The metabolism decline induces sense; a person who loses weight is smaller than they used to be, and so requires fewer calories to fuel their body’s processes. But the researchers note that the study participants had a resting metabolic rate that was about 500 calories lower than you’d expect based on their body composition and age. And in fact, over day, that metabolism kept get slower, particularly in people who maintained the most weight loss. This is because the participants started off at the highest weights( the average BMI was almost 50 ).

“We expect patients to have a reduction in their basal metabolic rate, ” said Dr. Holly Lofton, an assistant professor of medicine and the director of the medical weight management program at NYU Langone Medical Center. “This is congruent with other studies that have looked not only at metabolism but changes in hormones that affect appetite, longing for food and starvation in people who have lost weight from diet and exercise.”

One thing the study does exemplify, poignantly, is that weight problems are not simply a failing of will but instead a chronic medical condition. These “Biggest Loser” contestants have heart and drive in spades as they demonstrated on the depict, and if weight loss was merely a matter of self-control, they would have no problem maintaining it.

2. Re-gaining some lost weight isn’t necessarily a failure

If this crop of “Biggest Loser” contestants is representative of the entire alumni, the show’s intensive diet and exercise resources weren’t for naught: While all but one regained weight in the intervening six years, it was also true that 57 percentage of the 14 participants maintained at least a 10 percent weight loss , noted the study researchers. This is a significant amount of weight loss for anyone to sustain, but this number is all the more impressive considering that participants in this study started off with an average BMI of nearly 50.

Past research about other weight loss groups show that only about 20 percent of overweight people preserve at least a 10 percent weight loss after one year. Another analyse that followed up with weight loss participants eight years after an intense lifestyle change found that only 27 percent preserved a 10 percent weight loss.

“The good thing about[ “The Biggest Loser”] is that these individuals did manage to keep a significant amount of their weight off, ” said Aaron Roseberry, an assistant biology prof and a member of the Center for Obesity Reversal at Georgia State University. “Yes, they did gain weight back, but they are still lighter and ultimately healthier than when they started the show.”

True as that may be , not every physician agrees with the show’s techniques.

“From what I’ve watched of clips of the show, I have concerns about ‘the support’ — if you will — that is offered to the patients, ” said Lofton. “It seems at times to be punitive, which is not what I support when I try to induce weight loss in my own patients.”

3. We know that hormones control hunger cues, but there’s not much we can do about it right now.

The more weight you lose, the lower leptin levels get, leaving you hungry. The study notes that leptin levels in “Biggest Loser” participants plunged from a starting median of 41. 1 nanograms per milliliter to 2.6 ng/ mL at the end of the tournament. Six years later, those decimated leptin levels had recovered somewhat, but merely up to 27.7 ng/ mL.

Currently there are five FD-Aapproved medications on the market to aid in weight loss, but none of them is a replacement for leptin, one of the key hormones that make feelings of fullness. The New York Times notes that the pharmaceutical company Pfizer is conducting animal trials for a medicine that mimics leptin, but they’re still ongoing. If scientists achieve a replacement for leptin in people who have lower levels due to genes or weight loss, it would be an obesity gamechanger, says Lofton.

“If we had a medication that would help patients who have leptin inadequacies, that would be a breakthrough, ” she said. “And then for the rest of us, who lose weight and have lower leptin, it would be something that could improve our weight maintenance results.”

4. Obesity is a chronic condition that requires lifelong maintenance.

A few key components to help maintain weight loss include a new style of eating that you can stick to for life, a sustainable exert routine that doesn’t put you at risk of injury, at least seven hours of sleep a night and stress management strategies, said Morton. Finally, following up with a professional as you figure out your new life are crucial — at first on a monthly basis, and then down to quarterly sessions if you feel you’re get a handle on things.

It takes a village of medical professionals to help a person lose weight safely, says Dr. Lawrence Cheskin of the Johns Hopkins Bloomberg School of Public Health. But the work doesn’t end once you reach aim weight: Cheskin’s weight loss patients continue to check with their clinicians at least once a month for an extended period of time so that they can iron out any post-program bumps in the road.

“The more frequently you follow up with people, the better their opportunity of sustaining weight loss, ” he said. “As far as I know with ‘The Biggest Loser, ‘ when you’re done with the prove, you’re done.”

Dr. Robert Huizenga, the show’s doctor told HuffPost that contestants are invited to periodic conference calls with both him and the show’s nutritionist. Huizenga also said he began counseling contestants that they would be “metabolically different” after their weight loss starting in 2011, after the show’s own analyses revealed that metabolic slowing does occur in “Biggest Loser” contestants.

5. Perhaps we should focus on health and weight maintenance , not weight loss.

The danger in waiting to take action against weight gain is that your body’s weight control processes are like a thermostat, explains Roseberry. Define it too high( by gaining weight) and you run health risks of that temperature becoming your new normal. If the room manages to get colder( through weight loss ), that thermostat will kick down and work to get those temperatures up again.

“Your body actually opposes you to go back to that weight you were at, ” says Roseberry. And as “The Biggest Loser” study indicates, that “fight” can go on for at least six years.

It’s likely best to think about obesity as a something akin to high blood pressure, which can go down with the proper medications but will shoot back up if you stop taking the medication, Morton added. Or think of obesity in terms of cancer: it’s better to nip it in the bud when the problem is small, instead of stalling treatment and letting the tumor spread.

“Don’t let yourself get too far, ” Morton said. “If your BMI is about 30, it’s is high time to do something about your weight.”

While weight loss should be the goal if your BMI starts to reach unhealthy levels, even taking steps to maintain your weight achieves a great deal, because it avoids your body from getting are applied to that higher “set point” weight that could soon become its metabolic norm, Roseberry added.

“If we can find new ways to prevent more people from gaining weight and becoming overweight and obese, that would be a huge step forward, ” he said. “And if we can focus more on health parameters than weight per se, I think whatever you can do to help increase your overall health is more important than your absolute weight.”

6. Don’t lose hope.

It would be tempting to read the findings of the Obesity study and throw your hands up. If people who are the best at losing weight constitutes a threat to gaining it all back, what’s the phase?

But that would be the incorrect message to take away from the findings, said Morton. A full continuum of obesity care is right there, and these weight loss methods include dietary counseling, drug, temporary gastric balloons and bariatric surgery. The sooner you reach out for help, the more opportunity you have of losing the weight for good.

“If you do have an issue with your weight, please don’t await, and please don’t desperation, ” he concluded. “There’s a lot of answers out there that can help folks, and what this study proves is that people can be helped if they seek out therapy sooner and they have lifelong maintenance help.”