Weight loss expectations and determinants in a large community-based sample

While weight-loss expectations have primarily been studied in people enrolled in weight-loss programs, the present study explores patient expectations about weight-loss and identifies related determinants in a large, non-clinical population. 3916 volunteers (age > 18 years) participated in 2012 in a community-based survey in the French-speaking region of Belgium. Participants were asked to define "dream", "goal", "happy", "acceptable", and "disappointed" weights. Other self-reported measures were used to determine each participant's body mass index (BMI), body image discrepancy (BID), subjective norm (SN), weight loss activity, weight history, quality of life (QoL), and demographic and socioeconomic characteristics. The study focused on the determinants of unrealistic weight-loss "goal" (≥10% of initial weight). Results showed median weight loss targets ranged from 5 kg ("disappointed" weight loss) to 21 kg ("dreamed" weight loss). Respondents considered the recommended weight-loss target (5-10%) disappointing. Severe and morbid obesity categories are at high risk of unrealistic weight loss goal. Unrealistic weight-loss goals was associated with female gender, weight loss activity, overweight history and lower QoL in overweight and moderate obesity respondents. These findings confirm the urgent need to help patients accept more modest weight loss outcomes and the need for personalized care that considers the patient's specific profile and both weight loss expectations and determinants.