What ‘The Biggest Loser’ Can Teach Employers

    "I was being brutalized," he says. "It was horrible. I didn’t want to take this abuse in front of my little one. My daughter said, ‘Dad, it’s all right.’ "

    But it wasn’t.

    "It was the worst moment of my life," Germanakos says. "But it was also the best."

    That day in 2006 at a Six Flags amusement park marked the beginning of Bill Germanakos’ transformation as an obese American. And like a roller coaster ride, his life quickly picked up. Germanakos quit his job as a sales rep at Quest Diagnostics near his home in suburban Long Island outside New York City. He and his twin brother, Jim—identically obese—were chosen to compete on the fourth season of NBC’s reality television show The Biggest Loser.

    On a show in which obese contestants vie to see who can shed the most weight, Bill Germanakos ran away with first place, losing an average of a pound a day, or 130 pounds in 124 days. By the time the season ended, he weighed 170 pounds. He collected his $250,000 in prize money, a hybrid SUV, a free vacation and a home gym set. He partied with NFL stars at the Super Bowl and made TV talk show appearances. Most important, though, he regained his health, his self-respect and, he says, "the right to walk my kids down the aisle."

    Now Germanakos, 42, is back at work at Quest, this time as the face of the company’s wellness program. He’s using his turn as a minor celebrity to teach employers how to better conduct their wellness programs by following the lessons he learned on The Biggest Loser.

    Germanakos tells his story to employers and benefits managers at conferences and meetings focused on how to better deploy wellness programs. Though the show could be described as a company wellness program on steroids, Germanakos and the doctor who manages the health of contestants say its success can offer employers insight into their own efforts to slim down their workforces.

    Like many wellness programs, The Biggest Loser offers a cash incentive, although it’s much larger than the standard $50 stipend often given to employees who enroll in smoking cessation programs or join a fitness club. But there also are behind-the-scenes health coaches, dieticians, exercise opportunities and, like many wellness programs, a support group of like-minded people who share a common goal.

    Germanakos was interviewed twice by Workforce Management—first during a break at a meeting of the New York Business Group on Health and again at the recent Employee Benefits Forum and Expo in Maryland. He says the major difference between the show and most employers’ wellness programs is the support contestants get from their peers.

    "Many people pushed into diet and weight-loss programs learn to spite those that are pushing them," he says. "They don’t want to be pushed by an employer or family member; they need to find the inspiration themselves."

    The show has spawned a highly popular support group Web site,  Germanakos and his brother, who lost 133 pounds after six months and won $100,000 as the runner-up, started their own support group at www.weightlosstwins.com.  The employee benefits practice of insurance broker Willis Group Holdings launched in late October a wellness program modeled in part on the show. The program rewards individuals with prizes for reaching weight-loss goals and the company is promoting it through the Biggest Loser social networking Web site, where members compete against one another to see who loses the most weight.

    Patricia Benson, director of the health management program at the University of Louisville, says support groups are a form of positive peer pressure that helps normalize a healthy lifestyle.

    "If one person is doing something, it draws the other person in," she says.

    Support groups can then become a more effective destination for a company’s wellness message.

    "If [companies are] looking to spend money wisely, don’t think of targeting the individual one on one; build support networks that bring people together," says Emma Gilding, president of In:Site Cultural Anthropology Advisor, part of New York-based marketing company Omnicom.

    Germanakos says people who have struggled with obesity have a credibility that can be used to teach and inspire others with similar problems.

    "People who are smokers know they need to stop," Germanakos says. "They just don’t want to hear it from someone who doesn’t smoke, because they don’t know what they’re going through. Same with me. I was on the other side of that fence a year ago."

Getting worse before getting better
    Before he went on the show, Germanakos was the life of the party, everybody’s best drinking buddy. A habitual yo-yo dieter, he took his sporadic weight loss as a signal he could party it back on. The signs were as clear as the lab results paid for by his company. He was overweight and had high blood pressure and high cholesterol. He knew his life was on track to chronic illness and high medical costs. But like many men, he didn’t go to the doctor.

    "I knew I wasn’t healthy," he says. "But at that point, when you’re morbidly obese like that, you don’t want to hear from a doctor that you’re overweight. I was the poster child for metabolic syndrome."

    At the urging of Quest Diagnostics, he filled out a health risk assessment and finally saw a doctor, who told him his health was so bad he had taken 20 years off his life expectancy. He was 40 years old and didn’t think he’d make it past his late 50s. He was told he was morbidly obese. And his doctor did what doctors often do: prescribed medication, including blood pressure pills with a diuretic and a cholesterol-lowering drug. That was his future, he thought. Take the meds and hope for the best.

