Skip to main content

Weight Loss Expectations of Laparoscopic Sleeve Gastrectomy Candidates Compared to Clinically Expected Weight Loss Outcomes 1-Year Post-surgery

Obesity Surgery volume 23, pages 1987–1993 (2013)Cite this article

Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) results in significant, sustainable weight loss in obese individuals (body mass index (BMI) ≥40 kg/m2 or BMI 35.0–39.9 kg/m2 with major comorbidity). Average clinically expected % excess weight loss (%EWL) has been reported to be 56.1 % 1 year after LSG. Unrealistic weight loss expectations are purported to negatively impact treatment adherence and weight loss outcomes. This study examined the weight loss expectations of LSG candidates in Newfoundland and Labrador, Canada.

Methods

The Goals and Relative Weights Questionnaire was administered before the start of a bariatric surgery education session to 84 consecutive LSG candidates. Patients reported postoperative weight loss expectations in four categories: “dream”, “happy”, “acceptable”, and “disappointed”.

Results

Participants included 69 women and 15 men with an average age and weight of 43.7 years and 136.7 kg. The patients reported average postoperative “dream” and “happy” weights as 71.1 and 80.0 kg, respectively. Patients reported a weight of 86.2 kg as “acceptable” but would be “disappointed” with a weight of 105.6 kg. To achieve the desired amount of weight loss for each category, patients would have to achieve %EWLs of 88.7, 76.4, 68.2, and 40.6 %, respectively.

Conclusions

Patients have higher weight loss expectations than those that are clinically expected within 1 year after LSG.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  1. Picot J et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13(41):1–190. 215–357, iii–iv.

    CAS  Google Scholar 

  2. Lau DC et al. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2007;176(8):S1–13.

    Article  PubMed  Google Scholar 

  3. Sjöström L et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.

    Article  PubMed  Google Scholar 

  4. Karmali S et al. Laparoscopic sleeve gastrectomy: an innovative new tool in the battle against the obesity epidemic in Canada. Can J Surg. 2010;53(2):126–32.

    PubMed  Google Scholar 

  5. Shi X et al. A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010;20(8):1171–7.

    Article  PubMed  Google Scholar 

  6. Fischer L et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22(5):721–31.

    Article  PubMed  Google Scholar 

  7. Victorzon M. An update on sleeve gastrectomy. Minerva Chir. 2012;67(2):153–63.

    CAS  PubMed  Google Scholar 

  8. Padwal R et al. Bariatric surgery: a systematic review of the clinical and economic evidence. J Gen Intern Med. 2011;26(10):1183–94.

    Article  PubMed  Google Scholar 

  9. Dumon KR, Murayama KM. Bariatric surgery outcomes. Surg Clin North Am. 2011;91(6):1313–38. x.

    Article  PubMed  Google Scholar 

  10. Ames GE et al. Changing weight-loss expectations: a randomized pilot study. Eat Behav. 2005;6(3):259–69.

    Article  PubMed  Google Scholar 

  11. Anderson DA et al. Weight goals in a college-age population. Obes Res. 2003;11(2):274–8.

    Article  PubMed  Google Scholar 

  12. Dutton GR et al. Weight loss goals of patients in a health maintenance organization. Eat Behav. 2010;11(2):74–8.

    Article  PubMed  Google Scholar 

  13. Foster GD et al. Obese patients’ perceptions of treatment outcomes and the factors that influence them. Arch Intern Med. 2001;161(17):2133–9.

    Article  CAS  PubMed  Google Scholar 

  14. Foster GD et al. What is a reasonable weight loss? Patients’ expectations and evaluations of obesity treatment outcomes. J Consult Clin Psychol. 1997;65(1):79–85.

    Article  CAS  PubMed  Google Scholar 

  15. Masheb RM, Grilo CM. Weight loss expectations in patients with binge-eating disorder. Obes Res. 2002;10(5):309–14.

    Article  PubMed  Google Scholar 

  16. Wamsteker EW et al. Unrealistic weight-loss goals among obese patients are associated with age and causal attributions. J Am Diet Assoc. 2009;109(11):1903–8.

    Article  PubMed  Google Scholar 

  17. Provencher V et al. Defined weight expectations in overweight women: anthropometrical, psychological and eating behavioral correlates. Int J Obes (Lond). 2007;31(11):1731–8.

    Article  CAS  Google Scholar 

  18. Teixeira PJ et al. Who will lose weight? A reexamination of predictors of weight loss in women. Int J Behav Nutr Phys Act. 2004;1(1):12.

    Article  PubMed  Google Scholar 

  19. Heinberg LJ, Keating K, Simonelli L. Discrepancy between ideal and realistic goal weights in three bariatric procedures: who is likely to be unrealistic? Obes Surg. 2009;20(2):148–53.

    Article  PubMed  Google Scholar 

  20. Kaly P et al. Unrealistic weight loss expectations in candidates for bariatric surgery. Surg Obes Relat Dis. 2008;4(1):6–10.

    Article  PubMed  Google Scholar 

  21. Karmali S et al. What is my goal? Expected weight loss and comorbidity outcomes among bariatric surgery patients. Obes Surg. 2010;21(5):595–603.

    Article  PubMed  Google Scholar 

  22. White MA et al. Do patients’ unrealistic weight goals have prognostic significance for bariatric surgery? Obes Surg. 2007;17(1):74–81.

