The Biggest Loser… and Gainer

Biggest Loser 1

A few months ago the New York Times published an article discussing a study that examined the stuggles of “The Biggest Loser” contestants once they complete their stint on the show.  

Here’s the link to the full article: After ‘The Biggest Loser,’ Their Bodies Fought to Regain Weight

Their first example is Danny Cahill, the end of Season 8.  He began the season at 430 lbs and ended it at 191 lbs, for a loss of 239 lbs over the course of 7 months.

Here is his regimen as prescribed by the show went like this:

“…Mr. Cahill exercised seven hours a day, burning 8,000 to 9,000 calories according to a calorie tracker the show gave him. He took electrolyte tablets to help replace the salts he lost through sweating, consuming many fewer calories than before.

Mr. Cahill set a goal of a 3,500-caloric deficit per day. The idea was to lose a pound a day. He quit his job as a land surveyor to do it.

His routine went like this: Wake up at 5 a.m. and run on a treadmill for 45 minutes. Have breakfast — typically one egg and two egg whites, half a grapefruit and a piece of sprouted grain toast. Run on the treadmill for another 45 minutes. Rest for 40 minutes; bike ride nine miles to a gym. Work out for two and a half hours. Shower, ride home, eat lunch — typically a grilled skinless chicken breast, a cup of broccoli and 10 spears of asparagus. Rest for an hour. Drive to the gym for another round of exercise.

If he had not burned enough calories to hit his goal, he went back to the gym after dinner to work out some more.”

This is just nuts.  He exercised as much as some people work in a day.  I’m surprised that he didn’t develop tendinitis or some other over use injury from that much activity.  And just reading about his diet makes me hungry… he might as well have been just gulping down air and water.

Despite the ridiculousness of it all, he managed to win it all.  This was 2009.

In 2015 when he was re-evaluated he had re-gained 104 lbs to weigh 295 lbs.

Biggest Loser 2

More recent picture of Mr. Cahill from the NY Times Article

Unfortunately he wasn’t the only one.

“In fact, most of that season’s 16 contestants have regained much if not all the weight they lost so arduously. Some are even heavier now.”

The researcher who looked into this found that these changes were because the contestants metabolisms had slowed down.  This is a typical and expected finding.

The scary part is that this seemed to be a permanent… or at least long term change:

“What shocked the researchers was what happened next: As the years went by and the numbers on the scale climbed, the contestants’ metabolisms did not recover. They became even slower, and the pounds kept piling on. It was as if their bodies were intensifying their effort to pull the contestants back to their original weight.”

To make things worse, not only did his metabolism slow, it slowed more than expected!

“Mr. Cahill was one of the worst off. As he regained more than 100 pounds, his metabolism slowed so much that, just to maintain his current weight of 295 pounds, he now has to eat 800 calories a day less than a typical man his size. Anything more turns to fat.”

Sean Algaier was another contestant:

“Sean Algaier, 36, a pastor from Charlotte, N.C., feels cheated. He went from 444 pounds to 289 as a contestant on the show. Now his weight is up to 450 again, and he is burning 458 fewer calories a day than would be expected for a man his size.”

Not only did their metabolism slow, their hunger got worse too!

“They constantly battled hunger, cravings and binges. The investigators found at least one reason: plummeting levels of leptin. The contestants started out with normal levels of leptin. By the season’s finale, they had almost no leptin at all, which would have made them ravenous all the time. As their weight returned, their leptin levels drifted up again, but only to about half of what they had been when the season began, the researchers found, thus helping to explain their urges to eat.”

To Summarize:

After these contestants lost weight,

  • Their metabolism slowed down and did not recover even after 6 years
  • Their metabolisms were much slower than expected for their new size
  • Their hunger cravings worsened
  • Their hormonal milieu was all screwed up

This is pretty much the worst nightmare for anyone who has lost weight… and seems like a cruel prank played by biology.

As someone who has lost weight, I can attest that this is also one of my worst nightmares…. well since I work in healthcare I see nightmares all day long, so this isn’t so much a nightmare as it is just plain unfair.

The authors do qualify that this is a very small sample size, but it made me think of a few questions:

How did their microbiomes look before and after?  

We know that certain microbiome profiles are more associated with obesity than others and that drastic dieting and weight loss can alter the microbiome.  It’d be interesting to see what things looked like before and after.

I know I’m definitely not the first person to think of this, but it just seems intuitive that the rapidity of their weight loss must’ve played a big factor doesn’t it?

Mr. Cahill lost on average 8.53 lbs per week or 34 lbs per month!  This is the complete opposite of slow and steady, and seems like a pretty heavy shock to the system.  Maybe the degree of the shock is what caused things to go haywire.

Did they do any resistance training?

We know that resistance training leads to more muscle mass, an increased resting metabolic rate, and an improvement in hormones.  I couldn’t help but wonder if any of them lifted weights after in the 6 years since the show.

Maybe throwing around some iron… or stepping onto the mats for some BJJ could have prevented the weight re-gain.

What was their food quality like?

I wonder if they were eating a paleo/primal type whole food diet and if not, whether that would have helped.

If they went back to a standard american diet with processed foods, carbs, and sugars up the wazoo after 7 months of complete deprivation it might help to explain what happened.

What did their macronutrients look like?

Speaking of carbs, it’d be interesting to know if things would have been different if they ate low carb or ketogenic?

Especially since we know they must’ve had some degree of insulin resistance to have gotten so big in the first place.

Of course going low carb also doesn’t guarantee sustainable weight loss… see Jimmy Moore for example.

*Image from here.

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