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Obese participants in ‘Biggest Loser’ TV show showed metabolic benefits

NEW YORK (Reuters Health) – Participants in the NBC reality program “The Biggest Loser,” who exercised vigorously, not only benefited from significant body weight reduction but also had a substantial and rapid reversal of some serious health conditions, the medical advisor to the show told Reuters Health.

The consultant, Dr. Robert Huizenga, from UCLA in Los Angeles, CA, who is also a former team physician for the Los Angeles Raiders, told Reuters Health that this aggressive and intense approach to weight loss in morbidly obese individuals is more effective, safer, and far less expensive than Roux-en-Y gastric bypass.

Unfortunately, he said: “America just hasn’t embraced this approach, and until it does, it’s going to be difficult because such an intense regimen definitely requires a team approach. We need doctors, psychologists, nutritionists who really understand calorie counting, and we need a sports medicine team because when you do an aggressive medical exercise program, you have to be prepared for potential injuries.”

In Philadelphia last week at the 21st Annual Scientific and Clinical Congress of the American Association of Clinical Endocrinologists, Dr. Huizenga and his team reported on the metabolic and blood pressure effects of the intense exercise and moderate caloric restriction regimen in the Biggest Loser contestants who took part in the program’s seasons 11, 12, and 13 between May 2011 and March 2012.

The contestants all did four hours of daily exercise, which included one hour of intense resistance training, one hour of intense aerobic activity, and two hours of moderate aerobic activity, in addition to moderately limiting their caloric intake to 70% or less of their estimated resting daily energy expenditure.

This regimen virtually reversed diagnostic criteria for pre-diabetes, diabetes and hypertension as early as the 5th week, despite the discontinuation of numerous related medications, according to the research team.

The participants in this study included 17 males and 18 females, whose median age was 40 years (range, 26 to 54). Twenty-eight participants were Caucasian, four were African American, and three were Latino. Their mean weight at entry into the program was 143 kg (i.e., 315 lb; range 113 to 173 kg, or 249 to 381 lb). The mean BMI was 46 kg/m2.

Seventeen of the participants had normal glucose tolerance, 12 had pre-diabetes, and six had type 2 diabetes mellitus, including three who were taking metformin.

At the initial physical exam, 30 participants had hypertension and were taking a total of 24 separate antihypertensive drugs.

By the end of 24 weeks, participants had lost a mean of 31.9 kg (70 lb; p<0.0001). Their percent body fat decreased from 48.9 to 30.4 (p<0.0001).

Blood pressure declined significantly by week five. Mean systolic blood pressure went from 138 to 123 mmHg (p = 0.005), and mean diastolic pressure went from 90 to 76 mmHg (p <0.0001); these pressures remained stable throughout the assessment period.

Significant improvements in fasting glucose, insulin, and adiponectin were seen almost immediately and by week 24, HbA1c levels had reduced by 0.53% (p=0.0003).

By the fifth week, all diagnostic criteria for prediabetes, diabetes, and hypertension were absent in each participant, despite discontinuation of all diabetes and antihypertensive medications.

Dr. Huizenga said he was gratified to see these results.

He added that people have to go to the edge of their abilities to glean such benefits. “People think they can just walk every day but as you get in shape you have to do harder and harder. Really, 90 minutes a day first thing in the morning before people go to work will do them a massive benefit and probably get them 50% of the way to what we do on the TV show, and maybe more.”