During some recent channel surfing I came upon the show “Extreme Makeover – Weight Loss Edition.”  I’m not typically interested in any show that begins with the word “Extreme” but this one grabbed my attention.  Each episode features a morbidly obese person who can’t seem to make the necessary lifestyle changes to lose weight, even when it destroys health and happiness.

These folks are helicoptered out of their real lives (jobs and family) and taken to a remote destination where temptation is removed, they’re put on a strict diet and pummeled into shape by a celebrity trainer. They come back transformed … healthier, thinner, happier.

The premise of this show really bothered me – even though I cared about and was interested in the people and their heart-wrenching stories.  They are suffering, physically and emotionally, and they obviously need help losing the weight—they would not be in this situation (250 lbs. or more overweight) if they could do it on their own.   And this approach is one solution but, of course, few get to leave life behind for six months to live on a private island staffed with chefs and a celebrity trainer.  (The real life “extreme” option here might be bariatric surgery.)

But I found myself wondering about the show’s message.  Shows like this support our cultural bias toward doing everything to an “extreme” and leave people feeling that extreme measures are the only option.

This is not a practical approach to managing health and weight – whether you’re trying to lose weight or prevent obesity from happening in the first place.  Lifestyle change involves small, subtle changes – micro-decisions even, and not that many! – that people can and must undertake on their own.  To accomplish this they often don’t need much more than some information and practical advice, consistent reminders and the support of friends and family (for instance, willing walking partners and a spouse who doesn’t mind getting rid of tempting food in the kitchen cabinets).

Now that may not make for great television, but it’s a whole lot more practical and effective.