America is obsessed with watching its weight, and not just on the bathroom scale.

There has been a rash of reality television shows dealing with weight and dieting in recent years, including “The Biggest Loser” on NBC, “Ruby” on Style Network, and “Dance Your A** Off” on Oxygen.

Are these programs exploitive or are do they really encourage viewers to live healthy lifestyles?

We asked a panel of social workers who are experts on health and wellness issues to comment on television shows that focus on weight. The panelists are:

Francis L. Battisti, PhD, LCSW, BCD: CEO of Battisti Networks, a multi-discipline consulting firm specializing in individual and organizational transformation and life enhancement. Battisti is also professor of psychology and human services at the State University of New York — Broome Community College Campus.

Lorette Lavine, MSW, LCSW: A social worker at Loyola University Medical Center in Chicago, adjunct instructor at the Loyola University School of Social Work, and adjunct faculty member at the university.

Judith Matz, MSW, LCSW: Director of the Chicago Center for Overcoming Overeating, Inc. and co-author of “The Diet Survivor’s Handbook: 60 Lessons in Eating, Acceptance and Self-Care” ($12.95, Sourcebooks Inc.) and “Beyond a Shadow of a Diet: The Therapist’s Guide to Treating Compulsive Eating” ($37.50, Routledge).

Deirdra Robinson, MSW, CSW, PhD: Member of the clinical faculty at the University of Kentucky, program manager of the Appalachian Community Cancer Network, and vice president of the National Association of Social Workers Kentucky Chapter.

From left: Francis Battisti, Lorette Lavine, Judith Matz and Deirdra Robinson.

Q: Why are there so many television shows about losing weight? Are Americans obsessed with this issue?

BATTISTI: To place the weight issue in perspective let’s review the data. The National Health and Nutrition Examination Survey reports obesity rates increased dramatically in the last 25 years. A 2009 study by the Centers for Disease Control and Prevention, along with RTI International, found that direct and indirect costs of obesity are as high as $147 billion annually. A 2009 Health Affairs journal study concluded that the costs of hospitalizations related to childhood obesity rose from $125.9 million in 2001 to $237.6 million in 2005. From this perspective, I believe that the increase in the number of television shows that focus on weight issues is a direct result of the aforementioned data.

LAVINE: I agree the shows reflect the fact more people watching television are overweight and morbidly obese. American adults and children are suffering from this serious health problem at an enormously high rate. The networks are also hoping to gain viewers as well.

MATZ: Our culture also has an unhealthy preoccupation with weight — and with dieting as a way to lose that weight. If you look at the scientific research people can actually be healthy at a lot of different body sizes. The problem is that dramatic weight loss makes for good TV ratings. It speaks to people’s fantasies that if they can just become thin enough other problems — such as low self-esteem, relationship issues, or general dissatisfaction with life — will melt away along with the pounds.

ROBINSON: I think there has always been a cultural preference to people who are skinny. People who are overweight or obese carry a label and are outcast. The television show explosion, I believe, is the result of the reality show phenomenon coupled with America’s obsession with being thin. It’s a perfect marriage. Offer people who are severely obese so other Americans can offer justification as to why that isn’t their situation.

Ruby on Style Network.

Q: Do you think these television programs inspire others to get up and lose weight?

LAVINE: I actually do believe that “Ruby” and “America’s Biggest Loser” do inspire others to try to lose weight. Viewers see these people work very hard to achieve goals, which seem to be almost impossible from their first weigh-in to last. These shows also illustrate the fact that it takes a team of supporters to achieve their weight loss goals. Support is so important in losing the weight and keeping it off. There is also an emphasis on living a healthy lifestyle, not just dieting and shedding pounds.

MATZ: There is no doubt that these shows cause people to feel that they need to do something about their weight. Unfortunately this “inspiration” usually does more harm than good. Weight loss reality shows normalize unhealthy behaviors such as restricting dieting and over exercising. The focus on weight loss as motivation to change one’s lifestyle hurts the people participating in “The Biggest Loser” as well as viewers who believe that they too, should engage in diet-driven behavior.

ROBINSON: I have differing opinion than Judith and Lorette. I think these programs offer those who are obese or overweight a normalization option, a “see, they are like me attitude.” However, these types of television programs use a hygienic approach. This means they are done in a sterile, non-realistic environment. There is little sustainability. I don’t believe this is motivating, as most viewers will simply say, “If I had those resources, I could weigh 120 pounds, too.”

Q: What about the argument that these shows can be downright exploitive?

