Taking on 'The Biggest Loser' Doctor’s Criticism

Editor’s note: This is the seventh installment in an ongoing Next Avenue series about one Minnesota man’s lifelong struggle with obesity and what he’s learned since deciding to confront it through weight-loss surgery. Find earlier posts here.

This morning, the scale smiled on me: down 100 pounds from the time of my initial consultation with a bariatric surgeon in May of 2014. A triple digit loss. Only eight pounds from goal, at which time the goal will move lower.
 
So why am I so cranky?
 
Maybe because I watched the finale of The Biggest Loser on NBC last night.
 
Don’t get me wrong. I congratulate Toma Dobrosavljevic for his amazing weight loss from 336 pounds to 165 pounds in what is portrayed as six months.  
 
I’m a fan of the show. I find inspiration in many of the contestants’ stories and connect with the struggles that brought them to the show. I marvel at the raw physicality of the workouts shown on television. The workouts make my time on the elliptical each day look mundane. But perhaps most helpful for me in my weight-loss journey is the show's emphasis on staying positive and the importance of believing in yourself.  
 
(MORE: Opting for Weight-Loss Surgery in Midlife)
 
But I'm cranky because the show's expert medical doctor, Robert Huizenga of Beverly Hills, a proponent of what he calls an exercise-centric weight-loss approach, went negative on weight-loss surgery when he congratulated third place finisher Rob Guiry, saying: "You did it in a safe, effective manner, much better than those distasteful weight-loss surgeries that everybody wants to turn to." 
 
Distasteful weight-loss surgeries? Really, doctor?
 
The Realities of Struggling For Your Life
 
I could quarrel with the show's weight-loss methods. The Los Angeles Times in 2012 described Huizenga’s Biggest Loser approach as a combination of moderate calorie restrictions combined with four hours of exercise per day.

(MORE: The 8 Big Excuses that Kill Your Motivation to Exercise)
 
And I could point out some comments from former contestants who criticize their Loser experience and report significant weight gain after they leave.
 
I could point out that losing weight in a controlled environment like the fitness ranch on the show with access to doctors, trainers, psychologists, nutritionists and countless other support people is not realistic for the vast majority of people who are obese. But we all know The Biggest Loser isn't realistic. It is reality television, which is not reality.
 
But I am thrilled for those who find success on the show and those who find inspiration in it. The overall message is positive. The trainers emphasize positive thinking. The contestants achieve amazing results. 
 
But Huizenga's on-air dismissal of weight-loss surgery as an option for people struggling for their health — their lives in fact — is untenable. 
 
I called Huizenga today, the day after the season finale, to better understand why he said what he said. At first, he was strident in defense of his comment, but after thinking further he moderated his statement. “Weight-loss surgery is distasteful as a first choice,” he told me. “It’s a great second choice, but it’s sad that it’s a first choice in this country.”
 
Criticism Focused On Risk
 
During our interview, the doctor said that his approach relies on two and a half hours of exercise per day, “90 minutes in the morning and an hour after work.” He viewed this as possible for people who work and have children. He also disagrees with the government’s view (supported by, among others, the Mayo Clinic) that 20 to 30 minutes of daily exercise is adequate. 

(MORE: Walking 20 Minutes a Day Might Save Your Life)
 
“Personally, one-half hour a day is not fitness,” he told me.
 
Huizenga limited his comments about weight-loss surgery to the gastric bypass procedure, which until recently has been the most popular form of weight-loss surgery. He specifically did not comment on the gastric sleeve (the procedure I had) or the lap-band (a surgery that is declining in popularity because of long-term studies regarding its effectiveness). Both the sleeve and the lap-band are thought to have lower complication rates than gastric bypass. 
 
His criticism of the surgery focuses on its risks. He points out that his exercise-centric approach with 300 contestants on The Biggest Loser has resulted in no deaths, making it far safer than weight loss surgery. He also claims his exercise-based approach will produce a higher amount of muscle mass than weight-loss surgery, resulting in a better long-term outlook for participants in his program. And he says participants who lose weight with his approach have a better outlook from a mental health perspective.
 
150,000 People Choose Surgery Each Year
 
Huizenga also said that if he were to receive half of the money that is paid for bariatric surgery to implement his approach on a large scale he could replicate results similar to weight-loss surgery with far fewer complications, and that the government won’t fund a study to compare his approach to weight-loss surgery.
 
Yet, for those of us who have struggled mightily for years and come face to face with our morbidity because of weight, surgery is viable option, and 150,000 people choose it each year. I now personally know dozens of people who have achieved successful weight loss through surgery after all other methods failed.  
 
It's working for me. Did I mention I'm down 100 pounds?
 
I told Huizenga about what led me to my weight-loss surgery. He cautioned me to not be too optimistic, warning that the first two years after surgery are the easiest and that dark days may be ahead for me. I couldn’t help but think his advice was unnecessarily negative, just like his comment during the finale.

That comment, by the way, appeared to be rehearsed, given the number of times he used the word "distasteful" during our interview. For me, the hardest part is that Huizenga and bariatric surgeons have the same mission: to help people gain a healthier, happier life.

More than seven million people watched finale. That's a powerful platform for Huizenga to tout his approach and to launch an attack on a different one. I endorse a reasoned discussion about a variety of methods for weight loss, ranging from old-fashioned diet and exercise, to exercise-centric plans, to liquid diets and weight loss surgery. Our goal  should be encouraging the factions within the medical weight loss community to draw closer. But that's not what happened in Huizenga's sound-bite moment on The Biggest Loser finale. It seemed to be a very made-for-television comment, but not medically appropriate.

I admire those who find success through diet, exercise or whatever method they choose. I applaud the contestants on The Biggest Loser. Yet, Huizenga’s words last night on television, coming from a person in a position of influence given to him primarily through a TV show, were — well — disappointingly distasteful.