Eating Disorders and The Biggest Loser
I love a good documentary, so when I found out that Netflix was releasing a documentary on The Biggest Loser, I was certainly intrigued. I never watched it religiously, but I had seen it when I was younger, so I was curious to juxtapose what I remembered about that show with my training as an eating disorder specialist now. Unsurprisingly, most of the former contestants did not have positive things to say about their experiences on the show, including details about grueling workouts and unhealthy eating habits as well as reporting how quickly they put weight back on when they could no longer maintain the conditions of the show when they went home to real life.
What shocked me the most, however, was that explicit mention of “eating disorders” was only mentioned once (at least that I caught). Everything they described - from their behaviors before the show, to what they went through on the show, to some of the struggles after - are consistent with diagnosable eating disorders, yet I only noticed one person mention it and it wasn’t until episode three. Yes, they all admitted they did not have the best relationship with food, but in the eating disorder world, there really is a spectrum as to what that means, and I would argue that what the endured was a prescribed eating disorder. I even started making a list while I was watching of all the things that would be categorized as full-blown eating disorder behaviors:
One of the winners reported that he did not eat anything solid for the final 10 days of the show in his pursuit of $250,000 (which, let’s be real, is part of the problem here) - and he ended up with blood in his urine due to how dehydrated and malnourished he was. He did admit that this behavior is “unhealthy,” but let’s call a spade a spade here - this is an extreme level of restriction that can have dangerous consequences on the body, as evidenced by his urine sample.
One of the real issues here that multiple contestants talked about what was that they were trying to lose weight to win a significant amount of money. This led them to become even more extreme in their behaviors than what was being prescribed in hopes of winning, which also then is more likely to lead to their weight returning after the show because they returned to eating again.
One of the contestants reported bingeing the night before she went to California because she knew from watching the show that she would be deprived of food when she arrived. The binge-restrict cycle is very common in the eating disorder field, so it is definitely worth mentioning on this list.
This is more about mindset than specific behaviors, but one contestant thought that losing weight would make her a better mom, fix her marriage, garner respect from her husband, and get him to stop cheating on her. Often, I hear these idealistic beliefs from clients that if they could just reach the goal their eating disorder has laid out for them, then their life would improve. Not only does that lead to disappointment, but it does not get to the root cause of the issues. For this woman, she ended up realizing while on the show that her marriage was over and divorced her husband afterward, even though she had lost a significant amount of weight.
Contestants were ordered to burn at least 6000 calories per day. WHAT?! One of the advisors noted that they were being advised to train like professional athletes without the capabilities of professional athletes, and this is an example of that. Granted, I doubt professional athletes are told how many calories they need to burn each day, and are also fueled in the opposite direction of contestants on this show. If you ever Google how much a professional athlete eats in a day to make up for how much they are burning, you’ll see that The Biggest Loser was significantly under-fueling contestants in a dangerous way.
Speaking of exercise, contestants often worked out until they threw up and were advised to continue their workouts even if they were hurt, which I imagine happened often due to the level of intensity that they were pushed to without the professional experience or proper nutrition required to do so. One contestant even shared that her organs started failing after a beach run and she had to get flown to the hospital in order to save her life. I can assure you that none of this even remotely qualifies as promoting a healthy relationship with exercise.
There were reports in the show about contestants being given caffeine pills to suppress their appetites and have more energy for working out. For most people, caffeine pills are not healthy for the body and can lead to cardiovascular issues. For the contestants on this show, it can be downright dangerous, as these pills could increase their heart rates to dangerous levels, leading to a heart attack or stroke. Truly, it’s a miracle no one died eating as little as they were, exercising the way they were, and taking these pills on top of that.
There’s also the emotional layer of the show that the trainers were straight-up unqualified for. Bob Harper, one of the trainers, talked about trying to understand one of the contestants and why her relationship with food and exercise was so poor. However, he’s not a trained clinician so he’s really not qualified to look deeply at the underlying issues for anyone on the show, and then he also turned around and berated contestants - to the point where it seems like one woman might have dissociated due to being triggered by it. These kinds of emotional interactions are just as damaging to contestants as the behaviors they are engaging in.
Contestants also reported feeling guilty and ashamed after the show when they put weight back on, which is a common experience in the dieting and eating disorder world. However, the weight returning is part of the cycle - if you’re not eating enough, the weight will return when you begin to eat again, and the set point of your weight (where your body naturally settles) will likely increase in order for it to feel safe from entering starvation mode again.
The only contestant to actually mention an eating disorder reported returning home from the show “with a severe eating disorder,” her husband telling her that she was a shell of her former self as she spent hours exercising alone and fearing social situations where she would need to eat around people. As she focused more on food and maintaining her weight loss, she said she lost her own identity in the process, which is exactly what an eating disorder is. I can’t imagine she was the only person to feel this way before, during, or after the show.
The one contestant that finally made everyone pause came out for the final reveal looking objectively unhealthy. You can see Bob and Jillian’s (the two trainers) faces when they see her emerge from behind the curtain, and it was this contestant that finally got the conversation going on how horrible this show was and eventually led to its cancellation. To me, it’s sad that it took someone looking objectively sick - but doing the same thing as all the other contestants before her - for people to pause and think about the negative impact of the show. It’s like atypical anorexia - when someone in a larger body loses a significant amount of weight in an unhealthy way, it’s still anorexia and still an eating disorder, but people view it as wildly different from someone underweight who is continuing to not eat. In reality, they’re the same thing. And this contestant was probably just as sick as other contestants, definitely engaging in the same behaviors as other contestants, but because she looked frail and sick and unhealthy, it was a “problem,” whereas other contestants were viewed as successes on the show.
As you can see, the overlap between what I see in a session and what I saw on this documentary is significant. To be honest, anyone coming into my office reporting any of the behaviors the contestants talked about would be referred to a treatment center, likely residential, to be treated for their eating disorder. They would receive around-the-clock medical care and nutrition management with hours of therapy each day. It doesn’t seem like any of the contestants received that kind of support, which is a shame because they deserved to heal too.
