Loss and Weight Gain]
The Problem With Quick Fixes: Why Extreme Diets Fail
Recently, the docuseries “Fit for TV” revisited “The Biggest Loser,” prompting me to reconnect with Jeff. He had largely positive feelings of his experience on the show, and would even do it again. For him, “The Biggest Loser” offered a once-in-a-lifetime chance to step away from everyday obligations and focus entirely on his health. Yet he also acknowledged its fundamental flaw: It was reality entertainment, not a sustainable health program. The show’s format, prioritizing dramatic transformations, normalized extreme dieting and over-exercising. This often led to unsustainable weight loss, and for many contestants, including Jeff, the weight eventually returned.
But Jeff framed his participation as a calculated risk: These behaviors were undertaken for a short period, with the possibility of a huge reward. To him, focusing on adopting healthy nutritional habits and becoming active was a priority. Although the winner each season took home $250,000 (and others could win tens of thousands), for Jeff, his prize was regaining his health, inspiring his patients and being able to participate in physical activities with his wife, daughters and friends.
[SEE: How to Lose Weight Fast and Safely: Strategies From Dietitians]
Beyond the Scale: What True Health and Weight Management Entail
Both Jeff and I agree on a critical point: People crave simple answers to the complex challenges of eating and weight. “The Biggest Loser” capitalized on this desire, presenting a compelling but ultimately false narrative: That sustained weight loss is solely a matter of willpower. That story is seductive, but false. Health and weight are not simply matters of personal responsibility. They’re shaped by biology, psychology and environment. By reducing them to pounds on a scale, “The Biggest Loser” promoted a deceptive, black-and-white narrative.
The show’s obsession with numbers — hours exercised, calories consumed, pounds lost — reinforced that illusion of control. Do X, and get Y. But real health doesn’t work that way.
What truly matters are sustainable habits and long-term behaviors. Contestants collapsing on treadmills is made for dramatic TV, not real life.
The Damaging Impact of Weight Loss Reality TV
My research, focusing on body image and eating disorders, highlights the dangers of the extreme strategies championed by “The Biggest Loser.”
Fasting, severe calorie restriction and excessive exercise are often symptoms of disordered eating and can lead to serious health complications. If a contestant described those practices in an eating disorder clinic, they’d likely be recommended immediate treatment.
Follow-up studies on former contestants have revealed significant metabolic adaptation, where their bodies slowed down, burning fewer calories at rest, and making weight regain almost inevitable. In other words, the extreme methods the show glorified left participants biologically primed to regain weight.
[READ: Weight Loss Plateau: How to Break Through.]
Weight Stigma and Its Health Consequences
The cultural impact of “The Biggest Loser” extended beyond individual contestants and may be even more damaging. By framing weight loss as a moral triumph and weight regain as a personal failure, the show fueled harmful weight stigma. This stigma is not only unkind but actively detrimental to health, linked to depression, disordered eating and a reluctance to seek medical care. In its singular focus on the number on the scale, the show also neglected crucial aspects of well-being, such as strength, balanced eating, energy, mental health and self-acceptance.
[READ: What Is BMI: Body Mass Index Explained]
Sustainable Habits: The Key to Long-Term Well-Being
While “The Biggest Loser” presented an isolated, hyper-competitive environment, research consistently shows that meaningful social support is a powerful predictor of successful health behavior change. Whether it’s family encouragement, supportive friends or clinicians who emphasize collaboration rather than shame, people are more likely to maintain positive habits when they feel connected. Jeff himself credits his supportive family for helping him maintain healthy lifestyle changes after the show. Together, they committed to investing time and energy into healthy lifestyle changes, including homemade meals and family soccer games.
The Evolving Landscape of Weight Loss and Body Positivity
Today, the conversation around weight and health is evolving. New weight loss medications like GLP-1s offer alternative pathways, while social media platforms foster both toxic diet culture and empowering body-positivity movements. Contemporary, evidence-based models emphasize weight-inclusive care and focus on behaviors, not numbers.
What hasn’t changed is our hunger for transformation stories. “The Biggest Loser” sold one of the simplest and most seductive: that weight loss is a matter of willpower, and health a matter of pounds. But if we’ve learned anything in the years since, it’s that the truth is far more complicated. Sustainable health is about far more than just pounds lost; it’s about holistic well-being, supportive communities and a nuanced understanding of our bodies.
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Unmasking “The Biggest Loser.” What Reality TV Misses About Weight Loss originally appeared on usnews.com
