The Biggest Loser helps science understand weight loss extremes

Diet and exercise work together better than apart, and best in moderation, according to new research including contestant data from the reality television show "The Biggest Loser" and conducted by the National Institute of Diabetes and Digestive and Kidney Diseases. "The Biggest Loser" runs on NBC.

Eleven contestants from the television program were studied, during the course of a program that takes obese or overweight individuals and challenges them to reach healthy weights and BMIs over the period of a few months. Some have criticized the show for portraying unrealistic expectations and for being excessive in its intervention-style treatment of participants, but its supporters include fitness advocate First Lady Michelle Obama.

Simulations
Senior investigator Kevin Hall, PhD, analyzed data using a mathematical model of human metabolism, breaking apart diet and exercise separately to determine the attribution of effects experienced by participants, either to exercise or to diet.

Diet was thought to have a greater effect than exercise in the study results, with 65 percent of lost weight being fat and 35 percent being lean mass including muscle. While muscle loss could be attributed to diet, exercise can help reverse lean tissue loss and create muscle gain, though some muscle may still be lost under a strict diet regimen.

A secondary simulation determined that weight losses could be maintained with 20 minutes of vigorous daily exercise and a 3,000 calorie diet.

Risk populations
Although a doctor should be consulted before starting a strict diet or exercise regimen similar to "The Biggest Loser," those at risk for type 2 diabetes may want to make lifestyle adjustments to benefit their health. Patients who have been diagnosed with the condition may seek to buy Actos or other medications to alleviate their symptoms.

Over two-thirds of American adults are overweight or obese, and according to the Centers for Disease Control and Prevention, overweight and obese individuals may be at risk for coronary heart disease, type 2 diabetes, hypertension, dyslipidemia, stroke and a number of other conditions.

The study offers new insights into how exercise and diet interact to affect overall health systems, and may offer some relief to individuals who thought they had to exercise over an hour a day to see any results.