For the viewers it was just another example of the host's bullish bluster – the sort of bad-mouthed, bare-knuckled assault that draws millions of viewers to Gordon Ramsay, turning him into one of the most famous people in America.

"Your business is about to fucking swim down the Hudson," the Scot told Joseph Cerniglia, chef and owner of the floundering New Jersey restaurant Campania.

Saddled with debts of $80,000 from purchasing the restaurant, Cerniglia found himself in the hands of Ramsay and the team at Fox TV, taping an episode of the first US series of Kitchen Nightmares, in which the by turns ebullient and demonic chef follows the tried-and-trusted reality TV formula of visiting a struggling business and shouting at people.

Ramsay is no John Harvey-Jones, the BBC's gentlemanly Troubleshooter. Ramsay tells it like it is, and then some, glorifying in the travails of others, gleefully exposing their shortcomings and – most recently – vomiting their work into the nearest bin.

But in the case of Cerniglia, the reality of his situation caught up with him earlier this week. Three years after he first appeared on Ramsay's show, the 39-year-old Cerniglia was found dead, his body pulled from the Hudson river after a witness reported seeing a man jump from the George Washington Bridge.

It is not the first time that a contestant on one of Ramsay's shows has taken their own life: three years ago, Rachel Brown, a chef appearing on another of Ramsay's shows, Hell's Kitchen, shot herself in her Dallas home. Neither is it the first time that people who have appeared on TV have subsequently encountered problems in their lives. Of course, no one is suggesting that these deaths are directly related to their appearances on reality TV. But it has sparked a fresh debate about the genre.

Dr Bruce Weinstein, AKA the Ethics Guy and a columnist for Bloomberg Business Week who has looked at the mores of reality TV, believes there has been "a ratcheting up of the level of brutality . . . it's nastier, it's coarser, it's harsher".

"Going back to the first series of Survivor, there was conniving, but it's reached a level we've not seen before."

Weinstein suggest that the conflicts and drama that are the making of reality TV are quite detached from reality. "These programmes are as produced as drama," he says. "What we are watching is not reality unfolding, but reality as it is shaped by a group of people. Aristotle told us that the essence of all drama is conflict. What the producers of these shows are trying to do is to maximise the conflict."

And who better than the vulnerable to give the public – the economic drivers of reality TV – its kicks? And if audiences crave a rollercoaster ride of emotion, sweat, heat, tantrums and topsy-turvy balance sheets, look no further than the restaurant business.

The hierarchical structure of the restaurant kitchen and the tendency for chefs to move into management, an area in which many have little expertise, is manna to reality producers. According to Nation's Restaurant News, 5,500 restaurants closed in 2009 in the US, out of a total of 578,353.

"Dentists and chefs," says David LeFevre, who is leaving behind the success he has enjoyed as chef at the Water Grill in Los Angeles to start his own restaurant. "They are the two most-hated, highest-risk occupations."

The tension inside the kitchen, says LeFevre, is easily explained. "It's extremely hot, it's an extremely small space and there's a lot of people," he says. "You have a deadline every two minutes. You're kind of doing air traffic control with tickets. You're trying to organise all these planes and tickets to land at the right time, but these planes have to be hot and tasty and seasoned. That for me is one of the monkeys on your back."

All of which, he says, leads to the sort of tensions that have prompted some, such as Ramsay, to rise to the top of the ratings – and others to plummet to the bottom.

LeFevre points to the example of one of the greats of French cuisine, Bernard Loiseau, under whom he served at the Michelin-starred La Côte d'Or before Loiseau killed himself in 2003. "Here you are in a pretty stressful environment already, that's hot and loud, and you add in the stress of running a business. It's a lose-lose situation."

Cerniglia's sister has insisted that taking part in the show did not adversely affect her brother. "He really liked Gordon and the show was great," she said. "The show was also great for business. It really helped tremendously. There are no hard feelings at all from our family to Gordon Ramsay, who is a wonderful man. His behaviour on the show was played up for the cameras."

Ramsay himself issued a dignified statement, noting, "I was fortunate to spend time with Joe during the first season of Kitchen Nightmares. Joe was a brilliant chef, and our thoughts go out to his family, friends and staff."

But some critics have used the occasion of Cerniglia's death this week to take issue with Ramsay's unique selling point: his manner. "Smart chef[s] lead kitchen by sharing, teaching, inspiring with respect," New York-based French chef Eric Ripert wrote on Twitter this week. "Not insulting, abusing, humiliating their team . . . Nothing personal against Gordon Ramsay but he is a poor inspiration for professional chefs in his shows." Ripert, a judge on reality TV show Top Chef, quickly clarified that he was not blaming Ramsay for the deaths.

Mary Sue Milliken, chef and co-owner of the Border Grill in Los Angeles, argues that Ramsay-style shrieking may have something to do with gender. "Maybe because we're women," she says of herself and co-owner Susan Feniger, "we don't have the kind of egos that lead to this. You manage your personality to fit your passion, don't you? And we made a very conscious effort to find other ways to manage our kitchens."

She also suspects the Ramsay stereotype of the demon chef is something peculiar to TV. "In 29 years as a chef I've run into guys who were maybe 30-40% of the persona that Gordon Ramsay exudes," she says. "There were a few chefs who were like that, but I don't think it's as prevalent any more. But the Gordon Ramsay persona makes popular TV. I've met him and he was delightful to me."

LeFevre, however, recognises the difficulties of staying calm in the heat of the kitchen.

"I have my challenges with my temper," LeFevre says. "It's something I work with on a daily basis. If it's super-stressful, you need to be very firm and clear and curt about what needs to be done. Other times you can be more calm. I have to be aware of where I am in order to be in the right mood to put my food out."

And though Ramsay may be delightful to his peers, that isn't going to win viewers. Trailers for the current series of Ramsay's Hell's Kitchen, also on Fox, makes it sound like Gladiator: "Fighting reaches epic proportions," it proclaims.

But several former contestants have elided the standard $5m confidentiality agreement that all must sign before taking part in the programme, to suggest that much of the fighting and brawling and crying is exaggerated.

But as media analyst and former TV producer Richard Crew notes, few people recognise themselves on reality television. "You have the reality of who this public persona of you is. Unless you are incredibly narcissistic, it must be quite a shock to see that person: is that really me, or did they manipulate that person to be me?"

As with the ingredients of a gourmet meal, it takes a phalanx of people to achieve the right blend of personalities for a reality TV show. Would-be participants are subjected to psychological evaluations ahead of recording. Once contestant recalled being asked how he felt at his grandmother's funeral and what his attitude was towards promiscuous sex.

"Part of the reason that psychologists are involved is to screen out people that might not be suited for that sort of experience," says Crew. "But the other reason is to identify characters that will be attractive and entertaining to viewers. That show was certainly a part of Cerniglia's personality."

One psychologist who was a consultant on Survivor has compared the contained reality of reality TV with the Stanford prison experiment of 1971, which saw students taking their roles as prisoner and guard beyond the norms of acceptable behaviour.

"The primary business in LA is reality TV," Crew points out, "and the challenge is that, because it isn't fiction, you can't just make it up, so you have to manipulate it and make it as entertaining as you can."