An Open Letter to Dr. H from the “The Biggest Loser”

Dear Dr. Huizenga,

I am the founder of BariatricPal, the world’s largest online community for weight loss surgery patients and potential patients.

I am writing to you today regarding your role as an expert on “The Biggest Loser.” I am asking you to please stop publicly portraying weight loss surgery in a negative light without any explanation. Most recently, during the Season 16 Finale, you stated that losing weight using methods used on the show were far healthier than turning to weight loss surgery. The implication was that bariatric surgery is under no circumstances the best choice for individuals struggling with obesity.

I am asking you to stop making comments like this. You and “The Biggest Loser” have a significant amount of influence on America. The season finale attracted 5.4 million live viewers, with untold millions watching the show at a later time. Given that one-third of American adults are obese, it is almost certain that many viewers have obesity.

“The Biggest Loser” reaches out to this audience throughout the show. Contestants, trainers, and health experts like yourself directly address viewers who need to lose weight, offering encouragement and tips. As you know, positive gestures like this can motivate people to change their lives.

Unfortunately, the derogatory comments about bariatric surgery can have just as much impact, but in a negative way. Your statement at the Season 16 finale of “The Biggest Loser” and similar ones make weight loss surgery sound like a shameful, dangerous, and ineffective choice in all cases, with no further explanation.

According to the Weight-Control Information Network (WIN), 4% of men and 8% of women in the U.S. have extreme obesity (BMI over 40). That translates to about 20 million American adults who are potentially eligible for weight loss surgery. This figure does not include the approximately 60 million Americans whose BMIs are between 30 and 40, and who might be eligible for surgery due to the existence of a co-morbidity.

Not all of these individuals are eligible for and interested in weight loss surgery, but many are. BariatricPal alone, for example, has a quarter-million members who are weight loss surgery patients or who are considering surgery.

For weight loss surgery patients, your comments can be hurtful. Weight loss surgery is not the “easy way out.” It is a tool to help control food intake. Eligibility criteria include a requirement that patients be committed to the strict dietary changes necessary to lose weight after bariatric surgery. I and millions of other weight loss surgery patients who have successfully used weight loss surgery as a tool against obesity worked hard to get where we are today. We do not deserve for you and your colleagues to suggest that we have cheated to lose weight.

Comments that groundlessly condemn weight loss surgery can harm potential patients just as much if not more. Eligible candidates might decide not to get the surgery in part because of your position. First, your comments can lead to a feeling of shame for even considering bariatric surgery to fight obesity. This is unjust, since the post-surgery diet is strict and requires a lifetime of attention, just as “The Biggest Loser” contestants must modify their own diets for the rest of their lives to maintain weight loss.

Secondly, your comments on the show seem to imply weight loss surgery does not work. While there are patients who do not respond to surgery, and complications are always a threat, the scientific literature overwhelmingly agrees that weight loss surgery is a viable option for the treatment of morbid obesity.

Furthermore, the scientific community largely agrees that weight loss surgery can improve health and metabolic parameters. To varying degrees, methods such as gastric bypass, adjustable gastric band, and gastric sleeve have been linked to improvements in diabetes and other obesity-related conditions, such as hypertension, sleep apnea, and dyslipidemia. The UK’s healthcare system, known as the National Health System or NHS, is so convinced of bariatric surgery’s effectiveness, safety, and cost savings potential it covers bariatric surgery procedures.

Unconditionally stating that weight loss surgery is the wrong choice is particularly unfair given that “The Biggest Loser” contestants do not always achieve or maintain their goal weights. An article on Today.com, which is owned by NBC, looked at initial, finale, and current weights of selected contestants from the first 11 seasons of the show. Of the 56 contestants they highlighted, 20 were within 10 pounds of their finale weights, and 8 had gained back at least 40 pounds since the finale.

These results are impressive but not perfect. And, “The Biggest Loser” is not for everyone. So far, only hundreds of individuals have been lucky enough to have the opportunity to lose weight on the show. For a few others, losing weight at one of the Biggest Loser resorts is an option – but not a practical one for most people. At $3,000 per week, it could take $50,000 or $100,000 or more to reach goal weight, not including time out from work and life.

Weight loss surgery may be the only practical choice for people who have work and family obligations, and who live within a budget. People struggling with obesity do not choose weight loss surgery because they think it will be easy. They choose it because they have no other choice. Nothing else has worked for them. For me and hundreds of thousands of other weight loss surgery patients, it worked.

Because of this, I ask you again to please stop publicly attacking weight loss surgery without explanation. You and I and everyone else who is connected to obesity knows what a terrible disease it is. We should join forces in fighting it. Let’s work together to get the greatest possible number of people healthy, and not work against each other with derogatory and divisive comments.

Thank you for all of your hard work and commitment to fighting obesity. You have established yourself as one of the most influential health experts in obesity, and I hope you will use your voice in a positive way. Thank you for considering this.

Sincerely,

Alex Brecher

Founder, BariatricPal