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Dr Robert Huizenga, MD EXPERT

Robert Huizenga (better known simply as Dr. H), is an Associate Professor of Clinical Medicine at UCLA. He is the author of multiple scientific abstracts and papers on the aggressive non-surgical approach to obesity he has championed over the last 14 seasons of "The Biggest Loser," as well as the former LA Raiders team physician whose groundbreaking first book was adapted by Oliver Stone for the film "Any Given Sunday."

Huizenga grew up in Rochester, New York, and he was valedictorian and an all-county athlete in football, wrestling and track at Penfield High. At the University of Michigan, he received honors in math and biology and was an NCAA All-American wrestler. While at Harvard Medical School, Dr. H was an immunology major and all-star rugby player. He did his medical residency at Cedars-Sinai Medical Center, focusing on internal medicine and sports medicine, and was appointed Chief Medical Resident. He entered a pulmonary fellowship before leaving to serve as the team physician for the Los Angeles Raiders. Dr. H was also the national medical correspondent for "Breakaway" (FOX) and later for "The Home Show" (ABC).

After serving for eight years as LA Raiders team physician and four years as president and president-elect for the NFL Physician's Society, Dr. H wrote his first book, "You're OK, It's Just a Bruise: A Doctor's Sideline Secrets about Pro-Football's Most Outrageous Team," which provoked a national debate on anabolic steroids and other ergogenic (sport-enhancing) aids over a decade before the Senate "steroid" hearings. He continues to be active in the world of professional sports and was called in 2009 as an expert witness by the House Judiciary Committee looking into repetitive brain injuries (CTE) in football players.

Huizenga has repeatedly been interviewed as a health expert on NBC, CBS and ABC Evening News, "Nightline" and "Larry King Live," as well in the "New York Times," "Los Angeles Times" and other national print media. He has also been called as a medical expert in multiple high-profile legal cases, including both the criminal and civil O.J. Simpson trials. He has recurring roles as writer, correspondent and advisor on numerous TV shows and movies, including most recently "The Biggest Loser," "Extreme Makeover," "Work Out," "Thinervention," "American Gladiators," "Student Body," "Dance Your Ass Off," "Fourth and Long," "Joan and Melissa: Joan Knows Best," "Shedding for the Wedding," "Love Handles," "Dale Con Ganas" and "Into the Wild."

In 2008, Huizenga authored "Where Did All the Fat Go? The Wow! Prescription to Reach Your Ideal Weight and Stay There," about the radical exercise-centric obesity treatment he first pioneered in over 600 overweight applicants to NBC's "The Biggest Loser," resulting in over 15 published medical abstracts or articles. Huizenga lectures throughout the world and runs The Clinic by Dr. H, a state of the art, multi-disciplinary fat loss facility in Southern California.

Huizenga has deep sports and science-writer roots. His father, John Robert Huizenga, was an all-star basketball and baseball player before serving as a member of the Manhattan Project and later receiving the Ernest Orlando Lawrence Award (the U.S. Nobel prize) for nuclear physics for his nuclear fusion research (including co-discovery of Einsteinium and Fermium, element numbers 99 and 100).

Tonight’s “Biggest Loser” brings great news for contestant Gina McDonald – the type 2 diabetes that she came to the ranch with is gone. We’re not just talking improved blood sugar levels, we’re talking a “complete remission,” said the show’s physician Dr. Robert Huizenga in a phone interview this morning.

He said the show’s medical team tests for the four markers for diabetes:

Fasting blood sugar
Hemoglobin A1C
Insulin
A 2-hour glucose tolerance test
“Gina came in with medication, with a tremendously high fasting blood sugar and was just all over the charts,” Huizenga told us Monday morning. “To have all of them come to absolutely normal today – that would typically, in literature, be called a complete remission.”

So is she cured of diabetes? The word cure isn’t often used with a chronic condition such as diabetes, but Huizenga said “if you call it a cure it’s miraculous, because if you went to a doctor and you gave her more insulin or more medicine, the chance that she’d get to all normal numbers is far less than 10 percent.”

“We take into consideration all four of those blood sugar markers, and all of them have their own criteria for what is diabetes,” Huizenga said. “We use all four of those markers so we’re not missing anything. If we get all four of those markers to normal, then it’s either a complete remission or it’s a cure.”

Gina isn’t the first “Biggest Loser” contestant to reverse her type 2 diabetes. Among other contestants, season 12 contestant Ramon Medieros also reversed his diabetes as well as his high blood pressure.

What does the trick, Huizenga said, is the combination of diet and exercise.

“Gina had a huge amount of centripetal – around the belly – fat, and a lot of that fat was marbled in her liver,” Huizenga said. “Now I’m finding out that it’s fat in the liver that’s the proximal cause.

“You can have all the fat in your rear end that you want and it’s probably not that bad -- I think it’s bad for you but not that bad,” he said. “It’s fat marbled around the intestine, around the pancreas, around the heart and in the liver that’s causing this disease.

