Big Losers, but Can Viewers Keep the Pace?

AS if all the thin people on television weren't bad enough, now dieters must contend with the jealously inspired by contestants on "The Biggest Loser," the hit NBC reality series. The 18 obese Americans lucky enough to have been picked are sequestered on the show's campus, work out with a trainer up to five hours a day, vote people off their teams and participate in challenges like who can run faster than a kindergartner.

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KEEPING SCORE Kai Hibbard, a "Biggest Loser" finalist.

Trae Patton/NBC

FIELD TESTS A mix of group tasks, individual training and strict dieting helps knock the contestants down to size on the reality series "The Biggest Loser."

Such stunts may be embarrassing, but the 24-7 focus on weight loss leads to major reductions, which are tallied when contestants step on an enormous scale. And that's when the show may inspire a bout of self-loathing for viewers trying to lose weight at home: Jerry Lisenby, 62, from Peoria, Ill., dropped 31 pounds in his first week on "The Biggest Loser." Erik Chopin, 37, from West Islip, N.Y., was the winner last season, losing 213 pounds, dropping to 194 from 407 in eight months.

"I find myself in the beginning of every season raring to go," said Renee Peters, 35, a serial dieter and computer programmer in Atlanta, who is the host of the online weight-loss forum the Fatfighters. "But then they've lost 70 pounds and I've only lost 5 in the same time frame, and I find myself eating ice cream."

The show, in its fourth season, has attracted seven million viewers this fall. "The Biggest Loser" has also built a multimillion-dollar franchise selling goods and services to viewers hoping to lose weight. The show's first two books were best sellers, as were two workout DVDs.

Ms. Peters is not alone in finding the show's weight-loss formula undermining, or worse. Some former contestants have cautioned home dieters to stop comparing themselves to what they see. Kai Hibbard, 29, from Eagle River, Alaska, lost 118 pounds last season. She recently wrote on a blog that in the two weeks before the finale she severely dehydrated herself using asparagus (a diuretic), colonics and six-hour stretches of hopping in and out of a sauna. She lost 19 pounds, which as she joked, rebounded to her rear end "almost immediately."

Rob Cooper, 39, from Edmonton, Alberta, who dropped to 187 pounds from 475 pounds on his own, said that the show can be counterproductive. According to his logic, if you're losing two pounds a week and you're watching "The Biggest Loser," you probably think your diet is going horribly. If you lose two pounds a week and you're not watching the show, you probably think your diet is going great.

Mr. Cooper, who is now a motivational coach, lost his weight over three years, first by introducing whole foods to his diet, then adding exercise. In his view, drastic weight loss depends on a deep motivation to take care of oneself, plus a sense of accomplishment as the pounds slip off.

The television show "can actually depress a lot of people," Mr. Cooper said, especially when their steady weight loss cannot compare to the double-digit zingers on the screen. "That's the opposite of what you want," he said.

In that case, Ms. Hibbard's recent advice to fans should delight dieters. "You should only be losing half a pound to a pound a week," she wrote on MySpace. "If so, you are doing an amazing job."

Most medical professionals say dieters should lose weight slowly. Not only are they more likely to keep it off that way, but shedding more than 10 pounds weekly, as some contestants routinely do, is dangerous.

"Whether it's gallbladder disease, hair falling out, skin getting dry," said Karen Kovach, the chief scientific officer at Weight Watchers, "the more rapid the weight loss, the greater the risk." She added: "You get above a kilogram a week, the risk really shoots up."

"The Biggest Loser" takes precautions to be safe: The show promotes weight loss through exercise and healthy eating, and employs four doctors, including a psychiatrist.

But a responsible viewer who wanted to engage in a weight-loss blitz under medical supervision would be hard pressed to find a doctor willing to sign on. "What would I advise someone who wants to engage in a program associated with increased risks of gallstones, cardiac arrhythmias and electrolyte abnormalities, and that has been shown to be less likely to lead to long-term success in maintenance of a reduced body weight than losing weight more slowly?" asks Dr. Michael Rosenbaum, a doctor at Columbia University who has spent over 20 years studying the physiology of weight loss. "I would advise them not to do it."

Adding to the frustration for viewers, much of the radical weight loss seen on "The Biggest Loser" is a natural consequence of the contestants' conditions; many start out morbidly obese. The sheer size of their bodies increases the number of calories required each day, so restricting their calorie intake has a more pronounced effect.

"The bigger you are, the greater your energy expenditure," said Dr. Stephen O'Rahilly, an obesity researcher at the University of Cambridge.

A pound of fat is roughly equal to 3,500 calories, Dr. O'Rahilly said. So if obese people have an energy requirement of 4,000 calories a day, and they go on a 1,000-calorie-a-day diet, they "will have to burn over a pound a day to make up for that energy gap."

Not so for the modestly overweight. If they require 2,500 calories a day, and they eat a mere 1,000 calories, you'll "only lose a pound every two or three days," he said.

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Paula Schwartz contributed reporting.