Discrepancy Between Ideal and Realistic Goal Weights in Three Bariatric Procedures: Who Is Likely to Be Unrealistic?

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). 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. 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. 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.