Each episode begins, if applicable, with the remaining contestants performing the treatment that ended the prior episode.

After the treatment concludes, Val observes the players and alters the environment somewhat, such as not permitting the players to sleep or eat or precluding access to a player's personal items.

Next is a test, a mental challenge which is made more difficult by the players' physical condition. The challenges themselves are somewhat difficult to begin with; deteriorating physical and psychological condition makes these challenges even harder.

The first player to pass the test is granted immunity from the subsequent treatment, a physical challenge which often contrasts with the conditions applied in the episode. Players are challenged with a bed of nails after being deprived of sleep, or an endless feast after starvation.

The first player to quit the given challenge, either voluntarily or through a bodily rejection of the challenge, is eliminated from the program.
The player who eventually wins the program is given $50,000.