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					The Biggest Loser - Professionals Give thier View on the Reality Show                                    http://www.ideafit.com/fitness-library/weighing-in-on-the-biggest-loser


             Weighing In On The Biggest Loser
             By Amanda Vogel, MA

             This blockbuster reality show has ignited passionate reactions
             from fitness professionals and the clients they serve.




             Whether you love to watch The Biggest Loser or you find it offensive, you have to
             admit the primetime TV program has been effective in showcasing health and fitness
             to millions of people around the world.

             Here’s how it works: The hit reality show assembles people who are moderately to
             morbidly obese for a once-in-a-lifetime chance to get in shape, lose lots of weight fast
             and win cash. Contestants who drop the fewest pounds each week are subject to
             possible elimination. The objective for contestants—besides drastically changing their
             bodies and lifestyles—is to be among a handful of players still in contention for the
             quarter-of-a-million-dollar prize; the finalist who is literally the biggest loser at the
             season finale wins.




             Everything about this show is big. Produced in 25 countries and airing in 90 countries,
             The Biggest Loser franchise has morphed into a lifestyle brand that includes books,
             DVDs, video games and even protein powder. Close to 12 million viewers tuned into
             NBC’s season 7 finale earlier this year. With season 8 airing in September, The
             Biggest Loser is gaining more fans, more attention and more momentum. And this
             has some fitness professionals seriously sizing up the show. Is its portrayal of health
             and fitness helping our industry, or harming it? Industry experts and The Biggest
             Loser insiders weigh in.

             Where’s the Progression?
             For fitness pros, perhaps the most memorable segments of The Biggest Loser are the
             workout scenes. You might see contestants sprinting on indoor cycling bikes, doing
             plyometric jumps or hustling across the gym while piggybacking a trainer. Scenes
             such as these have some fitness experts worried that the previously sedentary
             contestants endure too much intensity, too soon.

             Jonathan Ross is one such fitness pro. “There seems to be little concern for
             biomechanics, and many contestants who clearly have been avoiding even the
             simplest forms of activity for years are now doing explosive, full-body plyometric
             exercises. There is simply no sound reason for doing this,” says Ross, a 2009 IDEA
             Personal Trainer of the Year finalist and personal training director for Sport Fit Total
             Fitness Clubs in Bowie, Maryland. “Speed is only appropriate when you’ve mastered
             the basics of movement. Many of the contestants on that show have no business
             jumping or doing explosive exercise.”

             Pete McCall, MS, is a San Diego–based exercise physiologist with the American
             Council on Exercise (ACE), who creates and delivers fitness education programs for
             ACE. He agrees that the basic principles of exercise progression appear to be missing.
             “There seems to be no rationale for exercise program design. Clients are pushed to
             their limits, which places them at risk of injury and overtraining. From the episodes I
             watched, there was no mention of how to design an effective, efficient workout,” says
             McCall.

             Going into the specifics of program design or the underlying principle for doing this or
             that exercise might be fine for a sports-training show, but The Biggest Loser is
             primetime television, says Mark Koops, co-creator and one of the executive producers
             of The Biggest Loser. The average viewer tunes in to be entertained and hopefully
             inspired to live a healthier lifestyle. From the standpoint of ratings, quick cuts of
             red-faced contestants doing sprinting intervals on treadmills is more compelling than
             long takes of the steady-state cardio that contestants do most of the time. And even
             with its indulgent 2-hour timeslot, The Biggest Loser can broadcast only a fraction of
             what goes on at “the ranch” or “on campus,” two terms that refer to the property
             where contestants live, eat and exercise for most of the show’s production.
             Background material gets shifted around and edited out. Bob Harper—one of the
             show’s two resident personal trainers—confirms that viewers at home don’t see the




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         vast majority of what goes on between the trainers and contestants on the ranch.

         “First, contestants have to get used to moving their bodies and getting comfortable in
         their own skin,” says Harper, who resides in Los Angeles. “At the beginning,
         contestants walk on a treadmill and walk the Presidential Mile, which is a flat surface
         outside. They step up on a 6-inch platform before they jump it or try higher steps.
         There’s definitely a progression in everything we do—but in fast-forward.” And “fast-
         forward” it is. These “clients” aren’t working out just three or four times a week for an
         hour at a time, like most folks do. Dropping pounds is a full-time job for The Biggest
         Loser contestants, and exercise is practically their sole responsibility on campus. As a
         result, says Harper, “their fitness capacity increases considerably in a short amount of
         time.” Given that contestants work out for 4 or 6 hours a day, it’s not surprising that
         they advance more quickly than the average client.

