In an era that has discovered how much people love reality TV, reality shows that centre around health and diet have boomed. They are the perfect combination of grotesque look-at-the-fatties freak-show viewing and emotional, inspirational heartstring-tugging. They’re also a very dangerous model for how (or, rather, how not) to change to a healthy lifestyle.

The Biggest Loser is a case in point. The whole premise is ‘get a load of morbidly obese people, isolate them from their families and friends for weeks, drastically reduce their calorie intake and make them do extreme workouts for six hours a day, then make them compete to lose the most weight each week’.

Let’s skip over for a moment the frankly horrible idea of separating vulnerable people from their loved ones for weeks at a time (one contestant had a son who was reportedly seriously ill in hospital during filming, but had to make a choice between going to see him in hospital and carrying on with the show, as he wasn’t allowed to go home for even a short period). Even putting that aside, this idea of making contestants reduce their calorie intake to under 1,000 calories a day and complete gruelling workouts while carrying vast amounts of excess weight, is frankly so close to torture that I’m not even sure where you draw the line.

You could argue that it’s all agreed-to by participants, but this is to ignore the immense pressure put on fat people to get thin and conform immediately. One contestant was told by her doctor that she was exhibting signs of Stockholm syndrome, and it’s easy to see why. Locked away for weeks on end with only shouting trainers and other ‘losers’ (as they refer to themselves) for company, it’s a case of fit in or get out. And deep down, most of us want to fit in.

And after all that, former contestants have come forward to say that ‘almost all’ Biggest Loser contestants put the weight back on. Being cooped up in an artificial environment, away from job, family and friends where all that matters is to starve yourself, work out and lose weight, it’s no wonder that the changes are not sustainable back in the real world.

The worst offender on TV, in my opinion, isn’t even The Biggest Loser, but a UK reality show called Supersize vs Superskinny.

The idea of this show is on an Orwellian level of creepiness. Get two people with eating disorders – one who is morbidly obese, and one who is worryingly thin – and get them to swap diets for a week. The thin person has to eat the mountain of food that the fat person eats and the fat person has to cut down to the starvation rations of the thin person. And that’s kind of it, to be honest. There’s not even really any attempt to disguise it as anything other than look-at-the-fat-freak-crying and look-at-the-thin-freak-crying.

But this doesn’t matter to the producers of these shows. They’ve taken their pound of flesh (so to speak). Reality shows about extreme weight loss may manipulate participants into crying and revealing their personal stories, but what they are not is health programmes. They aren’t concerned with making people’s lives better, only with making compelling television and selling merchandise. Who cares if the participants are left mentally shattered and physically damaged afterwards? At least the ratings are good.

Yes yes, alright Dwayne, I’m getting to my point. The problem is, you see these extremes all over the place in health and fitness now. The extreme diets, the extreme exercise regimes (I’m looking at you, CrossFit, you big daft cult), the fitspo slogans, the insistence that all you need rely on is willpower to carry you through and you’ll emerge on the other side a transformed and radient butterfly flapping off into the sunset.

Real change does not come through extremes. Real change comes slowly, and in an atmosphere of learning. Just as you cannot expect to go to Moscow and engage people in fluent conversation in Russian with no prior experience of speaking it, you cannot ‘just be’ healthy without learning slowly how to eat, how to exercise and what strategies to put into place to make healthy living easy for you. And you must be able to slip up sometimes and to learn from those slip ups without feeling judged or a failure.

You definitely, definitely don’t ditch a binge-eating disorder by simply swapping it with anorexia or orthorexia. Sustainable change comes slowly, but slow change does not equal compelling TV. Nobody wants to watch a show in which people gradually make sensible, sustainable changes in their diet without beating themselves up over their slip ups.

When it comes to finding role-models for your diet, perhaps the best idea is to turn off your TV and look to people in your own lives who’ve turned their health around long-term. How did they do it?

Without even knowing them, I’ll make you a bet: I bet it didn’t happen quickly. 95% of crash dieters regain the weight they lost within three years.

The message has been out there for years, but been drowned out by the likes of The Biggest Loser: it’s not glamourous, it’s not dramatic, but if you want to lose weight, slow and steady is the way to go.