A woman adjusts a physician scale.
Discouraged by the news about “The Biggest Loser” competitors gaining back the pounds? Don’t be. Slow and steady can still win the weight-loss race. (For Spectrum Health Beat)

As competitors on NBC’s “The Biggest Loser,” they fought hard and lost tremendous amounts of weight. But their bodies fought back.

Now, six years later, many of the contestants from Season 8 of the extreme-weight-loss TV show have regained a significant amount of the weight they lost during the seven-month program. Four of them are even heavier today than when their intense dieting and exercise regimen began.

What makes it so hard to keep the pounds off?

Researchers blame the biology of obesity.

In a study funded by the National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases, scientists followed 14 of the 2009 “Biggest Loser” contestants, tracking their body weight and metabolism over the long term.

Results of the study have just been published in the journal Obesity, and even the authors seemed surprised by what they found.

A double whammy

The researchers already knew that when people lose weight, their metabolism typically slows down, so they burn fewer calories.

“The body is aware of the fact that you’re taking in less calories, and it kind of resets your calorie burn ratio,” said Jon Schram, MD, a bariatric surgeon with Spectrum Health Medical Group, who is not connected with the study.

“That’s a very real phenomenon that occurs in the body,” he said.

The study’s big discovery was that, over time, the contestants’ metabolisms never bounced back—in fact, they got even slower. So participants wanting to maintain their post-“Biggest Loser” body weight had to slash their calorie intake even further.

For example, Danny Cahill, the Season 8 winner, now has to eat 800 fewer calories per day than a typical man his size, according to a report published in The New York Times. He has regained more than 100 of the pounds he lost on the show.

“It was as if their bodies were intensifying their effort to pull the contestants back to their original weight,” the New York Times article said.

Not only that, but the study also found that the participants’ massive weight loss led to a drop in leptin, the hormone that suppresses hunger, so they never felt full.

This double whammy—a slowing metabolism and a drop in leptin—goes a long way toward explaining why the pounds piled back on for all but one of the 14 contestants in the study.

Researchers hope these new insights will eventually lead to new treatments for people struggling with obesity.

What works in real life

What does this mean for people today? What should you do if you want to lose a lot of weight and keep it off?

Jessica Corwin, MPH, RDN, is a community nutrition educator for Spectrum Health Healthier Communities. She says slow and steady wins the race—and “Biggest Loser”-type diets set people up for failure.

“I’m not a big fan of ‘The Biggest Loser’ because it’s just so extreme,” she said. “It’s not realistic for anybody. When contestants go home, they just can’t maintain that lifestyle.”

When it comes to long-term weight loss, she added, a balanced lifestyle approach is really what works … “versus a program like this, where you’re basically shocking your whole system.”

Dr. Schram couldn’t agree more.

“Everything about that program is not reflective of normal life,” he said. “Once (people are) done with the program, they tend to go back to their normal existence and the weight seems to creep back up.”

Instead of being distracted by made-for-TV approaches, patients should focus on what works in real life, Corwin and Dr. Schram both said.

Here are a few of their expert tips:

  1. Get support—Find a dietitian who can create a food plan that’s tailored to you and is based on your preferences. “There’s no one-size-fits-all approach,” Corwin said.
  2. Make your plan structured but not rigid—Goals and guidelines are helpful, Corwin said, but inflexible food rules are counterproductive.
  3. Have frequent contact points—Be accountable to someone and touch base regularly so you stay on track with your plan.
  4. Eat more whole foods—When you eat plant-based foods, your body has to work harder to digest it, Corwin said, “and that in itself will start to boost your metabolism.”
  5. Use lean protein to curb hunger—“Protein has this unique ability to stabilize your blood sugar,” which keeps carb cravings at bay, Dr. Schram said. Examples of good proteins include lean meats, nuts, Greek yogurt, cottage cheese, skim milk and other low-fat dairy products.
  6. Make physical activity part of your life—Anytime you’re moving, you’re burning more calories. Plus, physical activity boosts your mental health and reduces your stress hormones. High stress hormones tell your body to hang onto fat, particularly belly fat, Corwin said.
  7. Try a fitness app—Free applications like MyFitnessPal can help people keep themselves accountable in their exercise and food intake. “It can be a really good tool and certainly eye-opening,” Corwin said.
  8. Don’t let your emotions control your food decisions—“Emotional eating is the No. 1 reason that we gain weight or regain weight,” Corwin said.
  9. If you’re morbidly obese and can’t lose weight, consider bariatric surgery—“With our surgery we’re giving patients a tool that will allow them to diet more effectively,” Dr. Schram said. In addition, the sleeve gastrectomy and gastric bypass surgeries reduce a patient’s levels of leptin and ghrelin, two hunger-related hormones, Dr. Schram said, so people don’t feel hungry all the time. Bariatric surgery is part of a multidimensional approach that also includes identifying the root cause of a patient’s obesity, nutrition education and addressing any related psychological issues.

In the end, the message to people with an unhealthy body weight is to take it one step at a time.

“Focus on finding your one small change—the one thing that you can focus on today,” Corwin said. Once you’re successful at that, take another small step and build it into your lifestyle. “That’s really what we have found is what works for our bodies.”