When too little is too much

But few were celebrating on Twitter. “I feel like Rachel lost too much,” one woman wrote. Another posted, “There needs to be a red line that disqualifies finalists for too much weight loss.”

Kai Hibbard, a finalist on Season 3, was at her home in Alaska when another former contestant sent her a message. “Have you seen tonight’s winner?” it read. “NBC is about to have a public-relations nightmare.” When Hibbard pulled up Frederickson’s photo, she burst into tears.

“Rachel doesn’t know what damage she has done to her body and her mind, and sadly she won’t until the spotlight goes away,” said Hibbard, 35, who seven years ago lost 118 pounds during her competition but has since spoken out publicly against the show’s extreme dieting and exercise regimen. “I feel I did a disservice by not saying on television the night of my finale, ‘I’m sad, and I’m sick from being on this show’,” she said, recalling that her hair had begun falling out from a vitamin deficiency. “I should have walked off the set. The only difference between Rachel and me is she looked on the outside the way I was feeling on the inside, totally unhealthy.”

Two days after the finale, NBC and the production company, Shine America, issued a statement saying: “We support Rachel and all of The Biggest Loser contestants. We remain committed to helping contestants achieve healthy weight loss and healthier lifestyles, and to inspiring viewers.”

In a conference call, Frederickson attributed her weight loss to workouts, saying “she takes maybe three, four classes a day.”

Since the show aired, two of the trainers addressed Frederickson’s drastic weight loss. Dolvett Quince, who worked with her, wrote in part on his Facebook page, “Rachel’s health is and always has been my main concern, and her journey to good health has not yet ended.” Bob Harper said, “What people don’t understand is when contestants leave home… they are in charge of themselves.”

But Hibbard recorded in detail in a daily journal the unhealthy behaviour she and others practised on the ranch, particularly 24 hours before a weigh-in. Contestants, she says, dehydrated themselves through excessive workouts in warm clothing, drank only coffee because it acts as a diuretic and ate little to nothing.

Jennifer J Thomas, an assistant professor at Harvard Medical School and co-director of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital, believes The Biggest Loser is teaching wrong dieting behaviours. “If a person you knew was working out six hours a day and eating a very restricted calorie diet, you would be worried they had an eating disorder,” said Thomas, who is also co-author of the book Almost Anorexic.

For her part, Frederickson said, “I’ve never felt this great.” But most of the hundreds of comments on her Facebook page echoed this post: “Rachel, I love you, but please, for us, get medical help.”