Traumatic Dieting

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How Young Is Too Young To Be On The Biggest Loser?

Will being on the Biggest Loser enrich or endanger the lives of children?

The Biggest Loser trainers and this season's children
Too young for prime time?
Yesterday marked the launch of the 14th season of the prime time scream at vulnerable, desperate people and make them cry phenomenon that's known as The Biggest Loser.  What will set this season apart from every other is that this year marks the first year that included among the vulnerable and desperate are three children.  Two barely teenaged 13 year olds and a 16 year old who while they won't face eliminations or public weigh-ins, will spend the next 3 months having their trials and tribulations with weight and adolescence paraded in front of millions of prime time television viewers.  No doubt it will be great for ratings, but will it be great for these children?

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Defenders of the show will argue that the children will be treated differently than their adult counterparts.  That the pressure won't be the same because they're not being voted off or publically weighed.  That there will be more compassion offered to them.  That every care in the world was and will be taken to ensure their safety.

And for the sake of this discussion let’s agree with all of those possibilities.  Let's agree that not being voted off or publically weighed somehow eliminates the unfathomable pressure of being a 13 year old who is suddenly thrust into the public spotlight which of course also includes 13 year old peers - not a population known for their kindness or empathy.  Let's also agree that they will be treated compassionately and that indeed, they’ll have the ear (and shoulders) of the show's producers, trainers, dietitians, psychologists, psychiatrists, physical therapists, and pediatric obesity specialists every step of the way.

Let's assume too that their outcomes will be comparable to the outcomes of the adult Biggest Losers.  In interviews with former contestants - who like many groups with a shared trial keep close touch with one another - the estimated percentage of participants who keep the weight they lose off is somewhere between 10% and 30%.  That of course means on paper it would be fair to assume that at least 2 of this season’s 3 children are going to regain their weight.  And everyone around them is going to notice.

Speaking with outspoken former Biggest Loser season 3 contestant Kai Hibbard affords some insight into what the outside pressure might be like for these kids,

“I think it’ll be 10 times worse because they’re adolescents.  I’m a grown adult, and it’s been almost 7 years and literally less than a month ago I had a complete stranger come up to me in the grocery store, look at my cart, and ask me whether I should be buying the ice cream that’s in it.  I can’t imagine what they’re going to endure”

Her fellow season 3 teammate Ken Coleman agrees that there’ll be long term scrutiny

“I still have that happening today (referring to Kai’s experience with the shopping cart).  Yes, 7 years later and it doesn’t change.  I do speaking engagements, I have people that come in to speaking engagements and the only reason they came, they don’t want to hear what I have to say, they just want to see if I gained the weight back”

Ken though feels the children will be safe because the show will have psychologists and psychiatrists to help the kids out, but when I asked him whether those professionals will still be there after the cameras stop rolling, he admitted,

“Well none of the contestants from NBC have been that lucky” 

Another contestant who wishes to remain anonymous had this to say about this season’s inclusion of children,

“I’m so appalled and disgusted with it.  It’s one thing to mess with our heads, but then they go to kids?  I’ve been battling with this for many years, and I can’t even imagine, I can’t even imagine what it’s going to do to kids.” 

That same contestant also echoed Ken’s assertion that after the lights go down, the support goes away,

“after the show was over, when I reached out, when the weight started to come back on I reached out and I begged and I pleaded and I said help me and they wouldn’t even respond to me.  I felt terrible.  I don’t think there are words to describe the defeat and the rejection I felt after the show”

Neither she, nor her partner on the show have kept their weight off and despite being mature, intelligent, fully-grown adults she notes that for her and her teammate,

“We still know that people look at us, people who know the show and we feel such shame because we had this opportunity that everybody wants, and we didn’t keep it off”

The pressure she felt on the show was extreme as well,

“It was a total mental battle, all of the time.  It’s so much pressure that you put on yourself.  I was taking sleeping pills to get through the night because I was so freaked out weighing myself daily.  It was so much pressure.  It was unbelievable”,

and she doesn’t think it’ll be any less difficult for the kids who aren’t being weighed in on a weekly basis,

“regardless of if they’re doing weigh-ins both that kid and the producer and their family and their trainer know exactly how much they weigh, exactly how much they need to lose and that’s always in your head.” 

She points out,

“remember, regardless of whatever safeguards they’re putting in for children this is a TV show, and they do this for ratings, and they want a reaction, and the only way you’ll get a reaction is if you get an extreme results.  So these kids are going to go to be one day 50lbs overweight, and they’re going to wake up 6 months later at a normal weight and they’re not going to recognize themselves.  So what is that going to do to an already fragile psyche?”

Not to mention what might happen to that fragile psyche if they gain it back.  In a now classic study, Rand and MacGregor revealed that formerly obese bariatric surgical patients would rather be of normal weight and deaf, dyslexic, diabetic, legally blind, have very bad acne, have heart disease or one leg amputated, than return to being severely obese.    And those were adult patients.

When I mentioned to Kai the best case scenario of 1 of the 3 children keeping their weight off she quickly jumped in,

“And the third one while they’ll look better on the outside, they might well be just as psychologically damaged on the inside and you know, vomiting up their food at night when nobody knows”

While I can appreciate the motivation of television producers to use children to drive ratings, I’m most puzzled by the involvement of pediatrician Dr. Joanna Dolgoff.  One of the first principles of medicine is, “First do no harm”.  As a pediatrician working with children with obesity, and undoubtedly being aware of the statistics involved in long term success, and presumably being intimately knowledgeable of the trials and tribulations of adolescence and weight bullying, I cannot fathom her willingness to put these children in what I see as true harm’s way.

And I'm not alone in my professional concern.  I reached out to Dr. Rebecca Puhl, the Director of Research at Yale University's Rudd Center for Food Policy and Obesity and one of the world's foremost expert in weight stigma.  Here concerns echo mine, 

"Contestants on the show make themselves very vulnerable to judgment and criticism from the public (not to mention some of the trainers on the show), and are under considerable pressure. To put youth in this situation is putting them at risk, especially when we consider the frequent bullying that has become a reality for many adolescents who are overweight or obese.",

Dr. Stasia Hadjiyannakis, a pediatric endocrinologist, principal investigator at the Children's Hospital of Eastern Ontario's (CHEO) research institute, and the medical director of CHEO's Center for Active Living, is also concerned,

"I worry that participation in a program like this will be further stigmatizing for kids who are overweight or obese- making them feel that their life can only get better after weight loss- which is untrue"

Last week on my personal blog I wrote more extensively about why I felt the children's inclusion was anathema to a physicians duty to protect their patients, and despite a tweet from Dr. Dolgoff 5 days ago suggesting that she wanted to engage in further discussion (perhaps tellingly sent at nearly 3:00am in the morning along with literally dozens of other tweets to folks who like me had expressed their concerns about children on the show,all of which having since been deleted from her timeline), I have yet to hear from her as to why she doesn’t see the inclusion of children as showpieces in a prime-time weight loss spectacular as putting them at an unjust risk of harm.

In terms of doing something about it - while there is a petition circulating to keep children off The Biggest Loser (and if you’re concerned too I urge you to sign), I wonder whether or not a Biggest Loser’s advertisers’ products boycott might have a greater impact - and if you’re game, you can head over here to read more about it.  

The Biggest Losers shouldn’t be the children.

Yoni Freedhoff, M.D., is the founder and Medical Director of the Bariatric Medical Institute in Ottawa, Canada.

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