         Despite the extreme amount of time contestants devote to exercise during the show’s
         production, some fitness experts wonder about safety. In fact, contestants are
         sometimes shown doing progressions that trainers might never teach to the majority
         of their clients. “My perspective is that the exercises and workouts are much too
         challenging, given the contestants’ rudimentary level of fitness and overall health
         status,” says Diane Raymond, founder of Blue Sky Gym in Dublin, Ohio, who has
         worked as a personal trainer for more than 10 years. “I understand they are
         monitored closely by physicians—or so we are led to believe by the disclaimer posted
         at the end of the show—but the impression it gives viewers who may not know better
         is that a morbidly obese person should be able to hop on a treadmill and perform an
         all-out sprint, or jump up onto a balance trainer that is placed on top of a plyo
         platform!”

         The Biggest Loser presents a unique situation that does not compare to an everyday
         training environment, says Koops, who confirms that doctors monitor the contestants
         every week and medical staff are on-site with the trainers at all times. “The trainers
         are working with contestants on a daily basis to make sure their health is obviously
         the first priority,” says Koops.

         That’s not quite how Laura Gideon, MS, sees it from her experience watching the
         show. In addition to being a personal trainer and an exercise physiologist, Gideon
         co-owns Bamboo Balance LLC, a fitness, Pilates and aquatics company in Los Angeles.
         “The participants come in deconditioned, grossly overweight and completely without
         knowledge of exercise. They are then forced into hitting the ground running,
         ‘literally,’” says Gideon. “This is dangerous TV.”

         Ali Vincent—the Phoenix-based winner of The Biggest Loser season 5, who is now a
         spokesperson for 24 Hour Fitness— reports that she did not literally hit the ground
         running when she first set foot on The Biggest Loser campus. “We start out very, very
         slow,” she says. “I started walking on a treadmill, 1 minute on and 1 minute off, at
         what I thought was high intensity—and it was like 2.6 [miles per hour]. At the time, it
         was the fastest I’d ever walked in my life. It was hard.” Vincent says she ran at high
         speeds only for short bouts—such as 30 seconds or 1 minute. “And that was at the
         very end when I was extraordinarily healthy compared to the beginning,” she says.

         While contestants aren’t doing wind sprints and plyometrics when they first arrive at
         the ranch, they are encouraged to work out vigorously from the get-go. However,
         “vigorous” for the drastically out-of-shape contestants might be a slow to moderately
         paced walk on flat terrain or a minor incline. In the process, Harper says contestants
         progress on more than just a physical level. “In the beginning,” he says, “exercise
         feels like Mount Everest [for these contestants]. Then a month later, they can do it
         and laugh, saying, ‘I can’t believe I couldn’t do this a month ago.’ If you watch the
         show, you see the progression of self-esteem.”

         The progression of self-esteem is apparent, even if the details of exercise progression
         are not. Still, the lack of insight about what happens before contestants run fast or
         jump high leaves some fitness pros uneasy. No one wants sedentary clients—obese or
         not—to think exercise is something they can’t handle even from square one. “The
         main objective, given the nature of the contest, is to burn up lots of calories.
         Exercises chosen to that end make sense,” says Ross. “But we don’t see enough of
         how the workouts are put together to see if there is even any design to the workouts
         or if it is just a random collection of movements thrown together for that day.” In
         response to members of the fitness industry who question whether there is rhyme or
         reason to the barrage of exercises shown on The Biggest Loser, Koops says, “There is
         a method behind whatever madness they may perceive. It’s not just thrown together,
         I can assure you.”

         What’s With the Last-Chance Workout?
         Exercise design and progression may be dealt with mostly off-camera, but the
         grueling exercises that get air time are a main attraction. These exercises are mostly
         shown during a segment called the “last-chance workout,” which is the final exercise
         session before contestants weigh in for the week. The last-chance workout is one
         last-ditch effort to zap as many calories as possible and avoid potential elimination
         from the show.

         During these segments, many contestants perform the kind of aggressive exercise
         that is typically reserved for athletes. Some of the industry sources interviewed for
         this article referred to certain exercises shown on The Biggest Loser as “exotic,”
         “far-fetched,” “bizarre” or “unnecessary.” According to Scott Pullen, MS, a fitness and
         nutrition specialist with dotFIT and a master instructor for the National Academy of
         Sports Medicine, the show’s training methods “fly in the face of what, hopefully, most
         responsible trainers would do.”

