On The Biggest Loser, contestants arrive fat and leave thin. And in between, they go through an intense fitness regimen that is, to put a good face on it, grueling.

The hours-long, athlete-level routines take place from the get-go. Some contestants have completed a quasi-mini-triathlon consisting of a 250-meter swim, a two-mile bike ride and a climb up 42 flights of stairs. Others have pulled airplanes down a runway or climbed up and down a hill as many times as they could from sunup to sundown -- not just sweating copiously but sometimes feeling dizzy, vomiting and crying.

With the show taping its seventh season and continuing to spawn an ever-larger assortment of books, videos, online clubs and forums, The Biggest Loser has made boot-camp-style training sessions seem a sure-fire ticket to weight loss for sedentary, morbidly obese people. And the success of its contestants suggests there's little risk -- contrary to common advice that such programs should be undertaken only with a physician's seal of approval.

Mainstream physical health experts are appalled by such extreme workouts.

''This is another example of taking a serious health condition and almost mocking it,'' says Jeffrey Potteiger, kinesiology professor and director of the Center for Health Enhancement at Miami University in Ohio. ``I find it deplorable.''

For starters, he points out that overweight people might have undiagnosed medical conditions such as high blood pressure, heart disease and diabetes.

''If you go out and do this type of workout,'' Potteiger says, ``you are going to dramatically increase your risk for some abnormal event and possibly exacerbate the condition. People could certainly have a heart attack, a stroke or become hypoglycemic. People need to be aware of these kinds of things.''

Second, the truly obese need moderate workouts that help them build up their strength and stamina gradually, he says, not ones that send them sprinting out of the blocks, risking injury.

''This is not the way we deal with this kind of weight issue,'' Potteiger says. ``At the end of the day, you're talking about behavior change -- nutritional, psychological -- and that's hard to change. If it were easy, we'd be able to change all sorts of behaviors. The question in putting on a program like this is that in having people watch, it isn't a scenario that will help people change their behavior and become healthy.''

Nicki Anderson, named trainer of the year by IDEA Health & Fitness Association, criticizes the show's portrayal of exercise as an almost Herculean effort. 'All the show does is reinforce to those who are overweight and inactive `See how hard (exercise) is?' . . . For most people, exercise is going to be hard, but it doesn't have to be that hard.''

Although some of her clients find the show motivating, Anderson, owner of Reality Fitness, an Illinois-based training studio, thinks they're being duped.

''It looks like in six weeks they lose 130 pounds,'' Anderson says. ``. . . Our job is to help you develop steps that will develop a normal, healthy lifestyle. And nothing they're watching is about being normal and balanced.''

And then there's the matter of muscle strain that extreme exercise produces -- and that can quickly crush idealistic workout goals.

''They're going to be fatigued and sore and they're probably not going to be doing it the next day unless they're highly motivated,'' Anderson says.

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