Drugs in the News: After ‘The Biggest Loser,’ Their Bodies Fought to Regain Weight

Contestants lost hundreds of pounds during Season 8, but
gained them back. A study of their struggles helps explain
why so many people fail to keep off the weight they lose.

Danny Cahill stood, slightly dazed, in a blizzard of confetti as the audience screamed and his family ran on stage. He had won Season 8 of NBC’s reality television show “The Biggest Loser,” shedding more weight than anyone ever had on the program — an astonishing 239 pounds in seven months.

When he got on the scale for all to see that evening, Dec. 8, 2009, he weighed just 191 pounds, down from 430. Dressed in a T-shirt and knee-length shorts, he was lean, athletic and as handsome as a model.

“I’ve got my life back,” he declared. “I mean, I feel like a million bucks.”

Mr. Cahill left the show’s stage in Hollywood and flew directly to New York to start a triumphal tour of the talk shows, chatting with Jay Leno, Regis Philbin and Joy Behar. As he heard from fans all over the world, his elation knew no bounds.

But in the years since, more than 100 pounds have crept back onto his 5-foot-11 frame despite his best efforts. In fact, most of that season’s 16 contestants have regained much if not all the weight they lost so arduously. Some are even heavier now.

Yet their experiences, while a bitter personal disappointment, have been a gift to science. A study of Season 8’s contestants has yielded surprising new discoveries about the physiology of obesity that help explain why so many people struggle unsuccessfully to keep off the weight they lose.

Kevin Hall, a scientist at a federal research center who admits to a weakness for reality TV, had the idea to follow the “Biggest Loser” contestants for six years after that victorious night. The project was the first to measure what happened to people over as long as six years after they had lost large amounts of weight with intensive dieting andexercise.

The results, the researchers said, were stunning. They showed just how hard the body fights back against weight loss.

“It is frightening and amazing,” said Dr. Hall, an expert on metabolism at the National Institute of Diabetes and Digestive and Kidney Diseases, which is part of the National Institutes of Health. “I am just blown away.”

It has to do with resting metabolism, which determines how many calories a person burns when at rest. When the show began, the contestants, though hugely overweight, had normal metabolisms for their size, meaning they were burning a normal number of calories for people of their weight. When it ended, their metabolisms had slowed radically and their bodies were not burning enough calories to maintain their thinner sizes.

Researchers knew that just about anyone who deliberately loses weight — even if they start at a normal weight or even underweight — will have a slower metabolism when the diet ends. So they were not surprised to see that “The Biggest Loser” contestants had slow metabolisms when the show ended.

What shocked the researchers was what happened next: As the years went by and the numbers on the scale climbed, the contestants’ metabolisms did not recover. They became even slower, and the pounds kept piling on. It was as if their bodies were intensifying their effort to pull the contestants back to their original weight.

Mr. Cahill was one of the worst off. As he regained more than 100 pounds, his metabolism slowed so much that, just to maintain his current weight of 295 pounds, he now has to eat 800 calories a day less than a typical man his size. Anything more turns to fat.

‘A Basic Biological Reality’

The struggles the contestants went through help explain why it has been so hard to make headway against the nation’s obesity problem, whichafflicts more than a third of American adults. Despite spending billions of dollars on weight-loss drugs and dieting programs, even the most motivated are working against their own biology.

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Dina Mercado at home with one of her sons, Jericho, in Commerce, Calif. CreditEmily Berl for The New York Times

BEFORE and AT FINALECreditLeft: Chris Haston/NBC Universal via Getty; Right: Trae Patton/NBC Universal via Getty

“It’s hard. The cravings are there.”

Dina Mercado

35, maintenance worker for Commerce, Calif.

WEIGHT Before show, 248 pounds; at finale, 173.5 pounds; now, 205.9 pounds

METABOLIC RATE Now burns 437.9 fewer calories per day than would be expected for a woman her size.

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Slimmer and Hungrier

Some scientists say weight maintenance has to be treated as an issue separate from weight loss. Only when that challenge is solved, they say, can progress truly be made against obesity.

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