         “The extreme methods employed on The Biggest Loser appear to pay no
         consideration to the structural or physical abilities of the contestants,” says Pullen. A
         number of fitness experts interviewed for this article assert that the exercises are too
         difficult and complex for most contestants’ skills and abilities. They’re wrong, says
         Harper. “Contestants are able to do [them],” he says. And just because you see one
         contestant performing a particular move doesn’t mean they’re all doing it or doing it
         to the same degree. For example, a contestant with particularly strong legs might be
         encouraged to do plyo jumps at a higher level than other contestants. And some
         contestants might not do plyo jumps at all. “There are no blanket workouts on The
         Biggest Loser,“ says Harper.

         However, even if contestants can do the exercises, some fitness pros think form is
         sometimes sloppy. “Seventy-five percent of the workouts and exercises are great,”
         says Jim Willett, a personal trainer in Toronto, Ontario, and owner of FABS™
         CyberFitness™. “They are probably similar to how any good trainer would train their




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         clients. The other quarter of the time, however, I question what I see. It’s not the
         exercises; it’s who’s performing them. Form and technique occasionally seem to get
         thrown out the window. I believe, as a trainer, you shouldn’t get ahead of your
         clients; you shouldn’t have them doing exercises they can’t properly perform. I
         realize it makes for better TV to show the struggle, but anything can be modified,”
         says Willett, who has appeared as a featured trainer in a Canadian reality show about
         weight loss, called X-Weighted.

         And The Biggest Loser contestants are by no means immune to injury. In season 7,
         for example, one young woman was sent home with a stress fracture along her
         pelvis. To that end, some fitness pros wonder why any of the obese contestants do
         potentially high-risk and high-impact activity. “I’m appalled at times by some of the
         things I see being said and done to individuals who have obvious risk issues,
         orthopedic concerns and many other considerations to contend with,” says Amy
         Bomar, an ACE faculty master practical trainer, and the owner and education director
         of FIT Launch, a fitness education and training studio in Snohomish, Washington.

         “I have seen the contestants attempting exercises that are more appropriate for
         collegiate and professional athletes than for the general population, much less
         someone who likely has a slew of risk factors that place them in a higher risk
         stratification,” says Raymond.

         “Some contestants do go to a place that only an athlete can go to,” says Harper. “It’s
         the triumph of the spirit.” Take Helen Phillips as an example. The Sterling Heights,
         Michigan, resident won season 7 after losing 54.47% of her body weight. “I never
         thought I could run fast or do interval sprints the way I did,” Phillips says. “I am so
         proud that I accomplished that. I think sometimes you need someone to push you.
         That’s how I lost the weight.”

         “We want to be safe,” says Harper, “but we do push boundaries.” Part of a trainer’s
         role is to inspire and motivate clients to do their best, but how do you avoid
         overstepping boundaries in the process? “It’s intuitive,” says Harper, who has been a
         trainer for 20 years. “You know how far to push. It’s an instinct; a good trainer
         assesses the situation and the client.”

         Phillips says she was never pushed past her ability when she trained with both Harper
         and Jillian Michaels, the other trainer on the show. “Our health and welfare was their
         main concern, so [the exercise] was never something we couldn’t handle,” she says.
         (Phillips and Vincent say the trainers were also diligent about ensuring contestants got
         adequate rest and nutrition to counterbalance all the “amped up” activity.)

         Even though the last-chance workout looks “crazy” and animated for the purposes of
         TV, it’s just a sliver of reality. Viewers at home don’t know the background behind
         exercise selection. “There is an art and science to training, and we all practice our art
         in different manners,” says Jay Dawes, MS, director of education for the National
         Strength and Conditioning Association in Colorado Springs, Colorado. “Before one can
         fully evaluate the safety and effectiveness of any training program, you have to see
         the entire picture and not just a snapshot.” It’s similar to someone walking past your
         boot camp or a training session. That person doesn’t know why you chose a given
         exercise for your client(s) at that moment. “The trainers on this show have far
         greater insight into the current health status, abilities and skills of the contestants
         than the public,” says Dawes. “Thus, they may use some techniques that would
         otherwise be considered more aggressive in certain populations.“

         Still, some extreme techniques just don’t make sense, ever, according to McCall. “I
         was appalled at the positions [trainers] placed themselves in with some of the clients
         —between the client’s legs or kneeling on a client’s back. These are completely
         inappropriate actions for a fitness professional. Trainers can provide an overload to a
         client through other methods,” he says.

