Obesity surgery: expectation and reality

Expectations and reality have been evaluated among 33 people considering, and 32 patients who had undergone, gastric restrictive surgery for morbid obesity. We addressed obesity history, dietary habits, expectations of surgery, weight loss, quality of life and obesity related diseases. Both groups had similar histories of a young age of onset and a strong family history of morbid obesity. Vomit avoidance was predominantly responsible for the highly significant decrease in total daily calories eaten (5283 +/- 356 vs 1622 +/- 95, P less than or equal to 0.0001). The ratios of carbohydrate, protein and fat, however, did not change. The desired weight loss was unrealistically high in both groups. Preoperative patients have unrealistic expectations concerning snack consumption. Postoperative patients have more realistic expectations concerning long term weight loss. Only 38 percent vs 70 percent of preoperative patients expected to lose 100-150 lbs (P less than or equal to 0.025). Disquietingly, 55 percent of preoperative and 41 percent of postoperative patients felt that weight loss following surgery is due to 'magic'. Percent excess weight loss for the postoperative patients was 61 +/- 9 percent from 4 to 84 months following surgery. Following weight loss there was the expected statistically significant improvement (P less than 0.001) in obesity related diseases. Long term follow-up (greater than or equal to 8 years) is now required to determine whether the changes following surgery for morbid obesity identified in this study will result in improvement of quality and/or length of life.