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The purpose of this study was to explore Marriage and Family Therapy students’ perspectives regarding food addiction and associated eating disorders, as a clinical treatment issue. In a standard addictions course housed in a Marriage and Family Therapy program approved by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE), 20 students completed a qualitative survey where they reflected on the topic of food addiction, Binge Eating Disorder, and Bulimia Nervosa, within the context of individual, couple, and family relationships. In the study four major themes emerged, which included (1) Defining Food Addiction, (2) Perceptions of Eating Disorders, (3) Conceptualizing Systemic Treatment, and (4) Experiences in clinical training. Clinical implications, recommendations for MFT education, clinical practice, and future research are discussed. Findings suggest that while MFT students in the study were well versed in conceptualized systemic treatment, it was of a general treatment and understanding using MFT theory, and not in relation to or specifically concerning food addictions and their connection or distinction from Binge Eating Disorder and/or other eating disorders found in the Diagnostic and Statistical Manual, potentially impacting the level of skillfully and appropriately working with clients.

For this study, authors engaged in 9 semi-structured interviews with romantic partners of contestants who were involved with a weight loss intervention (The Biggest Loser), to gain insight into the phenomenon of weight loss within the context of couple relationships and reality television. Utilizing Basic Qualitative Description influenced by aspects of phenomenology, the authors explored the role of weight loss and the role that the specific intervention utilized, has played within the couple relationship. Building upon previous research (Moore, Cooper, Williams, & Zwierstra, 2017a) authors added the voice of the non-contestant partners to the discussion and explored experiences of weight loss and perceptions regarding the utilization of Marriage and Family Therapists during the weight loss process. The major themes that emerged were (1) Behind the Scenes: The sacrifices we make, (2) After the Show Wraps: Re-entry and the Transition Home, and (3) Perceptions of MFT: Addressing couple relationships. Implications for Marriage and Family Therapists as well as other professionals involved in working with couples during weight loss are discussed as well as future directions in research.

NBC's "The Biggest Loser" is a competition-based weight loss reality television show, where individuals (and sometimes couples) are filmed while undergoing significant weight loss transformations. It is a reality television show in which overweight and obese participants are physically, mentally, and emotionally challenged in a contest to lose the most weight. Top health experts and celebrity fitness trainers work with participants on the show to create diet and exercise programs to give their bodies a drastic makeover (Readdy & Ebbeck, 2012). Contestants are often divided into two teams; the losing team, after a team weigh-in, eliminates a player each week. At the end of the show, one final contestant wins a large sum of money- $250,000 to be exact-after surviving eliminations as well as successfully completing the nutritional and physical challenges that result in losing the most weight (Domoff, Hinman, Koball, Storfer-Isser, Carhart, Baik, & Carels, 2012). In addition, another cash prize is often awarded to the person who loses the most weight after being sent home from the ranch.According to Yoo (2013), 30 million people tune in during the television season to view overweight, obese, and morbidly obese individuals attempt to lose weight and compete for a cash prize. "The Biggest Loser" has been immensely popular to the extent that the show, originally produced in the United States, is now produced and aired in a number of other countries, (Hall, 2013), including as far east as Australia (Thomas, Hyde, & Komesaroff, 2007).While the show has been successful in terms of inducing significant weight loss among its participants (as many members lose upwards of 150 pounds while on the show) it has been highly scrutinized and viewed in a negative way by some scholars and individuals in the media (Yoo, 2013). Specifically, some have alleged that the show portrays unrealistic results of weight loss; perpetuates anti-fat bias, obesity stereotypes, and weight-based stigmatization; and does not prepare participants adequately for the required lifestyle changes needed to sustain weight loss after the show (Berry, McLeod, Pankratow, & Walker, 2013; Domoff et al., 2012; Hall, 2013). For example, contestants are often filmed working out daily for multiple hours, which results in substantial weight loss. While the show portrays significant weight loss, the mechanisms used are unrealistic as most non-contestants cannot lose as much weight in such a condensed period of time and individuals are not able to maintain weight loss after the show. Another example of negative traits that some have described would be in the presentation of challenges where contestants are purposely tempted with food products. When participants are filmed giving in to temptation, it perpetuates a stereotype suggesting that obese individuals are addicts and possess an inability to regulate their food intake. While some individuals may struggle with food intake, it is commonly known that obesity can be caused by a variety of factors, some of which are external to the individual.Likewise, in the media, a number of former contestants have spoken out about their negative experiences with the show, specifically related to a lack of social support offered by the show's trainers while at the ranch and after the show, as well as the pressure to adhere to inappropriate dieting practices, among other factors (Callahan, 2015). However, outside of the media, there has not been any research conducted and then published to explore the weight loss process of participants who utilize such a unique intervention to induce significant weight loss. In addition, researchers have not explored the process of weight loss from a clinical perspective, specifically as it relates to mental health, emotional well-being, and couple and family relational dynamics after weight loss intervention. Marriage and Family Therapists who increasingly work with obese populations regarding behavior modification as well as when transitioning through the weight loss surgery process (Moore & Cooper, 2016; Pratt, Holowacz, & Walton, 2014) may be uniquely equipped to work with contestants from NBC's "The Biggest Loser" and other weight-loss reality television shows. …