Expectations for weight loss and willingness to accept risk among patients seeking weight loss surgery.

Area of Science:

• Bariatric Surgery
• Metabolic and Bariatric Surgery
• Obesity Medicine

Background:

• Weight loss surgery (WLS) offers long-term weight reduction but carries inherent risks and variable effectiveness.
• Patient expectations regarding weight loss and acceptable perioperative risks are not well understood.

Purpose of the Study:

• To assess the weight loss expectations and motivations of patients considering WLS.
• To determine the mortality risks patients are willing to accept for WLS.
• To identify demographic, clinical, and perceptual factors associated with high expectations and risk tolerance.

Main Methods:

• Interviews with 654 patients seeking WLS across two Boston centers.
• Multivariable analyses to correlate patient characteristics with high weight loss expectations and willingness to accept ≥10% mortality risk.

Main Results:

• Patients expected an average of 38% weight loss, with disappointment below 26%.
• 84.8% accepted some mortality risk; 19.5% would accept ≥10% risk.
• Lower quality of life and perception of needing substantial weight loss for health benefits correlated with unrealistic expectations and higher risk acceptance.

Conclusions:

• Most WLS candidates exhibit high weight loss expectations and a belief that significant weight loss is necessary for health benefits.
• Educational initiatives are crucial to bridge the gap between patient expectations and clinical outcomes.