         Why the Yelling?
         Like the last-chance workouts, the relationships between contestants and the two
         trainers are intense. Tune into most recent episodes of The Biggest Loser and you are
         bound to witness a trainer swearing and/or yelling at contestants. “Screaming and
         yelling in a negative manner wouldn’t fly with paying clients,” says Willett. It’s not
         just the yelling that has some fitness pros raising eyebrows; it’s also the perception
         that what’s being said is intimidating. “Making a person feel badly about his or her
         effort, mental/emotional status or progress is not a strong motivator, and it gives
         trainers a bad rap if viewers think this is how all of us behave with clients,” says
         Raymond. (True, some drill-sergeant-type boot camp trainers have a reputation for
         shouting at clients.)

         “It does get crazy in there because we all feel so passionate about what we are
         doing,” says Harper. “There’s a purpose for it if I yell at anyone, and there’s an arc to
         the yelling. We are in a situation where it’s a matter of life and death for the
         contestants, and sometimes they are looking for the easy way out. We are not
         beating them down emotionally—it’s about building up their self-esteem.”

         Trainer Jillian Michaels, in particular, has been criticized by some fitness pros for
         what’s perceived as her “bullying” style with contestants. For example, on YouTube,
         there’s a clip from season 6 of Michaels shouting at two contestants on treadmills: “So
         unless you faint, puke or die, keep walking,” she says. IDEA requested an interview
         with Michaels for this article, but she declined due to a busy schedule. However,
         Phillips, who trained closely with Michaels, had this to say: “Jillian knows how much
         you can give of yourself. She can read you like a book. [And when she yells], it
         makes you move! She wants you to succeed,” Phillips says.

         Harper says he doesn’t scream at his “regular” clients in a “regular” gym. The Biggest
         Loser campus is simply a different atmosphere. Whereas a “real-world” trainer might
         see a client up to a few times a week, The Biggest Loser trainers are in constant
         contact with the show’s contestants. Harper says he and Michaels are not on campus
         just for the 3 or 4 shoot days per week. They are there 6 days per week, assisting
         contestants with everything from training to nutrition to behavior changes. Both
         trainers keep lines of communication open with contestants from past seasons, as
         well.

         “If we scream, it’s because we care,” says Harper, “maybe too much.”

         “Being a trainer is tough,” says Pullen. “At some point a trainer is called upon to take
         on the role of psychiatrist, best friend, enemy, motivator, evil dictator and other
         varied personae. It is not necessarily right that it should be that way, but it is. I would
         say that the trainers on the show obviously do a great job of building relationships




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         with contestants, as they are able to influence their eating, exercise habits and
         behaviors.”

         Regardless of how much time the show’s trainers spend with contestants or how much
         they might care about them, some fitness pros could do without the yelling. According
         to them, you just don’t threaten, yell or swear at clients. “The Biggest Loser trainers
         may be great, horrible or something in between,” says Ross, who writes “TV Trainer
         Watchdog Blog,” where he posts his thoughts about the show. “But until we see them
         conducting themselves in a similar fashion to personal trainers, we can’t really call
         them trainers. They are really Mean Camp Counselors at the world’s most watched
         fat camp.”

         What About Public Perception?
         In addition to the yelling, fitness pros who question what they see on The Biggest
         Loser are most concerned with what messages the show sends to the general public.
         “I believe [the show] sets unrealistic expectations for many people who have a large
         amount of weight to lose,” says Bomar, a 17-year veteran in the fitness industry.
         “The show encourages such an effort to see such substantial reward (15-pound weight
         loss in a week) that it really discourages many individuals from exercise.” Since
         contestants strive to lose 5, 10, 15 or more pounds per week, Gideon adds that the
         show makes it seem as if losing 1 or 2 pounds per week (which is a safe
         recommendation) is worthless. However, Pullen doesn’t share that worry. “I would
         like to think that most viewers are smart enough to know that it is simply not realistic
         to expect that degree or rate of weight loss,” he says.

         “The positive message that [the show] sends is that weight loss is possible through
         hard work and behavior modification,” says McCall. “The negative message that is
         communicated is that exercise has to be extreme. In reality, the exact opposite is
         true: at least 30 minutes of daily physical activity along with proper nutritional habits
         can have a significant impact on long-term health and weight loss.”

