Why The Biggest Loser uses CT scans to help contestants lose weight

Originally published in MedPage Today

by Cole Petrochko

The train wreck has become an integral part of reality TV programming, and that’s terrible. As much as I’ve learned on the internet about the “Snooki Punch” fiasco from MTV’s Jersey Shore, there’s little to watching a household of adults thrown together under a wacky premise turn into overgrown, throat-seeking children under lights and a camera, except on the one-season CBS show Kid Nation, where the contestants were actual children. But I digress.

Why The Biggest Loser uses CT scans to help contestants lose weight The train wreck has become a motivating force of good for the NBC reality program Biggest Loser. For those who avoid any and all reality shows, Biggest Loser pits overweight contestants against each other to lose the most weight through an intense, physical trainer-regimented diet and exercise plan for cash prizes, healthy living, and a boosted sense of self esteem.

One of the highlights of the show is when the show’s medical consultant, Rob Huizenga, MD, and associate professor of medicine at UCLA, performs a CT scan on contestants and creates a visual of the individual’s muscle-to-fat ratio, as well as a chronological age to “body age” comparison. This early segment of each season is arguably the turning point for most contestants, who often appear shocked and deeply saddened by their cross-section and seem genuinely motivated to undo the damage seen in their visual report.

While this method of inducing change is all well and good when you’ve signed a contract and are on nationally syndicated television, a recent study from Cochrane Database of Systematic Reviews recorded changes in patient health behavior in several clinical and non-clinical conditions through the use of visual feedback, like on Biggest Loser.

The study included 1,371 patients who received either intervention for tanning practices by way of ultraviolet photography to highlight UV-related skin damage or needed help to quit smoking and were shown arterial scans for assessing cardiovascular risk. The results, even between the two different patient groups, were mixed.

Two out of three smoking cessation groups showed a significant change in behavior after the visualized intervention showed off the artery damage they’d incurred after smoking, a pooled odds ratio of 2.81 (95% CI 1.23 to 6.41, P=0.01). Additionally, in a non-clinical population group showing off patients’ skin damage from tanning, two of the four trials showed significant results. One group that used tanning beds showed a 1.10 mean reduction in use (95% CI 1.90 to 0.30, P=0.007). Conversely, a group that tanned in the sun showed a significant INCREASE in time spent intentionally sunbathing by a mean of nearly a half hour (95% CI 0.04 to 0.86, P=0.03).

One of the major caveats of this study is that, while the end result of changing a negative behavior remained constant between groups, the behavior receiving intervention was not constant. You can’t relate smoking to tanning, and even in the tanning condition, some used artificial tanning while others used solar power.

However, in the smoking trial at least, a more-than-half affirmative response was recorded across the three groups, while it may be less apparent what immediate detrimental effects tanning will have short of extremely detailed skin imaging. Not too bad when there’s only health and no $250,000 cash prize to gain at the end.

Cole Petrochko is staff writer at MedPage Today and blogs at In Other Words, the MedPage Today staff blog.

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