    "When you’re five-eight, 330 pounds and you’re 40 years old, you’re pretty much hopeless," he says. "You don’t think you’re going to be fit, you just hope you live a while."

    But then a friend, who was perfectly healthy, died from a freak blood clot. Soon after came the day at Six Flags.

How the show changed his life 
    In April 2007, Germanakos arrived in Los Angeles for the show weighing 334 pounds. He met with the show’s doctor, Robert Huizenga, who gave him another diagnosis: night feeding syndrome. The diagnosis revealed his gorging at night made him feel good.

    "I’m educated, I have a master’s degree," he says. "But I could not stop myself from eating. I’d pick up a half-gallon of ice cream and eat the whole thing. Everything was fine in my life, but you find your relief by eating. Now I find my relief by exercising."

    The show provided the education and motivation he needed to change his life. He spent seven hours a day working out with a personal trainer. He learned to cook and eat healthy food. He learned not to starve and binge.

    "I don’t deprive myself," he says. "If I crave something, I have it and then count off the calories."

    He lived simply. If he craved beer, he drank water. If he wanted to binge, he exercised. He learned about the benefits of eating unprocessed organic food.

    "We were taught the right way," he says. "Count calories, eat the right foods and exercise."

    He learned to multiply his current weight by seven to know how many calories he can consume in a day. One day a week, he eats more than usual to fool his body into thinking his diet is over. The body stops hoarding calories, metabolism speeds up and the body loses additional weight.

    He did this all while living in front of a camera 24/7 surrounded by a group of 17 similarly minded peers, all going through the same struggle. Like in the Weight Watchers model, his fellow contestants were his support group, people he could count on to help him through a moment of doubt or weakened motivation. Because his fellow contestants were all going through the same struggle, he trusted what they had to say, something he could not do with his wife and kids, who are fit and healthy, or with his buddies, whose friendships were formed over a can of Budweiser.

    "It’s all about the support group, not the peer group," he says. "They can’t be with you if they can’t empathize with you."

    Two years ago, Huizenga began to study the show’s long-term effect on contestants’ health, including those who tried out but did not make it. On average, people on the show lost 35 percent of their weight—a number he says is comparable to weight loss from bariatric surgery, but without the risks.

    Beginning in 2006, Huizenga took the 36 contestants who did not make the show and put them through a crash course in how to diet and exercise to lose weight. Once a week, the group held a conference call with Huizenga, something akin to a therapy session, to review problems. By the end of the first year, on average the group lost 25 percent of its weight; by the end of the second year the group had lost 21 percent of its weight.

The biggest challenge: keeping the weight off
    Germanakos says the group dynamic is a critical element.

    When Germanakos returned home, he had all the benefits of a person who just went through gastric bypass surgery, but without the health risks or physical trauma. He had lost 39 percent of his body weight, his cholesterol was down to 167 from 269. His HDL, the so-called good cholesterol, was up from 40 to 70, which he attributes to his exercise regimen. His waist slimmed to 33 inches from 50.

    After the show, Germanakos faced his biggest challenge: keeping the weight off. He has regained nearly 30 pounds, putting him close to 200. Germanakos says the weight is healthy and more manageable. He exercises in the morning and evening. He goes to "hot yoga" where the room reaches 105 degrees.

    "You have to keep at it," he says. "Get a support group of people who know what you are going through. To people who have had no success, they need to speak to someone: a doctor, a psychologist, a nutritionist."

    Each week, Germanakos works out 12 to 15 hours and practices yoga twice. He says it’s better to work out twice a day for shorter periods than once for a long time. He keeps a food journal, writing everything he eats down to the last grape, raisin and almond. Reading what he eats reminds him of how well he’s treating his body and how many calories he’s putting to it. Germanakos imparts the lessons he has learned to employers, hoping they will better understand how to construct wellness programs that encourage like-minded people to work toward losing weight and exercising.

    While he no longer has the constant support from his fellow contestants, he draws motivation from other support groups: his brother, the people he works out with, and—now that he has more energy—his wife and three children. The day he came home from winning the show, he planned to take his family back to the amusement park.

    "The very next day I was on my way with my family and we lived the dream all day at Six Flags, because I earned the right to be there," he says. "It was the place I had the worst moment of my life, my epiphany and the best day. Six Flags, Rolling Thunder—I rode it hard and fast the entire day."

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