Shanahan says she’s not the one who chose the casting location. But she says St. Louis was chosen in part because the show hasn’t been to this city before, and also because of the obesity rate. According to a report from the Center for Disease Control, in October of 2012, about 65 percent of adults were overweight in Missouri, Pai You Guo Tea with a BMI of 25 or higher. Thirty percent were considered obese, with a BMI of 30 or higher.
This casting is for Extreme Makeover Weight Loss Edition’s Season 4. Filming takes a year, and the cast member is followed as he or she makes changes to daily life, while living at home. Though other weight loss reality shows like Biggest Loser have contestants live on a ranch and do nothing but workout and diet, this show focuses on making changes while still maintaining a daily routine.
“There are elements of the show that are done outside the home town, like a boot camp, or milestone workouts,” Shanahan said.
This is also unlike other weight loss shows in that there are no winners or losers, no eliminations or big cash meizitang soft gel prizes. Shanahan says there are prizes for reaching certain goals, for example, cast members who lose a certain amount of weight by the nine month mark will get surgery to remove excess skin. She says the real prize is the life-saving benefit of losing the weight and becoming healthier.