Although medical professionals unrelated to the program lament dubious practices, the show's medical consultant, Dr. Rob Huizenga, says it is indeed safe. The show's trainers and producers, however, acknowledge to the Times that unsafe practices can occur.
A special to air tonight will see more than 40 former contestants gather for a reunion. The winner of the program's first season, Ryan Benson, who lost 122 of his 330-pound starting weight, will be absent. He's back above 300 pounds but he thinks he has been shunned by the show because he publicly admitted that he dropped some of the weight by fasting and dehydrating himself to the point that he was urinating blood, the Times says.
A trainer from the show said Benson's use of dangerous weight-loss techniques represents the dark side of the program.
At least one other contestant has confessed to using dangerous weight-loss techniques, including self-induced dehydration. This season, two contestants were sent to the hospital.
"I'm waiting for the first person to have a heart attack," Dr. Charles Burant, a professor of internal medicine at the University of Michigan Health System, told the NYT.
"If we had it to do over, we wouldn't do it," Huizenga allowed. He was referring to a recent one-mile race that resulted in hospitalizations. "It was an unexpected complication and we’re going to do better," he said, adding "that challenge has changed a lot of the way we do things," including more closely monitoring contestants' body temperatures during exercise.
JD Roth, one of the show's executive producers, told the Times that while the show was extreme, "it needs to be extreme in my opinion."
Jillian Michaels, one of the two trainers who supervise contestants' workouts on the series, told the paper, "Contestants can get a little too crazy and they can get too thin." She said contestants are medically checked and disqualified if they are dehydrated or are found to be taking drugs or diuretics. "That is the worst part of the show," she said. "It's just part of the nature of reality TV."
Contestants are required to sign releases that stand out even in the waiver-intensive world of reality television, the Times says. The paper acquired a copy of one of the releases from a former contestant which says that "no warranty, representation or guarantee has been made as to the qualifications or credentials of the medical professionals who examine me or perform any procedures on me in connection with my participation in the series, or their ability to diagnose medical conditions that may affect my fitness to participate in the series."
Roth countered that the "standard release forms" are similar to those used "on any reality show" and added that the show's medical professionals had "appropriate qualifications and credentials."
"For some of these people this is their last chance," he added. "And in a country right now that is wrestling with health care issues and the billions of dollars that are spent on obesity issues per year, in a way what a public service to have a show that inspires people to be healthier."
The Times notes that contestants were reticent to discuss the behind-the-scenes workings of the show. After a reporter started contacting them for interviews, many received an email from a talent producer on the series reminding them that "serious consequences" could ensue if they ever talked to a reporter without the show's permission. To do so could subject them to a fine of $100,000 or $1 million, depending on the timing of the interview, according to the email, a copy of which the Times obtained.
The show's producers did provide an opportunity to interview several former contestants, but the interviews were conducted with an NBC publicist listening in, says the paper.