Does the new 'Biggest Loser' documentary only add credibility to GLP-1 drugs?

A few thoughts from a former personal trainer.

More than six million Americans are now on Ozempic or a comparable GLP-1 drug, per a study by FAIR Health. It represents a 600% increase over six years and this figure is expected to rise dramatically over the next decade.

If this figure seems shocking, I challenge you to look around your social circle and see how many you know taking the drug. I know of at least five people taking it, despite my network being relatively small.

Each person on the drug has lost substantial weight, one woman going from weight 250 lbs to 160 lbs in only one year. Case after case like this is happening across the country. As these stories spread, public attention is shifting on how lasting weight loss can actually be achieved.

With the recent release of a troubling documentary about hit TV show, The Biggest Loser, which examines outcomes of contestants years after the fact,  it may further normalize the use of these weight loss drugs—for one important reason.

The contradiction of weight loss

The mass use of GLP-1 drugs, which dramatically reduce hunger, ostensibly challenges traditional thinkers on weight loss, who have long heralded diet and exercise as the most reliable and proven way to lose weight.

And I’ll admit, I fell into this camp for many years, in part because of my time as a personal trainer in my younger years. I spent hour after hour coaching, motivating, and doing everything I could to help people improve.

Yet, despite all this effort, so many clients still struggled with the yo-yo effect of weight loss. It felt like, if I wasn’t there to train and coach them, looking over their shoulder, the weight inevitably came back. I found it extremely frustrating and disheartening.

I eventually realized that, for some people, long-term weight loss feels like an insurmountable wall. Consequently, they resign themselves to a life of obesity and largely gave up on the fight.

The recent release of Fit for TV: the Reality of The Biggest Loser was incredibly revealing. The show featured contestants, many of whom were obese, all competing on teams to see who could lose the most weight over the course of the season.

The show featured scene after scene of red-faced contestants, struggling to maintain a brisk pace on an incline treadmill, gritting their teeth as they lifted heavy bags of sand, doing partial push-ups, all while their bodies near-buckled under their own weight. It was a struggle many of us identified with.

The immediate outcomes were undeniable. Most contestants saw dramatic drops in overall BMI, losing hundreds of pounds and looking unrecognizable by the end of the season. As their waists shrank and jawlines began to appear, their confidence grew. Their faces had more color and vitality. It was inspiring.

Their progress was celebrated in boisterous and shiny filmed ceremonial weigh-ins, with cheering crowds. Weight loss held this near religious importance.

Sadly, as the recent documentary, revealed, these results did not stand the test of time: 13 of the first 14 contestants had regained all of their weight, or more.

But — and this is a big but — the show also featured contestants from myriad seasons after that. Most of the contestants who managed to stay substantially thinner were on some variation of GLP-1 drugs. So many contestants, who had access to the best nutritionists, training and guidance for months, were unable to sustain all they’d learned and lost.

Yet — a simple weekly injection vastly outperformed these results over time. Which should speak volumes.

Why it matters now

As a decade-long health and wellness writer, I’ve written about GLP-1 on several occasions over the years and, without fail, there’s always a swathe of comments deriding the use of the drug, calling it problematic, cheating, or, perhaps fairly, criticizing the side effects.

Yes, the drug can lead to nausea, digestive issues, abdominal pain, and even vomiting. But what I think many people miss — is the tradeoff that’s being made. For many, this isn’t merely a cosmetic decision.

My friends on GLP-1 drugs have been able to dramatically reduce (or altogether stop) use of their blood pressure and cholesterol medications. They have much more energy and move their bodies more now. For context, all of these friends spent a majority of their adult life overweight, with a few brief intermissions during health kicks that didn’t last. Going to the beach, pool, or any outing that involved showing skin was a non-starter for many of them.

I find it understandable that people are jarred by the mass use of this medication across our society. It might feel slightly dystopian to imagine the entire population injecting themselves weekly, like some type of cyber-human, who needs their weekly dose to function. But the results don’t lie.

In 2024, the obesity rate stopped growing for the first time in decades. Even further, epidemiologists estimate that 40,000 lives per year could be saved if these drugs were made more affordable and accessible across the country.