The countdown to the biggest reality TV show finale of our times has begun as The Apprentice star Donald Trump prepares to leave the White House. The public voted him into the house and, like in Big Brother, the public has voted him out.

It’s unlikely that when the first reality show The Real World launched on MTV in 1992, anyone could have predicted the power this programme genre would go on to have, nor the havoc it would wreak. In the late 1990s I relocated from Amsterdam to London for a job at MTV, having mentioned in my job interview a Dutch TV format about to be launched — a little show by the name of Big Brother. Building on the popularity of The Real World, Endemol’s Big Brother quickly became a global hit and marked the start of the reality TV phenomenon that still rages today.

I went on to work on the international rollout of the hit format Survivor. Its launch on CBS in the US in 2000 saw ratings in line with the Super Bowl, with 125m people watching at least some part of the season one finale. Survivor had begun life more quietly in Sweden in 1997 under a different name, Expedition Robinson. After being voted off the show, one of the contestants, Sinisa Savija, had committed suicide.

Since then, Love Island, The Voice, Ramsay’s Kitchen Nightmares, The Bachelor and Real Housewives have all been associated with contestants taking their own lives. Last year, the suicide at 22 of Hana Kimura, who had appeared on the Japanese reality show Terrace House, prompted a response from former prime minister Yukio Hatoyama condemning cyber bullying. In the UK in 2019, a formal inquiry was launched by MPs into the link between reality shows and suicides and led to policy changes within broadcasters. Last November, the coroner at the inquest into the death of Steve Dymond, a guest on ITV’s The Jeremy Kyle Show, concluded that the TV presenter “may have caused or contributed” to his death.

The reality of reality TV can be grim, and we underestimate its social, cultural and political impact at our peril. Andy Warhol famously predicted in 1968 that “in the future, everyone will be world-famous for 15 minutes”, but celebrity culture has curdled into something sinister. While I was working for children’s channel Nickelodeon, a six-year-old was asked during an audience research presentation: “What do you want to be when you grow up?” Their response: “Famous.” The Kardashians have shown them that being a celebrity can be a full-time job in itself.

Reality TV is big business, global revenue from UK content alone breaking the £1bn mark last year. It is easier to list the countries where Big Brother hasn’t aired than those where it has, and no fewer than 64m households were gripped by Netflix’s Tiger King when it appeared last year. Such shows are larger than life and compelling viewing, and it is easy to forget that these are the lives of real people who in many cases are vulnerable for many real reasons. The world was gripped by shocking scenes of one of Joe Exotic’s husbands, Travis Maldonado, accidentally shooting himself in the head at the age of 23. The show didn’t cause his death but we, the fans, were willing voyeurs.

Reality shows hit the sweet spot for TV commissioners of low costs coupled with high ratings. An episode of unscripted content can cost as little as $100,000-$500,000 to produce, whereas the final season of HBO drama Game of Thrones was reported to have cost upwards of $15m an episode. Reality TV is (relatively) cheap, and we just can’t seem to get enough of it. What’s not to like?

These programmes have changed the economics of TV and now we’re paying the highest price. It was British producer Mark Burnett who oversaw the turnround in fortune of Survivor when he brought it, revamped and renamed, to the US. It was also Burnett who produced the US version of another UK format, The Apprentice, and cast Donald Trump as ABC’s answer to Alan Sugar. Trump was emboldened by his TV stardom, and has said: “Nobody thought I was going to be big on television, and then I dominated the ratings and my name was on everybody’s lips.” Who could have guessed that a TV show could help catapult an unqualified candidate into the most powerful position in the world?

At one end of the scale, reality TV can push participants to the depths of despair, at the other to the heights of grandiose delusion. Either way, the impact can be deadly, in Trump’s case when fame, power and refusing to admit defeat become more important than saving lives. How fitting that Trump has spent much of his presidency watching TV, himself now its biggest star. Rioting in the Capitol is a shocking and tragic but also unsurprising plot twist.

I am part of the problem — my involvement in reality shows has in large part paid for the roof over my head — but, then again, aren’t we all, to some degree? We can’t get enough of peeking behind the curtain of other people’s lives, whether via Instagram, Twitter or TV. Until we, the consumers, can bear to look away, the demand for all-exposing reality shows is unlikely to dwindle.

The writer is a former senior vice-president of Viacom turned comedian, journalist and broadcaster