BATTISTI: These programs are primarily geared toward keeping audience members high by keeping viewers watching by editing and selectively showing “emotionally charged” moments. The message directly or indirectly given is that, if the participant tries hard enough or wants it hard enough, they can make it happen. This naïve concept leads directly to bias and ridicule. If this biased concept was true, two-thirds of our population would not be obese. The issue is not about losing weight — it’s about developing life-long lifestyle change. And this does not occur by watching a television show. In fact, television watching can add to the misinformation concerning what needs to be done to develop a healthy lifestyle.

MATZ: All reality shows, whether they focus on weight or any other issue, appeal to our desire to find out what’s going on in the lives of others. We can watch how someone else is handling life’s challenges and say, “I feel like that sometimes,” or, “At least that’s not me.” In a sense, any reality show is exploitive of its participants; but regardless how you feel about reality shows it’s always important to treat people with respect. The problem with reality shows that focus on weight is that there is an implicit message of shame that the person is not okay.

Q: Eating or overeating can be tied to a person’s emotional state. Would these shows be improved if they examined what factors in a person’s life contributed to their weight?

ROBINSON: I don’t know if addressing the origin of the weight problem is the key. I believe how or why someone is the weight they are is important but not the defining issue. Individuals have to believe and be empowered and these types of shows don’t offer enough practical approaches to doing something about it. Rather, it’s about the drama of the issues.

MATZ: As to focusing on how people became heavy, that’s an interesting question. Focusing on why someone is fat presumes that weight is always within our control. It’s important to keep in mind that weight is a characteristic and not a behavior. Although our lifestyle certainly can affect our weight, science shows that our set point — or natural weight — is determined in large part by our genetics. We stay in our set point range if we eat when hungry, stop when satiated, and move our bodies in a way that is comfortable. Human physiology has been programmed through evolution and adaptation to respond to times of famine in ways that maximize species survival; our bodies are actually wired to fight against weight loss. Each time the body defends itself against a diet it becomes more efficient at storing fat. When we diet, our set point gets reset at a higher weight, so one of the many reasons for weight gain is the increase in dieting over the past few decades. As for psychological factors, people who are fat have no more or less issues than people who are thin. And there are thin people who engage in very serious eating disordered behavior. There are compulsive eaters who are “normal” weight and there are fat people who do not overeat. So focusing on how some came to be their current size is not necessarily an answerable question. Focusing on why people have trouble practicing caretaking behaviors would be a more useful concept.

Scene from "Dance Your A** Off" on Oxygen.

Q: “Dance Your A** Off” on the Oxygen Channel has contestants compete against each other by doing dance routines and losing weight. Does this program send a positive message about physical activity? Or does it hold heavier people up for derision by having them compete in sometimes skimpy attire?

LAVINE: I am not particularly a fan of “Dance Your Ass Off” but in today’s environment I think that anything that encourages increased physical activity is definitely a positive thing. The skimpy attire is for the television ratings. In general the things that are for ratings do not usually appeal to me but that is part of the media hype…so be it!

ROBINSON: This show exploits the concept of “Dancing with the Stars.” These people aren’t judged by their talent or their dancing technique. The concept of health isn’t promoted. The topic of self-esteem and confidence and healthy choices are not addressed. This show seems to be more focused on mirroring “Dancing with the Stars” in a way that gathers ratings.

MATZ: Reality dance shows such as “Dancing with the Stars” and “So You Think You Can Dance” have been immensely popular with TV viewers. I hope these programs send a positive message that physical activity doesn’t have to be tedious — dance is a wonderful way to move one’s body and have fun at the same time. The problem with the show “Dance Your A** Off” is that it uses contestants’ weekly weigh-ins to determine the scores, which then promotes unhealthy behaviors such as over-exercising and restricting. It also sends the message that if you exercise and don’t lose weight it’s not worth it. I would much prefer to see reality shows where people of all sizes are invited to compete and the focus is on talent rather than weight. As for skimpy attire, people have different levels of comfort as to how much skin is revealed on TV shows. I am no more or less uncomfortable with skimpy outfits when a person is heavy than when a person is thinner.

Q: National Association of Social Workers member Shay Sorrells was a popular contestant on “America’s Biggest Loser.” Amanda Davis, another social worker, appeared on The Dr. Oz Show for a weight loss challenge. Sorrells said her weight loss inspired her to help others live healthier lives and eat better. What role should social workers take in helping clients lose weight?

BATTISTI: The ecological systems and social work, strength-based perspectives offer ideal concepts to address the obesity issue. Social work intervention needs to be based on a firm understanding of the psychosocial elements within the family structure and the ecology system within which the individual lives. Oriented toward strengths and competence of the client, the strengths perspective represents a collection of ideas and techniques that identifies a lens of empowerment through which to view the world of the client. The strengths perspective connects with the essence of the social work profession. It articulates the core values of integrity, distributive justice, dignity and worth of the individual and the quality of therapeutic relationship.

