Unrealistic weight loss expectations in candidates for bariatric surgery



      Unrealistic expectations of weight loss are prevalent in obese patients and can negatively affect their adherence to dietary and health goals. We sought to examine the expectations and perceived notions about weight loss in candidates for bariatric surgery.


      A total of 284 consecutive and prospective bariatric patients were surveyed using a validated Goals and Relative Weights questionnaire before an educational seminar. The participants categorized their weight loss expectations as “dream,” “happy,” “acceptable,” and “disappointed” and rated the effect of surgically-induced weight loss on 21 indicators of health, quality of life, social functioning, and self-image on a 1–10 scale. The data are presented as the mean ± standard deviation.


      Of the 284 patients, 230 were women and 54 were men (age 45 ± 10 years; body mass index 50 ± 8 kg/m2). These patients stated that their “dream” weight would be 89% ± 8% excess body weight loss and that 77% ± 9%, 67% ± 10%, 49% ± 14% excess body weight loss would be their “happy,” “acceptable,” and “disappointed” weight, respectively. Participants ranked health, fitness, body image, work performance, and self-confidence as the most important benefits of bariatric surgery. Women had greater “happy” and “acceptable” weight loss expectations and put more emphasis on physical presence (r = .17–.33, P <.01). Younger patients put more emphasis on attractiveness and improvements in social and sex life after bariatric surgery (r = .15–.19, P <.01).


      The results of our study have shown that although the candidates for bariatric surgery understand its benefits, they have unrealistic expectations of weight loss. In our study, the patients’ most modest weight loss expectation, the “disappointed” weight, was equivalent to what providers would consider a successful weight loss outcome after bariatric surgery. Setting realistic expectations is an important aspect of the preoperative evaluation and education, especially for younger women.


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        • Fobi M.A.
        Surgical treatment of obesity: a review.
        J Natl Med Assoc. 2004; 96: 61-75
        • van Hout G.C.
        • Verschure S.K.
        • van Heck G.L.
        Psychosocial predictors of success following bariatric surgery.
        Obes Surg. 2005; 15: 552-560
        • Buchwald H.
        • Avidor Y.
        • Braunwald E.
        • et al.
        Bariatric surgery: a systematic review and meta-analysis.
        JAMA. 2004; 292: 1724-1737
        • Foster G.D.
        • Wadden T.A.
        • Phelan S.
        • Sarwer D.B.
        • Sanderson R.S.
        Obese patients’ perceptions of treatment outcomes and the factors that influence them.
        Arch Intern Med. 2001; 161: 2133-2139
        • Foster G.D.
        • Wadden T.A.
        • Vogt R.A.
        • Brewer G.
        What is a reasonable weight loss?.
        J Consult Clin Psychol. 1997; 65: 79-85
        • Poole N.A.
        • Al Atar A.
        • Kuhanendran D.
        • et al.
        Compliance with surgical after-care following bariatric surgery for morbid obesity: a retrospective study.
        Obes Surg. 2005; 15: 261-265
        • Schwarzer R.
        Self-efficacy: thought control of action.
        Taylor & Francis, Inc, Bristol1992
        • White M.A.
        • Masheb R.M.
        • Rothschild B.S.
        • Burke-Martindale C.H.
        • Grilo C.M.
        Do patients’ unrealistic weight goals have prognostic significance for bariatric surgery?.
        Obes Surg. 2007; 17: 74-81
        • Wadden T.A.
        • Butryn M.L.
        • Sarwer D.B.
        • et al.
        Comparison of psychosocial status in treatment-seeking women with class III vs. class I-II obesity.
        Surg Obes Relat Dis. 2006; 2: 138-145
        • Wolfe B.L.
        • Terry M.L.
        Expectations and outcomes with gastric bypass surgery.
        Obes Surg. 2006; 16: 1622-1629
        • Wee C.C.
        • Jones D.B.
        • Davis R.B.
        • Bourland A.C.
        • Hamel M.B.
        Understanding patients’ value of weight loss and expectations for bariatric surgery.
        Obes Surg. 2006; 16: 496-500
        • Giusti V.
        • Suter M.
        • Heraief E.
        • Gaillard R.C.
        • Burckhardt P.
        Rising role of obesity surgery caused by increase of morbid obesity, failure of conventional treatments and unrealistic expectations: trends from 1997 to 2001.
        Obes Surg. 2003; 13: 693-698
        • Dalle Grave R.
        • Calugi S.
        • Molinari E.
        • et al.
        Weight loss expectations in obese patients and treatment attrition: an observational multicenter study.
        Obes Res. 2005; 13: 1961-1969
        • Wadden T.A.
        • Womble L.G.
        • Sarwer D.B.
        • Berkowitz R.I.
        • Clark V.L.
        • Foster G.D.
        Great expectations: “I’m losing 25% of my weight no matter what you say.”.
        J Consult Clin Psychol. 2003; 71: 1084-1089
        • Goldberg J.H.
        • Kiernan M.
        Innovative techniques to address retention in a behavioral weight-loss trial.
        Health Educ Res. 2005; 20: 439-447