Yo-yo dieting reaches a new level when personal trainers pack on pounds so they can slim down alongside their overweight clients.

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Credit: Fit to Fat to Fit, A&E

A&E's new reality show Fit to Fat to Fit takes the idea of yo-yo dieting to a whole new level. In what the network is calling "the most extreme weight loss experiment ever," fitness trainers agree to pack on pounds so they can slim down alongside their overweight clients.

The series, which premiered last night, is hosted by Drew Manning, the personal trainer who famously gained and then lost 75 pounds on purpose. (In the fall of 2014 he dramatically revealed his back-to-ripped body on Good Morning America to promote his book about the experience.) "Getting fit again was the hardest thing I've ever done, but it made me a better man," he says in the opening credits of Fit to Fat to Fit.

Inspired by Manning's journey (or gimmick, depending on how you look at it), the show follows 10 trainers as they abandon their rigorous diets and exercise routines to intentionally gain as much weight as possible, under medical supervision, for four months. Then they work with their clients to get in shape together.

When we heard about the show our first thought was, How can this possibly be safe? After all, we've read time and again that both extreme weight gain and crash diets pose serious risks.

It turns out we weren't the only ones to have that reaction. On Twitter, many people expressed concern that Fit to Fat to Fit was portraying something troubling at best and straight-up dangerous at worst.







After watching the premiere, it's hard not to be moved by the enormous personal sacrifice that the trainers make to better understand the challenges their clients face. And it's interesting to watch their perspectives evolve. JJ Peterson, for example, starts out completely unsympathetic: "Who on earth wouldn't want to be thinner, to be healthier, to have more energy?" he says. "Being healthy is a choice. If you're not healthy, change."

Meanwhile his client, Ray Stewart, articulates why changing is far easier said than done. "Oh, 'Eat less and work out,''' he says, mimicking the standard advice. "Wow, why didn't I think about that? It is a little insulting. I doubt a trainer would really understand that emotional pull that food has."

But after JJ doubles his caloric intake and puts on 61 pounds (prepare to feel a little sick as he stuffs himself with burgers, pizzas, and milkshakes) his outlook changes: "The more time passes in this experiment, the more empathy I'm gaining," he says.

But is this too extreme?

While it's heartwarming to witness the success of JJ and Ray (spoiler alert: they both lose a ton of weight), Fit to Fat to Fit is still an incredibly irresponsible "experiment."

Putting on a few pounds isn't necessarily harmful if you're eating healthy fats, lean proteins, plenty of fruits and veggies, and staying physically active. But trouble starts when you pack on weight from a high-calorie diet that also includes a lot of saturated fat, as JJ appears to do on the show.

"Weight gain like this can increase your risk of diabetes, hypertension, and mortality in general," says Bartolome Burguera, MD, PhD, an endocrinologist at the Cleveland Clinic and Director of Obesity Programs.

When you eat large amounts of fatty foods, deposits of fat get stored in your muscles and organs, especially your liver, explains Eneida O. Roldan, MD, an associate professor of pathology at Florida International University. "And a diet that's heavy in saturated fat raises LDL cholesterol levels, causing plaque to build up in your arteries," she says.

Then there's JJ's lack of physical activity while he's trying to gain weight. The sedentary habits he adopts would make the damage he's doing with his diet even worse. "What many people don't realize is that a sedentary lifestyle in and of itself can cause cardiovascular problems, even if you're thin," Dr. Roldan says. "So eating a high-calorie diet and not exercising? That's like a double-whammy for your health."

After yo-yo dieting, can your health fully bounce back?

Fortunately for the trainers on the show, the answer is yes. "Acute, short-term physical changes are usually reversible," says Dr. Roldan. "In this case, with someone who was previously physically fit and had healthy habits, it will be very quickly reversible."

Dr. Burguera agrees: "Recent literature does not suggest that weight 'cycling' like this necessarily increases morbidity or mortality."

But another big question remains: Does this whole experiment even make sense? Can two people really share the same weight loss journey?

Not exactly, as you might have guessed. A trainer who is most likely a thinner, healthier person would have a distinct advantage, says Dr. Burguera. "If a lean person gains weight, it will be relatively easy for them to lose it again, because their brain will be programmed to crave fewer calories," he explains.

"In order to really understand what it 'feels' like to be an overweight person struggling to lose weight, a 160-pound person would have to actually lose 20 pounds for example." Only then would they experience the intense hunger usually felt by an overweight person (whose brain is programmed to want more calories) on a diet.

The bottom line?

The real problem with weight loss reality shows like this one, says Dr. Roldan, is that they don't always address the long-term behavioral changes that are necessary to establish healthy habits. Weight loss can take years of effort, she points out. "As a doctor, I disagree with what they're doing. Any change of structure takes a lifetime to establish. And it's important to consult with a physician who understands weight loss and has seasoned skills in how to treat these conditions."

People forget that obesity is a chronic disease, adds Dr. Burguera. "It's not always as easy as simply eating less and exercising more," he says. "The key to maintaining weight loss over a long period of time is making small changes you can stick to. Specifically, improving your diet, getting involved in an exercise program, getting enough quality sleep, and managing stress."