Mar 7, 2012

The ‘Biggest Loser’ eviction: a lapse is not a failure

Some important lessons about how to make health-promoting behavioural changes can be drawn from recent events involving the television show 

Melissa Sweet — Health journalist and <a href=Croakey co-ordinator" class="author__portrait">

Melissa Sweet

Health journalist and Croakey co-ordinator

Some important lessons about how to make health-promoting behavioural changes can be drawn from recent events involving the television show The Biggest Loser and a drunk contestant. So says Laurence Alvis, the CEO of Moreland Hall, an alcohol and other drug treatment and education service in Melbourne. *** When it comes to changing unhealthy behaviours, there is no quick fix Laurence Alvis writes:  A recent episode of Channel Ten’s ‘The Biggest Loser’ featured the removal of a contestant from the program for being drunk. The media coverage and public discussions that followed (for example,, have highlighted a general lack of awareness of the processes for making and maintaining significant changes to individuals’ behaviour. This needs to be addressed. Making any substantial life change (from diet and exercise to giving up smoking, alcohol or other drugs) is a difficult process, especially when under stress.  Lapses (such as that demonstrated by the removed contestant) are a natural part of this process which, while not desirable, can become powerful learning opportunities for people, if they are enabled to ‘get back on track’ after a ‘slip up’.  If people are unable to regain control (either on their own, or with support from others), it is likely that their temporary setback will turn into a full relapse to their previous patterns of problematic behaviour before they are able to consider trying again. This is the nature of the behavioural change process, a process that is well described in the Federal Government’s ‘never give up giving up’ TV ads.  It is difficult, inevitably involves setbacks and likely multiple attempts before long-term changes can be achieved. As appears to have been the case with Luke Stephens, the removed ‘Biggest Loser’ contestant, his alcohol misuse was just one of several factors that need to be addressed if his other lifestyle changes are to be sustainable.  Available evidence would suggest that his intoxication was an established strategy for coping with stress.  He is not alone. While there are less damaging (and more effective) ways of responding to challenging situations, alcohol and other drug use is a common response to stress – and indicator of related mental health concerns – at all levels of society (e.g. People’s lives are complicated.  Problematic behaviours do not occur in isolation but as part of a range of interrelated factors that contribute to any particular decision or act.  Changes in one area of someone’s life generally require others.  In drug and alcohol treatment we know that there is a genuine need for holistic approaches that enable mutually-reinforcing changes and more sustainable outcomes. Successfully changing behaviour takes time and practice.  It is not simply a matter of flicking a switch.  There are many options available to people to help support their endeavours, but there is no quick fix, no magic cure. All too often, a lapse is seen (by individuals and those around them) as a sign of failure, weakness or lack of commitment.  While for some, this attitude may help to strengthen their resolve to ‘do better’ next time, for many it simply undermines their self-confidence and adds a further psychological barrier to be overcome when contemplating any future efforts. All too often, we see people struggling to overcome the debilitating impact of a perceived history of ‘failures’.  As a provider of drug and alcohol treatment, the most effective things we can do are to help people develop the skills to regain control of their lives and to rebuild their self-confidence: to build upon successes and to learn from mistakes. Moreland Hall’s own experience has shown the particular benefits of retaining people within the structured supports of our treatment programs following a lapse.  This approach reduces the immediate harms to the person (and those around them) and enables them to continue the progress they have made up to that point. As opposed to punishing people further by excluding them from the very service that was supposed to be assisting them, this produces far better outcomes for them, their families and friends, and the wider community. While the decision by ‘The Biggest Loser’s’ producers to punish Luke at a time in which he was most in need of support is regrettable, some of our staff have commented on the effort that was made to ensure that he continued to receive support once he left the competition. Others have spoken to me in support of the program’s overall approach, with its focus on nutrition as a key enabler of sustainable change. One small (but encouraging) sign that the wider community is beginning to understand the challenges of making sustainable behavioural change is the content of comments left for Luke on his profile page ( • Despite the odd relapse into unhealthy lifestyles and negative thinking, I have improved my health over the years (Richard83) • Don’t let one slip up make you give up!! (margaretta333) • Hey Luke I just want to encourage you to dig deep and keep going. Must have been hard - that last show, but today's a new day and it is full of opportunities. I've seen many men turn their lives around by facing their alcohol problems and the issues that drive them. You can too (rocdog) I wish Luke (and anyone else making the effort to improve their lives) every success in his future efforts.  I hope he learns from his experiences and from those of others who have set out on the same journey. • For more alcohol and other drug news, follow @MorelandHall on Twitter  

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