“Different people genetically have different tendencies to marble around the organs, and it’s these organ marblers who have the really bad problems.”

Reversing diabetes strictly through diet and exercise takes commitment and a willingness to make drastic lifestyle changes, Huizenga said. Small, incremental lifestyle changes are nice but they’re not going to make that paradigm shift in your health.

“An hour a day is great to maintain your weight if you’ve lost some weight,” Huizenga said.”The problem with Americans is that they spend an hour a day exercising but they’re not really exercising because they don’t know about intense exercise, which is what you have to do to prevent and cure diabetes.”

Huizinga’s ideas on diet and exercise have also changed a lot since he first started practicing medicine.

“I did the same thing the first 20 years in my medical practice,” he said. “I said ‘work out a little bit more and eat a few less calories, a few less simple carbohydrates and you’re going to slowly go.’ It turns out that’s the giant hoax in this country because that formula absolutely, unequivocally doesn’t work. And while we’ve been a country of doctors telling our patients that, 2 [million] to 3 million people cross into the ranks of the obese each year in this country.”

So that means more than a leisurely stroll around the block.

The average amount of exercise for a contestant on “The Biggest Loser” when they first come to the ranch is 20 to 30 minutes a day, he said. “But when the show is over we have people say ‘Oh, I had no idea what exercise was. What I was calling exercise was my cool down or maybe less.’ Just because you exercise, you don’t get credit for that until you learn what intense exercise is.”

But what about people who say they don’t have enough time to exercise a couple hours a day? Huizenga said that for the most part, it’s just not true.

“People say they don’t have hours to devote to exercise – I think that’s the first misconception that a number of people have,” Huizenga said. “The American average for TV time and leisure computer time is about four hours.

“I think people do have plenty of time to devote to exercise if they want to cure diabetes, live longer and have a better quality of life,” he continued. “If they really don’t have time for it, then we have to re-examine their life and say ‘Would you have time for chemotherapy, would you have time for renal dialysis if you were dying of kidney failure or cancer?' "

Contestants on the reality TV program "The Biggest Loser"not only lost weight fast, they "rapidly and substantially" lowered their blood pressure and improved their metabolic function, the physician who is the show's medical consultant reported Friday to the American Assn. of Clinical Endocrinologists.

Dr. Robert Huizenga, the medical director of the NBC program and several other shows, including Univision's "Dale Con Ganas," says the combination of moderate calorie restriction and roughly four hours of daily exercise yields bigger health gains, more cheaply and with fewer complications, than bariatric surgery.

The formula for weight loss a la "Biggest Loser": a daily regimen of one hour of intense resistance exercise, one hour of intense aerobic exercise and two hours of moderate aerobic activity, and calorie intake that ranges from 1,600 to 2,000 calories for men and 1,000 to 1,400 for women. The show's approach to weight loss has been highly controversial, with many dietitian and physicians denouncing "Biggest Loser" for promoting rapid and unsustainable weight loss and unrealistic expectations for physical activity.

In an interview after his presentation Friday, Huizenga defended the show's approach, saying that although slow weight loss can be effective, it rarely resolves patients' obesity-related health problems entirely before patients abandon it and weight regain ensues. He added that slow weight loss routinely results in muscle loss, leaving patients with a higher proportion of fat-to-lean muscle tissue: "Loser" participants, by contrast, changed their body composition in the opposite direction, ending with a higher ratio of lean muscle and bone to fat than they had had at the outset. Participants' average percentage of body fat decreased from a starting level of 48.9% to 30.4% at week 24.

Huizenga said that such changes had "never been documented before in the history of severe weight loss." He said he had applied to the National Institutes of Health for a study grant that would allow him to compare the health benefits of a "Biggest Loser"-type regimen with those of bariatric surgery.

At a minimum, said Huizenga, the health benefits seen in the "Loser" participants demonstrate that current definitions of intensive medical intervention for weight loss fall far short of what will be needed to restore the severely obese to health.

"What doctors call 'aggressive medical therapy' is laughable," said Huizenga, an assistant clinical professor at UCLA's Geffen School of Medicine.

In a study of 35 of the show's contestants from Seasons 11, 12 and 13, Huizenga said he had documented "absolutely unprecedented" drops in measures of metabolic dysfunction within five weeks of patients starting a grueling regimen of exercise and caloric restriction. Significant improvements in subjects' fasting glucose levels, insulin levels and adiponectin levels were evident at the end of their first week in the rigorous program, and persisted throughout an assessment period of 10 months.

Participants' average starting body mass index was 40, the cutoff for "severe obesity," and half arrived on the set of the show with Type 2 diabetes or pre-diabetes. Thirty of the 35 participants were hypertensive and took medication to control their high blood pressure. Among participants who came in with an apparent clean bill of health, Huizenga said finer measures of metabolic function showed clear signs of trouble.

By Week 5 of their participation in the program, "all diagnostic criteria for pre-diabetes, diabetes and hypertension were absent in each participant," he said.