LAVINE: Social workers have a role cut out for them working with clients that are overweight. It could be a coaching, therapeutic role which helps a person to achieve his/her goals along with other disciplines advising them on proper diet and exercise. It is all part of a successful weight loss program and in my opinion it could help someone keep the weight off.

MATZ: Social workers have an obligation to promote practices that help our clients improve their lives. It is imperative that social workers understand the research related to dieting, health and weight, and that we offer services that foster our clients’ physical, emotional and spiritual well-being. Statistically 95 percent to 98 percent of people who embark on diets will gain back the weight and two-thirds will end up heavier than their pre-diet weight. Instead, we need to lead the way in influencing policies and offering services that will support healthful and sustainable lifestyles for our clients and our communities. I co-wrote “Beyond a Shadow of a Diet: The Therapist’s Guide to Treating Compulsive Eating” because social workers and other mental health professionals do not usually receive training in these areas.

ROBINSON: Social workers have a unique understanding of how individuals function in their own environments. Of course social workers should be leading this charge. We understand the needs of individuals — their need for support, direction and education. And we also understand how to mobilize the community to best support the individual. Social workers are critical to the issue of obesity.

Q: If you could create a television program to encourage people to lose weight how would it be formatted?

MATZ: Rather than creating a TV show that focuses on weight loss I would much prefer to see people who struggle with overeating and poor body image learn how to strengthen themselves physically and emotionally so that they can live more fully in the world. Since I co-authored “The Diet Survivor’s Handbook” with my sister and fellow social worker Ellen Frankel my ideal show would feature us as Diet Survivor Sisters. We would create a “Diet Survivors” reality show where people would make the revolutionary decision to quit dieting. Instead therapists, dieticians and exercise physiologists would teach participants how to make peace with food by ending the deprivation of diets and learning to honor their hunger and fullness. Participants would improve their health and fitness level by finding ways to exercise that feels comfortable and joyful. Ultimately, each participant would follow her dream, whether it’s to climb a mountain in the Himalayas, learn to scuba dive off the coast of Belize, or hike along the coast of Italy. Diet Survivors would focus on creating a supportive and collaborative environment rather than encouraging competition among participants and viewing weight loss as the ultimate goal. Any takers?

BATTISTI: The ideal television presentation would consist of two interconnected segment venues.  The first venue would assemble a team of professionals (medical professional, dietitian, exercise physiologist and social worker) who possess a clinical background in obesity for working with participants.  The show would be aired once-a-month for a year and would follow the clinical treatment of the participants.  From diagnosis, to treatment, to maintenance, each participant would be observed, interviewed and triaged.  The true focus of editing would be to offer a snapshot of diagnostic treatment.  The second segment venue, which would be offered during the other three weeks of the month, would focus on different modalities of health intervention with different participants.  Developing a healthy lifestyle and successful ecological intervention approaches, which have been put in place and offer hopeful results, would be the content of this segment venue. Examples of successful ecological interventions could include:  Shape-Up Summerville, a city-wide health enhancement program, successful worksite health intervention programs funded by The National Heart, Lung, and Blood Institute (NHLBI), and   the Sustainable Nutrition Application Program (SNAP), a Blue Cross/Blue Shield funded childhood-family obesity intervention program. A health promotion model would be used as the format of this show.

LAVINE: I like the “Biggest Loser” format where there is a competition as well as teamwork. This is supportive and challenging at the same time. However, I think that there could be more focus on healthy eating. They do share recipes at times but the show is mostly about the exercise and the competitions. Personally, I would put more emphasis on food preparation and how to adjust a person’s eating habits. But again, I would also look at what captures ratings as I feel that the more people that are reached by these shows the better. Obesity is a serious problem and can lead to so many other medical problems — diabetes, heart disease, kidney failure and eventually death. A sad fact is that many young people will not live to be as old as their parents due to poor eating habits and obesity. That is not only sad but intolerable.

ROBINSON: I would create a show that offered individuals who were obese weight loss options that are sustainable.  The physical fitness component would be about personal bests – how much did the person push him or herself to do their personal best.  This could easily be calculated using stats.  Additionally, I would give participants points for healthy cooking.  I would give them a food that most people enjoy and ask them to research and prepare a healthy version of it, perhaps using the taste testing method like on “America’s Next Great Chef.” The most important component would be offering participants points for documentation – food diaries and workout logs. Research shows this is what causes lifestyle changes – and that’s the only place where success in weight loss occurs.

For more information on how social workers help consumers live healthier lifestyles, visit the National Association of Social Workers’ “Help Starts Here” Health and Wellness Web page by clicking here.