         However, The Biggest Loser relies on more immediate results to keep it compelling.
         “The contestants are not people who are looking to lose 1, 2 or 3 pounds per week.
         They need to lose 100, 150, 200 pounds. It’s hard for them to stay motivated if they
         don’t see rapid change,” says Koops, who estimates that about 50% of contestants
         keep to their goal weight after the show, another 25% keep off a significant amount
         of weight and a final 25% “struggle. “We’ve never claimed it’s a magic pill,” he says.

         Regardless, fitness consumers may adopt weighty expectations, and most trainers
         lack the on-site resources and/or desire to achieve the highly motivating weight loss
         results seen on the show. “The contestants on The Biggest Loser, at least while at the
         [ranch], have trainers, support and time that allow them to get a lot of physical
         activity. The trainers can oversee all aspects of their exercise training, so it is able to
         work for them. My greatest concern is that everyone sees this on TV and thinks that
         this is the only way to do it—like boot camp,” says John M. Jakicic, PhD, FACSM,
         director of the Physical Activity and Weight Management Research Center at the
         University of Pittsburgh. “For some, starting with this level of intensity and dose is
         simply not the best approach given their physical conditions, which in my opinion
         means that this may send an unreasonable message to the general public. Moreover,
         there is no need to exercise to the point of getting sick, which is a common theme of
         The Biggest Loser approach,” says Jakicic.

         McCall says the show has the potential to teach its contestants and audience about the
         components of well-rounded exercise—but fails to do so. “The Biggest Loser doesn’t
         focus on teaching clients how to create a comprehensive exercise program but instead
         tries to throw as much stress on the body as possible in order to create short-term
         losses,” says McCall. However, Harper disagrees. “How sad if I, as a fitness
         professional, only focused on the results of the show,” says Harper. “This is an
         opportunity to help contestants change their lives. I tell them the small picture is the
         show, and the big picture is what they do when they go back home.”

         While Gideon feels the show is guilty of “marginalizing a segment of the population
         based on appearance,” Harper says the show does the exact opposite. It offers hope
         to a segment of the population that is largely under-represented on TV—and in the
         fitness industry, for that matter. “I get a lot of e-mail from people who are inspired
         by the show,” says Harper. “They see the contestants, who are just like them, and it
         brings validation to their lives.”

         “Ultimately,” says Pullen, “I think the show does a good job at getting the point across
         that people need to take responsibility for their health and that eating better and less,
         combined with consistent, challenging physical activity, can keep weight and health in
         check.”

         “I can understand why The Biggest Loser is a popular show,” says Raymond. “Seeing
         contestants transform their appearances, gain confidence, conquer difficult tasks and
         change their lives can be inspirational and motivating, especially for the sedentary/
         obese individual sitting on the couch wondering, ‘If they can do it, maybe I can too.’
         But I think it sets an unrealistic expectation for what healthy weight loss is, and it also
         creates an image that all trainers are like Bob and Jillian—loud and mean.”

         Whether you perceive Bob and Jillian as loud and mean or motivating and caring, one
         thing is certain: the enormous popularity of The Biggest Loser casts a bright light on
         the benefits of exercise and proper nutrition to a worldwide audience. In that sense,
         says Willett, the show’s been wonderful for our industry. “It’s given personal training
         more exposure than it could have wished for,” he says.

         What’s the Fitness Industry’s Responsibility?
         Moving forward, then, what can we do to extend the inspiration that is so clearly a
         trademark of The Biggest Loser to our own communities, gyms, clients and fitness
         classes? You don’t have to agree with all the show’s tactics—or even any of them—to
         use it as an opportunity to reach out to prospects and clients who need sound
         fitness/weight loss advice and guidance. The show is popular partly because the
         physical and emotional results that contestants achieve are very inspiring to a great
         many people. For example, The Biggest Loser’s involvement with Feeding America’s
         Pound For Pound Challenge has inspired viewers at home to pledge to lose a collective
         3.5 million pounds (at press time) while helping to fight hunger across the U.S.

