The Biggest Loser Revisited

I was on The Experts Hangout Podcast this week, and we got on to discussing The Biggest Loser TV show, weight regain and the effect on metabolism longer term. While looking for the links to send over for the post show notes, I re-read the original research and found an interesting update from the author.

To those who are unaware, The Biggest Loser was a TV show from about 10 to 13 years ago which took very overweight people and got them to do ridiculous things like climb assault course obstacles or do mad HIIT sessions. This was all done while eating hardly any food and exercising for many hours a day. The show caused controversy, creating rapid weight loss, with many high profile weight regains when they went back to their normal life. However, the show allowed for some unique research studies to be done.

The original study showed the contestants lost on average 58kg over the 30-week competition yet six years later they had regained 41kg of that. Their measured resting metabolic rate had fallen by 610 kcal per day by the end of the competition, and at 6 years it was still 704 kcal per day below baseline. However, when adjusted for body composition and age, the researchers calculated a metabolic adaptation of about 275 kcal per day at the end of the show and about 500 kcal per day six years later.

The headline news from this spread everywhere, lose weight quickly, wreck your metabolism, then gain it all back anyway so what is the point. We are doomed! However, once you actually look at the paper properly, it is not quite the real message. Firstly, the average hides a lot of variation. Five of the contestants went back to where they started or worse. So, by the law of averages, the rest of the people must have regained much less than 70%. The research doesn’t quite allow you calculate it, but you would estimate around 50% regain in those who did keep it off.

While most people view the show as a total failure, losing 10% of your body weight is one of those barriers that most people struggle with. More than half the contestants were still down this much after 6 years. These people were not just slightly overweight to begin with, they were severely obese, so by nature they are some of the harder cases to get results with. Because of that, I would say this is a pretty good success rate. The extreme change of being on TV, away from normal life, also meant there was a much bigger shock when they returned home, compared to what a normal person would experience.

Metabolism

What got the most attention was the metabolism story, which is not as simple as people think either. One of the more surprising findings in the original follow-up was that the degree of metabolic adaptation at the end of the competition was not significantly related to later weight regain. In other words, the people whose metabolism looked most suppressed at the end were not automatically the ones who later regained the most.

Then came the later update from Kevin Hall, one of the original researchers. He basically said the results may have been misinterpreted by the wider public. His newer argument was that the unusually large and persistent drop in resting metabolic rate may not be because of weight loss itself wrecking metabolism, rather it could have been partly driven by the contestants maintaining unusually high levels of physical activity long term. In that reinterpretation, the body was not necessarily “broken” so much as adapting to an extreme and ongoing lifestyle input.

That is a very different message. It takes the story away from “weight loss destroys your metabolism forever” and towards “this was an extreme intervention, in an extreme environment, followed by unusual long-term behaviour”. In the 6-year follow-up, physical activity expenditure remained markedly elevated compared with baseline, and Hall later argued that this may help explain why the metabolic adaptation stayed so large in the people still doing the most.

Another useful paper from the same Biggest Loser cohort found that the contestants who maintained the greatest losses at 6 years were the ones with the biggest increases in physical activity, while energy intake changes were similar between maintainers and regainers. So again, the people who kept more weight off were not just lucky. They appeared to still be living very differently to before the show.

This does not mean the show was healthy, sensible or something to copy. Far from it. It was a weird TV environment with hours of exercise, severe calorie restriction, public accountability and a support system that nobody in normal life has. That is part of the point. It was never a normal fat loss plan, so people should be careful about using it to draw dramatic conclusions about all dieting in the real world. The original author later made this exact point, saying the Biggest Loser findings were widely misread as evidence that weight-loss diets in general “destroy metabolism” and doom everyone to failure.

What Does This Mean For You

The reality is you probably do not need to lose 60kg or more. It is also very unlikely you are going to go on a TV show to do it. The good news is the research suggests more moderate and realistic weight loss targets are likely to come with far less dramatic metabolic pushback, while still producing major health benefits. It reconfirms what we have talked about before, that maintenance success is strongly linked to activity and movement longer term.

If you do have a large amount of weight to lose, then the research should still encourage you. Many individuals did keep meaningful amounts of weight off. The ones who did better long term were generally the ones who kept their activity levels far higher. So, the message is not “why bother”. It is that success after weight loss usually comes from continuing the behaviours when the excitement has gone, the support has dropped, and nobody is clapping anymore. This is part of my book’s philosophy, where I talked about the fitness environment you live within, your fitness personality and overall identity. These are part of long term shifts in results.

Photo – Me on the Lethal Venom podcast two weeks ago. I forgot to take a picture in the Experts Hangout as I was too busy chatting in the studio. They will both be out to watch soon. 

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