    Article  PubMed  Google Scholar 

  23. Byrne SM. Psychological aspects of weight maintenance and relapse in obesity. J Psychosom Res. 2002;53(5):1029–36.

    Article  PubMed  Google Scholar 

  24. Dalle Grave R et al. Weight loss expectations in obese patients and treatment attrition: an observational multicenter study. Obesity Res. 2005;13(11):1961–9.

    Article  Google Scholar 

  25. Cooper Z, Fairburn CG. A new cognitive behavioural approach to the treatment of obesity. Behav Res Ther. 2001;39(5):499–511.

    Article  CAS  PubMed  Google Scholar 

  26. Rothman AJ. Toward a theory-based analysis of behavioral maintenance. Health Psychol. 2000;19(1 Suppl):64–9.

    Article  CAS  PubMed  Google Scholar 

  27. Linde JA et al. Are unrealistic weight loss goals associated with outcomes for overweight women? Obes Res. 2004;12(3):569–76.

    Article  PubMed  Google Scholar 

  28. Linde JA et al. Weight loss goals and treatment outcomes among overweight men and women enrolled in a weight loss trial. Int J Obes (Lond). 2005;29(8):1002–5.

    Article  CAS  Google Scholar 

  29. Jeffery RW, Wing RR, Mayer RR. Are smaller weight losses or more achievable weight loss goals better in the long term for obese patients? J Consult Clin Psychol. 1998;66(4):641–5.

    Article  CAS  PubMed  Google Scholar 

  30. Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviors. Am Psychol. 1992;47(9):1102–14.

    Article  CAS  PubMed  Google Scholar 

  31. Montero PN et al. Reported excess weight loss after bariatric surgery could vary significantly depending on calculation method: a plea for standardization. Surg Obes Relat Dis. 2010;7(4):531–4.

    Article  PubMed  Google Scholar 

  32. Metropolitan Life Insurance Company. 1983 metropolitan height and weight tables. Stat Bull Metrop Life Found. 1983;64(1):3–9.

    Google Scholar 

  33. Padwal RS et al. Characteristics of the population eligible for and receiving publicly funded bariatric surgery in Canada. Int J Equity Health. 2012;11:54.

    Article  PubMed  Google Scholar 

  34. Sarwer DB et al. Self-reported stigmatization among candidates for bariatric surgery. Obesity (Silver Spring). 2008;16 Suppl 2:S75–9.

    Article  Google Scholar 

  35. WHO Consultation on Obesity, Obesity: preventing and managing the global epidemic. In: WHO technical report series. 2000, World Health Organization: Geneva.

  36. Libeton M et al. Patient motivation for bariatric surgery: characteristics and impact on outcomes. Obes Surg. 2004;14(3):392–8.

    Article  PubMed  Google Scholar 

  37. Heinberg LJ, et al. Older bariatric surgery candidates: is there greater psychological risk than for young and midlife candidates? Surg Obes Relat Dis. 2011.

  38. Crawford R, Glover L. The impact of pre-treatment weight-loss expectations on weight loss, weight regain, and attrition in people who are overweight and obese: a systematic review of the literature. Br J Health Psychol. 2012;17(3):609–30.

    Article  PubMed  Google Scholar 

  39. Engstrom JL et al. Accuracy of self-reported height and weight in women: an integrative review of the literature. J Midwifery Womens Health. 2003;48(5):338–45.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The first author received a graduate student stipend from the Faculty of Medicine, Memorial University of Newfoundland and the Newfoundland and Labrador Centre for Applied Health Research. The study was researcher-initiated and did not receive funding. The authors would like to thank the Translational Research Program in Bariatric Care team, the Bariatric Care Clinic at Eastern Health, Dr. Foster, Dr. Karmali, and the research participants.

Conflict of Interest

The authors, Hilary Price, Dr. Deborah Gregory, and Dr. Laurie Twells, have no conflicts of interest to declare.

Author information

Affiliations

  1. Clinical Epidemiology Unit, Faculty of Medicine, Memorial University of Newfoundland, Room 1715, Health Sciences Centre, 300 Prince Philip Drive, St. John’s, NL, A1B 3 V6, Canada

    Hilary I. Price, Deborah M. Gregory & Laurie K. Twells

  2. Eastern Health, 300 Prince Philip Drive, Health Sciences Centre, St. John’s, NL, A1B 3 V6, Canada

    Deborah M. Gregory

  3. School of Pharmacy & Faculty of Medicine, Memorial University of Newfoundland, Room 3445, Health Sciences Centre, 300 Prince Philip Drive, St. John’s, NL, A1B 3 V6, Canada

    Laurie K. Twells

Authors
  1. Hilary I. Price
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Deborah M. Gregory
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laurie K. Twells
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hilary I. Price.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Price, H.I., Gregory, D.M. & Twells, L.K. Weight Loss Expectations of Laparoscopic Sleeve Gastrectomy Candidates Compared to Clinically Expected Weight Loss Outcomes 1-Year Post-surgery. OBES SURG 23, 1987–1993 (2013). https://doi.org/10.1007/s11695-013-1007-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-013-1007-y

Keywords

  • Laparoscopic sleeve gastrectomy
  • Weight loss expectations
  • Goals and Relative Weights Questionnaire
  • Obesity
  • Newfoundland and Labrador