The past couple of days there have been a storm of tweets and news articles related to the outcry regarding the weight and appearance of the most recent winner of The Biggest Loser, Rachel Frederickson. Many people are saying that she appears to be anorexic or unhealthy at best. I don't know and won't comment on if Frederickson is anorexic. Why? Because I only know her weight and her appearance and eating disorders are not diagnosed on these two criteria. For what it's worth, according to the numbers presented on the show, Frederickson now has a BMI that puts her in the 'underweight' category. Although the use of BMI as a measure of health is limited, at best, being underweight is actually considered more dangerous than to be overweight.
I do have a multitude of thoughts about the show and it's been somewhat of a challenge to organize them coherently as I could get on a soapbox for a while. I think that I may have watched one episode during one of the initial seasons and was so dismayed by it that I haven't watched it since. So, in case you're like me and you don't know exactly how the show works, here it is in a nutshell: Essentially, fifteen contestants stay at a ranch where they work with trainers for a period of 3-4 months (I couldn't find the exact timeline) and then return to their homes where they lose weight for another 6 months and then return for the finale. Over the course of the show, contestants are sent home, but can achieve 'immunity' by losing the most weight each week. The final winner is determined by who loses the most weight, by percentage, since the beginning of the show. It is my understanding that the method of weight loss is drastic calorie restriction and exercising up to six hours per day.
One former contestant, Kai Hibbard, from the third season of the show has spoken out and has said that being on the show triggered an eating disorder for her. In an interview, Hibbard recounts how physicians on the show recommended an electrolyte supplement but that trainers encouraged the contestants to "throw it out" because it would result in water retention (and higher weights). She also reports that, "the lighter I got during that T.V. show, the more I hated my body." I suspect that she's not the only one. I'd also venture that because of the complicated relationship many of these contestants have with food and weight, that some may have already had an eating disorder before the show began.
Other than the obvious disordered behaviors such as calorie restriction and over-exercise, I also think it is worth pointing out that weight is the only measure of 'health' seen on this show. Although certainly some of the contestants have grown larger than their genetics alone would have dictated, there is no mention of their blood pressure, cholesterol or other measures of health. Were these contestants actually unhealthy before they began the regimen? Did these measures of health actually improve over the course of the show? For those who used food as a coping mechanism, do they now have other ways to cope with life's stresses? What is their relationship with food and their bodies like now? My guess is that none of the answers to these questions would make for a successful television show.
It is extremely troublesome anytime that people are willing to sacrifice their health (both physical and mental) in the name of weight loss. Although I am glad that Americans are finally reacting negatively to this show, I worry that Rachel Frederickson's appearance is only the tip of the iceberg.
Flegal, K., Kit, B., Orpana, H., & Graubard, B. (2013). Association of all-cause mortality with overweight and obesity using standard body mass index categories: A systematic review and meta-analysis. Journal of the American Medical Association, 309(1). 71-82.