Do patients' unrealistic weight goals have prognostic significance for bariatric surgery?

Research has shown that obese individuals report goal weight losses in excess of those achievable with standard treatments for obesity. Little is known about the goal weights of bariatric surgery patients, or the prognostic significance of unrealistic goals on surgical outcomes, including weight losses and changes in associated behavioral and psychological domains.

A consecutive series of 139 gastric bypass (GBP) surgery candidates reported weight loss goals prior to GBP surgery and at 6 and 12 months after surgery. Dream, Happy, Acceptable, and Disappointed weights following treatment were reported.

Consistent with previous research, goal weights at baseline were lower than those attainable even with surgery. Repeated measures analyses, controlling for baseline BMI, revealed no changes in any of the goal weights from baseline to 6 and 12 months following surgery. After controlling for baseline BMI, weight loss expectations at baseline did not predict weight loss at either follow-up point. Unrealistic weight goals were also largely unrelated to psychological functioning prior to surgery, and were unrelated to the magnitude of the improvements in eating-related behaviors and psychological functioning after surgery. Interestingly, mean goal weights parallel current weight classifications: i.e., dream BMI corresponds with the cutoff for normal (BMI < or =25), happy BMI (=27) with the lower bound for "overweight", and acceptable BMI (=30) with the lower bound for obesity.

Among GBP surgery patients, goal weights are remarkably consistent over time, and unrealistic weight loss goals do not appear to have negative prognostic significance on surgical outcomes.