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Some episodes feature a second, "red line"; if a contestant falls below the red line the contestant is automatically off the show with no vote.Other episodes allow for the contestants, if successfully meeting a goal at the weigh-in, to all receive immunity for the week.The Biggest Loser: Second Chances included a one-mile foot race in its first week, an event that led to the hospitalization of two of its contestants; Rob Huizenga, the show's medical consultant, when asked about the foot race said that "If we had it to do over, we wouldn’t [have done] it" and noted that in response, the show's producers have "changed a lot of the way [they] do things" (including the close monitoring of contestants’ body temperatures during exercise).One attempt to create a more healthy environment after Season 8's dangerous foot race was to include an Endless Pool for low-impact cardio.Depending on the season a team may work with a specific trainer or all trainers may work with all contestants.The trainers are responsible (in conjunction with medical personnel retained by the show) for designing comprehensive workout and nutrition plans and teaching them to the contestants.It takes an overly extreme course of action on an important, but far less effective and achievable way to attain good form and better health.""Risks aside, weight-loss experts say that the biggest problem with the Biggest Loser is that extreme methods of dropping pounds are less likely to work in the long run.Several former Biggest Loser contestants have regained some or all of the weight." Contestants on the show lose upwards of 10 pounds per week (in the very first week, some contestants have lost 20–30 pounds in that one week alone), whereas the established medical guidelines for safe weight loss are between 1 and 2 pounds per week.
It has also attracted significant controversy, including both general critiques of its approach of rapid weight loss, and specific allegations that contestants have been malnourished, dehydrated, overexerted and, in some cases, been given weight loss pills, in order for them to lose as much weight as possible.
Second, the more people exercise, the hungrier they become." Dr.
Sears continues by claiming that "even with the most intense training, people are unlikely to add more than five pounds of muscle in 12 weeks of weight training.
When the number of contestants has shrunk to a predetermined smaller number (unknown to the contestants), the teams are dissolved and the contestants compete one-on-one against each other.
The season finale features both the contestants remaining on the show and those sent home early; the latter are brought back for the final show.
The Biggest Loser format has been highly popular around the world, spawning over 30 international adaptations, some of which remain on the air.