Abstract
Background
Patients choose to undergo bariatric surgery for a variety of medical and psychosocial reasons. However, the majority of bariatric surgery candidates have unrealistic weight loss goals, and certain subgroups within this population may be more likely to endorse such beliefs. This study examines weight loss expectations in patients undergoing three different weight loss procedures (laparoscopic Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, or laparoscopic sleeve gastrectomy).
Methods
Between October 2007 and June 2008, 114 patients (81.6% female) underwent weight loss surgery. At entry into the program, patients identified their postsurgical goal weights. “Realistic” weights were calculated based on patients' presurgical excess weights and expected loss based upon their surgical procedure.
Results
Patient [mean preoperative body mass index (BMI) = 48.89] weight loss discrepancies were quite variable with “realistic” versus “dream” weight discrepancies ranging from 0.34 to 71.11 kg (M = 28.79 kg; SD = 13.21 kg). The mean was equivalent to losing 106% (SD = 0.15%) of excess body weight. Baseline BMI, female gender, younger age, and Caucasian ethnicity accounted for up to 62% of the variance in discrepancy scores. After controlling for initial BMI, there were no differences in discrepancies based upon type of surgery.
Conclusions
Across all three surgery types, women, Caucasians, younger patients, and those with higher initial BMIs were more likely to have unrealistic goals. Informed consent procedures should help patients, particularly those most likely to be unrealistic, understand likely outcomes as part of education on risks and benefits of weight loss surgery.
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References
Brethauer SA, Chand B, Schauer PR. Risks and benefits of bariatric surgery: current evidence. Cleve Clin J Med. 2006;73(11):993–1007.
Nocca D, Krawczykowsky D, Bomans B, et al. A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obes Surg. 2008;18(5):560–5.
Kaly P, Orellana S, Torrella T, et al. Unrealistic weight loss expectations in candidates for bariatric surgery. Surg Obes Rel Dis. 2008;4(1):6–10.
White MA, Masheb RM, Rothschild BS, et al. Do patients' unrealistic weight goals have prognostic significance for bariatric surgery? Obes Surg. 2007;17(1):74–81.
Linde JA, Jeffery RW, Levy RL, et al. Weight loss goals and treatment outcomes among overweight men and women enrolled in a weight loss trial. Int J Obes. 2005;29:1002–5.
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(11):1961–9.
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.
Dixon JB, Dixon ME, O'Brien PE. Body image: appearance orientation and evaluation in the severely obese. Changes with weight loss. Obes Surg. 2002;12(1):65–71.
Sorbara M, Geliebter A. Body image disturbance in obese outpatients before and after weight loss in relation to race, gender, binge eating, and age of onset of obesity. Int J Eat Disord. 2002;31(4):416–23.
Aruguete MS, Yates A, Edman J. Gender differences in attitudes about fat. N Am J Psychol. 2006;8(1):183–92.
Riley NM, Bild DE, Cooper L, et al. Relation of self-image to body size and weight loss attempts in black women: the CARDIA study. Am J Epidemiol. 1998;148(11):1062–8.
Heinberg LJ, Thompson JK, Matzon JL. Body image dissatisfaction as a motivator for weight loss: is some distress beneficial? In: Smolak L, Striegel-Moore R, editors. Eating disorders: new directions for research and practice. Washington: American Psychological Association; 2001. p. 215–32.
Foster GD, Wadden TA, Vogt RA, 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.
Chevallier JM, Paita M, Rodde-Dunet MH, et al. Predictive factors of outcomes after gastric banding: a nationwide survey on the role of center activity and patients’ behavior. Ann Surg. 2007;246:1034–9.
Alvarado R, Alami RS, Hsu G, et al. The impact of preoperative weight loss in patients undergoing laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;15:1282–6.
DeMaria EJ, Sugerman HJ, Kellum JM, et al. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002;35(5):640–7.
Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg. 2008;247(3):401–7.
Ahroni JH, Montgomery KF, Watkins BM. Laparoscopic adjustable gastric banding: weight loss, co-morbidities, medication usage and quality of life at one year. Obes Surg. 2005;15(5):641–7.
Watkins BM, Montgomery KF, Ahroni JH. Laparoscopic adjustable gastric banding: early experience in 400 consecutive patients in the USA. Obes Surg. 2005;15(1):82–7.
Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20(6):859–63.
Skrekas G, Lapatsanis D, Stafyla V, et al. One year after laparoscopic "tight" sleeve gastrectomy: technique and outcome. Obes Surg. 2008;18(7):810–3.
Wadden TA, Womble LG, Sarwer DB, et al. Great expectations: “I’m losing 25% of my weight no matter what you say”. J Consult Clin Psychol. 2003;71:1084–9.
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Heinberg, L.J., Keating, K. & Simonelli, L. Discrepancy Between Ideal and Realistic Goal Weights in Three Bariatric Procedures: Who Is Likely to Be Unrealistic?. OBES SURG 20, 148–153 (2010). https://doi.org/10.1007/s11695-009-9982-8
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DOI: https://doi.org/10.1007/s11695-009-9982-8