Influence of weight discrimination on weight loss goals and self-selected weight loss interventions

What is already known about this subject •  There is a discrepancy between clinical and patient goals for weight loss. •  Evidence suggests that some bariatric patients highly value, and are willing to endure hardships for weight loss. •  Obesity is commonly framed as an easily reversed and individual problem, which in turn promotes weight discrimination. What this study adds •  Patient beliefs about weight loss are in accordance with social understandings of obesity but not with current treatment options. •  Patients may not be willing to endure hardships for weight loss. •  Weight discrimination may relate to how patients approach weight loss.

Bariatric patients report weight loss goals, which are three times higher than weight loss recommended by clinicians. It is unclear which weight loss interventions patients feel are necessary to reach these goals or whether responses associate with perceptions of weight discrimination. One hundred fifteen patients (BMI = 40.0 ± 6.9 kg m(-2) , age = 47.2 ± 12.2 years, 85% female, 77% reporting weight discrimination) were surveyed from weight management clinics. Participants reported ideal weight losses of 37.6 ± 16.7 kg (33% of initial weight), and the majority felt weight loss could be achieved through lifestyle changes such as improved physical activity (80%) or diet (52%), with fewer reporting pharmacotherapy (8%), surgery (12%) or genetic modification (7%) as necessary for goal attainment. Participants selecting lifestyle changes or pharmacotherapy for weight loss reported ideal weight loss goals that would generally be achievable through surgical means (32% and 33%, respectively), and participants selecting surgical intervention reported ideal goals at the upper end of what is generally achievable with this intervention (38%). All participants selecting surgery or genetic modifications reported experiencing weight discrimination. These results indicate a disparity between weight loss goals and selected interventions, and suggest that weight discrimination is associated with the selection of potentially riskier weight loss interventions.