Fit for TV: The Reality of The Biggest Loser. A Review.
Most people don’t know this but in addition to my work as a clinical psychologist who specialises in eating disorders, body image and weight stigma, I also work as a consultant psychologist for reality television productions, having served on over 16 seasons so far. I watched the new documentary Fit for TV: The Reality of The Biggest Loser with both professional and personal interest (though note that I have never worked on this particular show - nor would I if it were ever revived!).
The documentary pulls back the curtain on one of the most infamous reality shows of the 2000s - and what it reveals is deeply troubling. For many of us working in the eating disorder and body image fields, the findings come as no surprise, but it’s still confronting to see the harm laid bare.
Abuse Disguised as Entertainment
The Biggest Loser was, at its core, abusive and dehumanising. Contestants were mocked, shamed, and pushed to extremes, all in the name of entertainment. The very format of the programme reinforced the idea that larger bodies are inherently shameful and must be punished into submission.
The producers openly admitted that they did not want (to use their words) “happy and fat” contestants. Instead, they selected individuals who were struggling - many of whom we may presume would be already living with the pain of weight stigma, shame, trauma, or eating disorders. This was a deliberate choice to maximise emotional vulnerability and on-screen breakdowns.
In my own experience of screening participants for reality television, those with certain psychological vulnerabilities were removed from casting pools - and I can only hope that The Biggest Loser employed similarly rigorous screening processes to safeguard contestants’ wellbeing.
Physical and Emotional Health Risks
I’ve personally seen contracts that contestants are asked to sign - pages of waivers that protect producers and networks from liability. This means that even when participants are placed in unsafe or emotionally harmful situations, the showrunners are insulated from accountability. That’s the backdrop against which The Biggest Loser operated.
On shows like Survivor, there are obvious physical risks - heatstroke, dehydration, injuries in challenges. But those risks are transparent, and viewers understand them as part of the game. What disturbed me about The Biggest Loser was that the risks were disguised as “health interventions.”
The physical and psychological risks of this particular show were immense. Contestants endured severe food restriction and punishing exercise regimens - conditions that mirror restrictive eating disorders. One former contestant even spoke about developing an eating disorder as a direct result of their time on the show. Another contestant developed a life-threatening case of rhabdomyolisis (a condition that occurs with overexercise, where damaged muslce fibres break down and leak toxins into the blood stream, risking kidney failure).
Even when the show’s resident doctor attempted to set minimum calorie levels for health and safety, his efforts were reportedly undermined by the trainers. In one case, Jillian Michaels allegedly gave her team caffeine pills - a dangerous move that could have increased cardiovascular risk.
Meanwhile, “temptation” challenges placed calorie-dense foods in front of contestants who were already in states of intense physiological deprivation. The cruel irony: these challenges exploited the biological drive to eat when starved, and framed it as a personal weakness.
Fatphobia on Display
The production wasn’t just negligent - it was fatphobic. The editing and camera work often mocked contestants’ bodies. In some scenes, the camera literally shook with each footfall, creating the illusion that the earth itself was quaking under their weight. This wasn’t subtle - it was bullying disguised as humour. The show perpetuated damaging fatphobic stereotypes, strongly implying that people in larger bodies are “lazy, greedy, and unloveable”. Racist stereotypes were also perpetuated on the show.
Lasting Damage to Metabolism
One thing I was glad to see included in the documentary was a reference to a critical piece of research conducted on former contestants. The study found that the rapid weight loss contestants underwent had irreversibly slowed their metabolisms, making weight regain not only likely but inevitable. For example, someone who weighs 120kg (about 265 lbs) after losing 50kg (110 lbs) would have to eat significantly less than another person who weighs 120kg without prior weight loss.
In other words, the body interprets rapid weight loss as a state of famine and fights back by slowing energy use. This makes long-term weight maintenance extremely difficult, even when people are eating carefully and exercising. The result is not a personal failure, but a biological response - one that can leave individuals feeling trapped in cycles of weight loss and regain. Add to this the impact of weight loss on increasing hunger (ghrelin) hormones and reducing fullness (leptin) hormones, and an increased likelihood of binge eating developing.
This finding shatters the myth that weight loss is purely a matter of “discipline” or “choice.” Instead, it highlights how dangerous crash dieting and overexercise can be - damaging the very systems meant to sustain life.
Dignity in the Midst of Exploitation
Despite the harms of the reality show itself, the documentary gave space to the voices of former contestants. They were thoughtful, articulate, and often deeply compassionate - not only toward themselves but also toward others who had shared the experience. Their reflections highlighted resilience in the face of public humiliation and the strength it takes to reclaim your story after being reduced to a stereotype on national television. Many spoke with honesty and vulnerability about the lasting impacts of the show, without bitterness, and with a clear commitment to helping others understand the harm caused.
Transparency
One thing I respected and appreciated was that interviewees (former contestants of The Biggest Loser) were candid about their slimmer figures when appearing in the documentary. Their smaller physiques could easily have been misinterpreted by viewers as evidence that extreme weight loss is sustainable long-term. Thankfully, several participants were candid about using GLP-1 medications (such as Ozempic), ensuring transparency and avoiding the perpetuation of misleading narratives about diet and exercise alone. They did not have to disclose this personal health information, but I’m relieved they did.
What We Can Learn
For clinicians, advocates, and anyone concerned about body image and health, Fit for TV reinforces lessons we already know but must continue to repeat:
Weight stigma is harmful and never motivates sustainable wellbeing.
Extreme dieting and exercise place individuals at risk for both physical and psychological harm.
Bodies are not entertainment props, and people living in larger bodies deserve dignity, care, and respect.
Most importantly, the show reminds us of the urgent need to disentangle health from size. Weight is not a measure of worth, and punishing the body into submission is never a path to wellbeing.
Final Thoughts
Every reality format carries risks - whether it’s the emotional toll of rejection (e.g. The Bachelor, MAFS), the physical dangers of endurance challenges (e.g, Survivor), or the vulnerability of being judged on creative work (e.g., Project Runway, RuPaul’s Drag Race). But The Biggest Loser was unique in how it cloaked abuse, trauma, and disordered behaviours in the language of “health.” That’s what made it so insidious - and why this documentary is so important.
Watching the documentary, I was reminded again of how essential it is that we, as a society, stop equating thinness with success.