One of the most dramatic changes in “The Biggest Loser” came about in its first season.

In 2004, producers were faced with either using morbidly obese people as an entertainment tool or make a statement about the ramifications of Americans’ thickening waistlines.

“There was a moment when a decision needed to be made if this was going to be a ‘wink-wink’ reality show or a show that really changed lives,” says showrunner Todd Lubin. “A conscious decision was made by the creator to move to a feel-good place. This is a show that is literally saving lives.”

Adds David Broome, topper for “Bigger Loser” producer 25/7 Prods.: “I was nervous. I don’t know if America was ready for it. I didn’t know if people wanted to face the truth. … The idea was always infotainment. How do we take daytime subject matter and primetime it up?”

Recalls J.D. Roth, whose reality shingle 3Ball Prods. was there at the beginning and throughout most of the lifecycle of “The Biggest Loser”: “We wanted to find the fine line between what was entertainment and what was the right thing to do. These people wanted dignity, and they showed the story of their pain. No one at that time talked about it. You could always talk to the smoker and the drinker at the dinner table about changing their habits, but nobody ever went to the fat person. We changed that conversation.”

With few changes in the basic format over the years, the show has soldiered on to become a real workhorse in NBC’s stable of shows. Now in its 13th cycle and set to hit the 200th episode milestone tonight, “The Biggest Loser” is praised by the network and producers as being a positive force in helping Americans stay in better shape and reduce a plethora of health risks.

“The Biggest Loser” has cashed in on America’s fixation with weight issues and branched out into several ancillary businesses, ranging from workout DVDs to a weight-loss resort. The show’s weight-loss plan was named No. 1 among diabetic diets this year by U.S. News & World Report and No. 2 as top weight-loss plan behind Weight Watchers.

The skein has had a smooth ride in eight seasons on the air, with only two major changes in its history. The first arrived in 2007 when Alison Sweeney replaced original host Caroline Rhea. The second was at the end of the 11th season when trainer Jillian Michaels decided to leave.

With her departure, that opened the door to invite trainers who had different perspectives on losing weight. Former tennis star Anna Kournikova was brought on, but quickly exited the series. New trainer Dolvett Quince proved a better fit.

Trainer Bob Harper has been there from the beginning, and Roth says his contributions can’t be overestimated.

“Bob holds the contestants’ emotional baggage and gives it back to them in pieces,” Roth says. “He works the mind as much as the body.”

NBC alternative topper Paul Telegdy says the combination of Harper and new arrival Quince have brought a freshness to the storylines.

Telegdy, however, realizes that longrunning franchises such as “Biggest Loser” need to stay fresh in order to survive and that changes are in order, including making the show a “leaner” program.

“It’s not a secret that we probably relied too much on ‘Biggest Loser’ in the past, and we’d like to rely on it less to make it special,” Telegdy says. “Clearly, it is facing challenges that all shows get as they become more seasoned.”

That overexposure has recently cut into the show’s ratings. After premiering to 10.3 million viewers in the first cycle in 2004 and then recharging itself and hitting a high point in fall 2009 with 10.4 million, the skein is now averaging 7 million viewers an episode.

No matter its length on the air, however, the weight-loss message resonates with audiences who are fighting the battle of the bulge.

“People responded to these inspiring stories about people who had problems controlling their weight, which most of us do,” says St. Louis Post-Dispatch TV critic Gail Pennington. “We root for them as that giant scale posts their weight loss. And we see the pain they go through trying to achieve their goals.”

“Shows go through natural ups and downs, and we are in a constant state of making each episode better than the last,” says Eden Gaha, president of Reveille, which produces the “Biggest Loser” along with 25/7 Prods. “This show has a very vocal fan base. We tap in to what they want, and what they want is to be able to take that journey with these people.”

Roth recalls how vital this type of tranformational program was to both viewers and “Biggest Loser” participants in the show’s early days, but it wasn’t always easy convincing everyone. Yet, 200 episodes later, it was worth the struggle.

“We wanted to teach them how to order off a menu but we couldn’t find a restaurant who wanted to bring in overweight people,” Roth remembers. “Five years later we were picking vegetables from the Obama garden.”

‘The Biggest Loser’ 200th Episode
Series a good fit for NBC, overweight public | ‘Loser’ brand breaks new horizons | Trainers accept being in the spotlight | Sweeney takes host gig to heart | Past contestants spread the message