         For the most part, people who watch The Biggest Loser probably already know in
         basic terms that exercise is good for them and poor eating habits are bad for them.
         After all, educational resources to help people exercise or eat better are aplenty. Yet,
         the obesity epidemic continues to be a problem. Maybe people could use a stronger




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         shot of inspiration. The Biggest Loser and its trainers provide that, whether you agree
         with the show on a professional level or not. Ultimately, primetime television is
         concerned with the “bells and whistles” that make for exciting TV. So perhaps it is
         better to have clients who watch the show come to us for what is actually feasible
         versus not coming to us at all because they would rather sit on the couch all day.

         According to Koops, the central tenet of The Biggest Loser is to inspire people to live a
         healthy, active lifestyle—with no excuses—and with the idea that it is never too late.
         “If the show has one legacy,” he says, “it would be to help everyone get active and
         healthy whether it’s at a gym or with a personal trainer or by doing fitness classes.”

         Lo and behold, it appears we are all on the same page, at least enough for it to
         matter. So what about learning from each other and perhaps working in tandem to
         some degree? Maybe then we can all “win big” in our efforts to inspire more people to
         enjoy healthier lives.

         SIDEBAR: The Biggest Loser Trainer Certifications
         Editor’s Note: During the research and writing of this piece, the author collected the
         following information from the NBC website about the certifications held by the show’s
         trainers.

         Bob Harper

             American Fitness Training of Athletics (AFTA)
             Aerobics and Fitness Association of America (AFAA)

         Jillian Michaels

             AFAA
             National Exercise & Sports Trainers Association (NESTA)

         The author’s efforts to confirm these certifications included the following steps:

             The author made contact with AFAA eight times (seven phone conversations or
             voicemails and one e-mail) but did not receive confirmation about certifications
             for either trainer.
             AFAA president Linda Pfeffer provided the following comment through AFAA media
             relations representative Tom Ivicevic: “AFAA encourages and supports both
             formal education and training in physical fitness and entertainment programming
             based on sound fitness principles and techniques. However, AFAA does not
             comment on products and services offered by others unless we find it appropriate
             to do so in our own publications.”
             NESTA responded after one phone call to confirm that Michaels has held a valid
             NESTA personal trainer certification since 2004.
             In a conversation with the author, Harper personally confirmed that he is AFTA-
             and AFAA-certified, and that these certifications are current.
             An e-mail from Michaels’s publicist on June 17 confirmed that Michaels was once
             certified by AFAA, but that the certification is no longer current (as of our press
             deadline).

         SIDEBAR: Obese People’s Attitudes Toward The Biggest Loser:
         An Australian Study
         A qualitative study published in Obesity Management journal explored study
         participants’ attitudes and opinions of The Biggest Loser series in Australia. The
         researchers conducted in-depth interviews with 76 men and women in Victoria,
         Australia, whose average age was 47 and mean body mass index was 42.5. Forty-two
         percent of participants were classified as obese, and 57% were classified as morbidly
         obese. Here are some general findings from the research.

             Thirty-five participants watched the show because they identified with the
             contestants’ personal struggles; 13 participants watched the show for education
             and information about weight loss.
             The majority of participants (54 people) thought the basic concept of the show
             was negative. Some participants felt the show was “offensive.”
             The majority of participants (51 people) thought the show’s core approach to
             weight loss—using healthy eating and exercise to lose weight—was good.
             Thirty-one participants said the show “promoted weight loss techniques that the
             majority of people living with obesity could not access or afford.”
             About a quarter of participants (20 people) said the show’s emphasis on rapid
             weight loss was “a dangerous message for all members of the community and
             went against advice given to them by health professionals.”

         Source: Thomas, S., et al. 2007. Cheapening the struggle: Obese people’s attitudes
         towards The Biggest Loser. Obesity Management, 3 (5), 210–15.

         Amanda Vogel, MA, holds a master's degree in human kinetics and is a certified
         fitness professional in Vancouver, British Columbia. In addition to being an IDEA
         presenter and a fitness book author, she owns Active Voice, a writing, editing and
         consulting service for the fitness industry. Her articles have appeared in Prevention,
         Shape, Health and SELF. Reach her at www.ActiveVoice.ca,
         http://FitnessWriter.blogspot.com or www.twitter.com/amandavogel.

         References
         Hill, J.O. 2005. Is The Biggest Loser really a big winner or just a big loser? Obesity
         Management, 1 (5), 187–88.

         NBC. 2009. www.nbc.com/The_Biggest_Loser_5/about/bob.shtml
         (www.nbc.com/The_Biggest_Loser_5/about/bob.shtml) ; retrieved Apr. 28, 2009, and June 22,
         2009.

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