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Extreme weight loss like on reality shows is dangerous and counter-productive

HEALTH-OBESITY

Arthur cried when he realized he successfully dropped 20 pounds. He stood on the scale, faced his team and tearfully thanked his friends for their support.

His 20 pound weight loss wasn’t the result of a summer long exercise program. As a contestant on NBC’s “The Biggest Loser,” Arthur lost 20 pounds in one week.

Medical professionals recommend losing one to two pounds in order to avoid medical complications such as muscle loss or gall stone development. But contestants on reality programs are regularly losing massive quantities of weight in short time periods and many in the medical field are concerned.

“I think they’re awful, I really do. I tell my patients not to watch them,” said Jennifer Ventrelle, a registered dietician and certified personal trainer at Rush University Medical Center in Chicago.

“The Biggest Loser” and its spin-off “Losing it With Jillian” are just two of many weight loss programs Ventrelle advises her patients to avoid. MTV has introduced several weight loss programs such as “Fat Camp” and the 2011 “I Used to be Fat.”

On “I Used to Be Fat,” participants spend a summer losing as much as 90 pounds. In one episode, Gabriella, 18, lost 90 pounds by exercising several hours a day while eating a restricted calorie diet.

Exercising in excess while eating a restricted diet may produce interesting television but it can lead to medical problems in real life, Ventrelle said.

“These people are exercising five to six hours a day. That’s completely absurd,” Ventrelle said. “It’s dangerous to put people on such an extreme exercise regime.”

When denied adequate fuel, Ventrelle said the body can enter starvation mode in which it hoards fat. The metabolism slows and the body begins to break down muscle.

“If your body is starvation mode it will reach for your muscle stores before it reaches for fat store,” Ventrelle said.

Employing a low-calorie diet in an attempt to lose weight also deprives the body of calcium, iron, vitamins and minerals. Ventrelle said gallstones can develop as a result and bone density can diminish.

Dieters also using extreme exercise to lose weight are at risk for injury. Since the bones weaken in starvation, the body is more likely to suffer sprains or breaks.

“Their bones are already stressed from being so heavy and when you’re putting intensity on joints carrying so much weight then you run the risk of injury,” Ventrelle said.

Dieters copying reality weight loss shows are also at risk for quitting or regaining the weight, said Stephanie Vander Veur, a researcher with the Center for Obesity Research and Education at Temple University in Philadelphia.

“People come to programs like ours for and lose one to two pounds in a week and they’re disappointed; it sets up unrealistic expectations for the general population,” Vander Veur said.

Viewers have the satisfaction of watching participants on reality weight loss programs lose as much as 90 pounds in a one-hour program. Off-screen, the process can take up to two years.

“We’re asking them to burn 500 to 1,000 calories a day their either through exercise or reducing their caloric intake,” Vander Veur said.

For obese patients, Vander Veuer initially recommends burning calories through reduced caloric intake and adding exercise as part of a lifestyle change.

“Realistically most people don’t have time to exercise every day,” Vander Veur said. “The average is 100 calories burned per mile walked. If you’re asking someone to burn by walking five to ten miles per day, that’s not going to happen.”

Obese dieters may also be uncomfortable with excessive exercise and workouts may feel like punishments. Instead of attempting to log daily exercise hours, Ventrelle said new exercisers should start with one to two exercise sessions and work up to five 30 to 60 minute sessions per week.

“I recommend things that are going to be sustainable,” Ventrelle said. “Losing the weight is comparatively easy to keeping the weight off.”

Vander Veuer agrees and said weight loss researchers are struggling to understand how massive weight loss can best be maintained.

“How do we help people maintain weight loss? I don’t know if we know the answer. It’s a huge concern in the field,” Vander Veuer said.

Regaining weight does not only return a patient to the medical problems associated with obesity, but it also opens up new medical concerns connected to yo-yo dieting.

“I’ve seen that people go on these shows and gain their weight back, and that’s more damaging to your body. Yo-yo dieting damages your metabolism, stresses the heart and body organs,” Ventrelle said.

Weight gain — even if a slight one or two pounds — is presented as scandalous on weight loss reality programs. Contestants on “The Biggest Loser” are weighed in front of the full cast and often stammer apologies or promises to work harder.

“I can’t think of another way to make people feel more disadvantaged and shamed,” Ventrelle said. “Punishing and kicking them off the show for not maintaining an unrealistic expectation. I think it can damage someone’s self-esteem.”

(c) 2011, McClatchy-Tribune Information Services.

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