I don't watch the show because it disgusts me. I only opened this thread because I heard something about it on the radio. That said, I thought it was pretty well known that this show is about as "real" as The Bachelor.
From interviews I've read with past contestants, I remember hearing that the weight they lose is done in a very unhealthy way, producers override whatever the on-site doctors say, and contestants are encouraged to ignore injuries and medical advice to just lose, lose, lose. When they start to gain back after they've left such an unhealthy, competitive weight loss challenge, they have to endure people commenting about how "she looked great at the finale, but now…." even though they may be healthier at the heavier weight than they were at the finale. It's gross.
For those interested, apparently this blogger interviewed Kai who had tons to say about how crappy and essentially abusive the game is for contestants.