We’ve talked extensively in the past about the mental toll playing Survivor has on its contestants. Not just out on the island but afterwards as well, trying to get used to everyday life again. The mental element of it all is certainly something castaways need to consider when getting ready to play Survivor but it isn’t the only thing. It can often be pushed aside for the strategy but playing Survivor is one of the most physically demanding things anybody could ever do.

Have you ever gone a full day without eating? After a while, you start to feel tired from the lack of calories. Maybe you get a little woozy. Now try repeating that over and over again while you also sleep on bamboo and spend all day under either the hot sun or in the midst of a massive rainstorm. Make no mistake, Survivor is hard.

Because it is first and foremost a television product, Survivor doesn’t always focus on the difficulties the players are under. In the earlier seasons, it was certainly a factor because they wanted to establish how real the living conditions were. We would get some attention to Colleen’s legs being absolutely destroyed by bugs, the real threat of the Survivor: Africa players being eaten by lions or how difficult the no-nos were to deal with back in Survivor: Marquesas.

As the seasons kept coming, the producers shifted their priorities. We had seen the struggles the castaways had to go through. After a while, if you show the same thing over and over again, people are going to start tuning you out. We moved away from seeing these players really struggle to keep it together and started getting more into how the game dynamics impacted a season.

If you need further proof of how difficult the game can be, look no further than some of the players that have been medevac-ed in the past. Michael Skupin fell into the fire in Survivor: the Australian Outback. Russell Swan and Caleb Reynolds both got uncomfortably close to dying in their respective seasons. Those were two of the most terrifying, and realest, moments that Survivor has ever aired.

Just recently, Australian Survivor’s most recent winner, Jericho Malabonga, posted a before and after photo from his time on the island. The difference is drastic.

Granted, they play for 55 days on the Australian version, which is crazy by itself, but the amount of muscle and weight Jericho managed to lose is incredible. Jericho isn’t the only person to go through such a physical change.

Take Big Tom for example. In Survivor: Africa, Tom lasted almost the entirety of the game and lost nearly 80 pounds. It’s almost unthinkable that somebody could lose that much weight in less than 40 days. While Tom was certainly no stick, dropping in weight so quickly had to mess him up internally and make him feel incredibly weak. Africa was particularly harsh to all of the players because of the limited choices the players had for their diet.

We lived on a [wildlife] reserve, and there was no hunting. We had to eat just what we carried — and what we carried was a little bit of mush. It was terrible. [Coming back with the weight loss] everybody said, ‘Boy, you look nice!’ But I never felt good.

Going back for Survivor: All-Stars, Tom had managed to put back on most of the weight he had lost in Africa but he made another deep run into the game. It was less dramatic than the first time around but Big Tom managed to drop another 42 pounds his second time through the game, with slightly better living conditions.

Likewise, Rupert Boneham lost 45 and 50 pounds in Survivor: Pearl Islands, and All-Stars respectively. Big men tend to get the worst of it, but they aren’t the only people who’s body can change dramatically and dangerously. In Survivor: Marquesas, Kathy Vavrick-O’Brien lost 34 pounds in 38 days. She returned for All-Stars and lost another 36. As she claims herself, it left her stomach feeling terrible anytime she ate food that had any sort of fat. It took doctors and nutritionists to get her body feeling right again. Even Kelley Wentworth, an already petite woman, went through severe weight loss after Survivor: Cambodia.

While some players might have been happy with the weight loss, former Survivor doctor-in-residence, Adrian Cohen would not want people to go through this in real life and yet, the Survivor players go through it every season.

The Survivor diet is not one I’d recommend. It’s extreme, the food groups are poorly represented, and it doesn’t provide enough fiber. Players receive about a cup of rice or corn a day and as much fish and local produce as they can gather — which usually isn’t much. It’s about 1,000 calories a day. Because it’s TV, players ‘have a feeling of ‘they’re not going to let us starve, are they?’ Your metabolism takes a beating — it’s not a healthy way. If it were, I’d publish a book.

It isn’t simply the weight loss that castaways must watch out for, the elements provide danger too. Back when Survivor: the Amazon was airing, People had an interview with Cohen. He elaborated on the many things the players had to be on high alert for during their time in the jungle.

The biggest threat is from snake bites. There are a lot of them there, like the Bushmaster. We make it our practice to have antivenom on location and at the local city intensive care units. Also, the anacondas aren’t quite as animated as in the film [1997’s ”Anaconda”], which was shot in the same area, but they are to be feared nonetheless. Fleas, ticks, and flies are always a problem, particularly the mosquito, which carries malaria, Dengue fever, and yellow fever. And scorpions, centipedes, bees, and wasps are always wherever we put our contestants. All I can say is, check your shoes and your bed!

On some seasons, the downpour of rain can be a hazard. It can accelerate the dehydration process if a player spends too much time standing there, soaked from head to toe. It’s exactly what happened to Russell Swan on Survivor: Samoa when he collapsed during a challenge and came way too close to dying. Fortunately, that hasn’t happened to anybody in the American version but internationally, we can’t say the same.

The 13th season of Koh-Lanta, the French version of Survivor, had to be cancelled in 2013 after Gerald Babin died of cardiac arrest during the first day of filming. Babin was only 25 years old and in good physical condition. In Survivor: Conquering Asia-Philippines, the fourth season of Bulgaria’s Survivor franchise, Noncho Vodenicharov died of a heart attack on day 14. Get this… they didn’t even cancel the season and proceeded to later crown a winner! That’s unfathomable to me.

Even after the show, the contestants are from done with their physical issues. Putting on the weight that they have lost is necessary to regain some muscle. That can be hard when the body isn’t used to eating full meals, multiples time per day. It can cause some serious intestinal issues. Then, once that weight has been put on, it can become difficult to stop yourself from gorging on the bad foods you’ve been eating to regain some weight.

After Survivor: San Juan del Sur, winner Natalie Anderson went on a Krispy Kreme and Chik-Fil-A diet to put on some weight. She has said that she needed some help to eventually curve those habits and start eating some healthier foods again. The same can be said of both Josh Canfield and Reed Kelly who put on an additional 10 pounds from their starting weight. If they aren’t careful, Survivor players can easily tread into dangerous waters with weight issues.

On top of that, numerous players have discussed their issues with sleeping. Going multiple weeks sleeping on some bamboo on a beach can do a number to your body. Most players only get a handful of hours rest every night and come home extremely sleep deprived. They get into weird sleeping patterns and generally find it hard to get a good night’s rest.

In fact, many former contestants have reported that coming back home initially, they couldn’t even sleep in their bed. Most recently, Rick Nelson of Survivor: South Pacific, discussed this very issue with the panel at Rob Cesternino’s RHAP-con. He said that coming back home from his season, he asked his wife if they could sleep on the ground. He hadn’t experienced the comfort of a bed in so long (he was in a tent at Pondoresa), that it felt unnatural to him. These are the kind of issues, physically speaking, that we don’t get to see back at home.

That’s all we have to remember when watching at home. Survivor is a tough game. Both mentally and physically. We are so quick to judge these players on their every move, I do it myself every season, but it would be important to keep in mind the strain they are under. Some people make dumb decisions under far less intense circumstances so maybe some time, we should cut these people at least a bit of slack.

Despite 17 years on television, I will still encounter people who tell me that the show is fake. That these players all get catered meals three times a day and are whisked off to a hotel to sleep at night. To those people, I simply show them a picture of Russell Hantz on day one of Survivor: Samoa side-by-side with a picture of Russell Hantz at the end of Survivor: Heroes vs Villains.

If that isn’t enough to make them change their minds, they are unsalvageable.