Extreme Makeover is all about the "wow" factor. The show tries to find a down-on-their-luck family who has a problem that can be fixed by extreme home improvement. Well, maybe not all of their problems but at least some of their problems. And actually, the show likes to focus on the big changes their making (to their home) and all the good it will do them. It often seems the families in need are doing things like running a shelter for blind, paraplegic dogs or a foster home for run-away Chinese orphans, etc. The point is, based on a handful of viewings, often a new living situation will go a long way towards helping the family. The crew shows up, sends the family on a vacation, changes everything, and brings them back for a heart-pounding reveal. Very dramatic, makes for good TV, fits well in a one hour time slot.
This mode of assistance is very different than Biggest Loser. Biggest Loser is all about long-term changes. The obese individuals shows up and sign themselves into the ranch for as long as they can stay, possibly as long as three months or so. They are on-board all day, all night, week after week. Every day they are making choices about what they eat, how hard they work out, what they are going to do to try to lose the most weight and continue to stay in the competition. The only way they get on the show is by having developed a fitness pattern that is horribly bankrupt and by coming to a realization that they need to change something soon and change it in a drastic way.
One of these shows is focussed on a change in circumstances, the other on a change in process or, because these are people after all, character. Extreme Makeover does a one-week blitzkrieg on your life, Biggest Loser is in for the long haul, hoping to make you a fundamentally different (and better) person.
Extreme Makeover isn't a bad show, doesn't have evil motivations, and is not despicable. The kind of aid they provide can be very effective helpful. There are families out there that have one significant problem in their lives that a new house could go a long ways to fixing. Sometimes money is the only barrier. Sometimes.
There are some down-sides, though, to building them a new house. Invariably, the house is bigger than before which almost guarantees larger utility bills going forward. (Granted, they do try to use energy efficient techniques/appliances but no amount of efficiency will change the fact that there is twice as much square footage to heat/cool.) Sure the kids get totally decked-out rooms with INCREDIBLE interior design but, especially for younger children, their interests will change in time. When the love of airplanes wanes, what do you do with the 747 cockpit that has been built into your room?
What Extreme Makeover does is very generous and I truly hope that every family that is helped has thrived since receiving their new home. I doubt this is the situation, though. It may be like winning the lottery; after the emotional thrill wears off, the blessing may end up being more of a curse. Once the crew drives away and leaves you with your new house, its all up to you. Any problems you had before that the new house doesn't fix are still going to be with you. You're not a new person, just the same old person in a new house. Maybe with higher heating bills, to boot.
Biggest Loser has a much less ambitious goals in some ways; they just want to help you learn to eat right and take care of your body. Sure, the winner at the end of the show gets some money but its not even enough to make you independently wealthy for life. Maybe just enough to pay off the mortgage and/or buy a new car but that's it. The real prize is the change in who you are. Your attitude towards food is new. You see the value in exercise. You've learned to accept the pain of working out or denying yourself ice cream. You've put in a lot of hours in the gym. Every pound lost has been the difference between calories in at the dinner table and calories out on the treadmill. There's no way around it and they have spent as long as three months living with that reality in their face.
And there aren't any excuses, either. There is no 2 lb. handicap because you grew up on Twinkies and never stopped eating them. No week off because your parents just divorced and you have been over-eating to avoid the emotional pain. The cause of the problem is irrelevant. If you want to stay on the show, you're going to have to work at it, just like everybody else. No excuses, just work.
I don't I know if either show does any long-term follow-up (I'm guessing not simply because it may not make good TV), but I bet the Biggest Loser people have a much better chance of experiencing lasting change. In a non-trivial and mundane way, they've been transformed.
Generalizing this to society as a whole, I think most of our problems need change that is more like The Biggest Loser than like Extreme Makeover. Most people's problems can't be solved by throwing money at the problem, even if they think it can. The big, difficult problems in our world require change in people at a fundamental level and it is VERY difficult, if not impossible, for that to happen in any other way than long-term personal commitment on the part of both those giving and those receiving help. Everybody has to work at it and there are no excuses; if you want change, if you want to be transformed, you've got to put in the hard time.
I hope that whatever the future brings, that we as a society can learn to not accept quick fixes and instead be willing to commit to long-term, hard work to fix our problems. We need to be willing to roll up our sleeves and make an effort in each other's lives, doing our best to help others and stick with it over the long-haul. Real change is hard work and we need to have the patience and strength to not give up. Transformation is hard-fought but long-lasting.