Unrealistic Weight Loss Goals and Expectations Among Bariatric Surgery Candidates: The Impact on Pre- and Postsurgical Weight Outcomes

Background: Bariatric surgery is an effective weight loss option. However, past research has demonstrated that surgery candidates' weight loss goals and expectations are often unrealistic. Previous research has also demonstrated that female patients are more likely to hold unrealistic weight loss goals and expectations, albeit it is unknown whether these beliefs have prognostic significance. The current study examines gender differences in weight loss goals and expectations in terms of pre- and postsurgical program achievement. Methods: At the outset of a 6-month presurgery program, 219 surgery candidates (75.8% female) completed a battery of tests, including objective measures of height and weight and subjective reports of weight loss goals and expectations. Weight outcomes were reassessed regularly, and of the original 219 candidates, weight data were available for 114 candidates at 1 year postsurgery. Results: At program end, 42.2% of female candidates and 45.3% of male candidates had experienced ideal weight loss, more than 10% of their excess body weight (EBW). However, 16.3% of females and 3.8% of males experienced weight gain. In females, unrealistic weight loss expectations/goals were not related to weight outcomes. However, in males, unrealistic expectations/goals were significantly related to weight gain. Unrealistic expectations/goals were also related to postsurgical outcomes. Conclusions: Although female candidates were more likely to hold unrealistic goals and expectations, these beliefs had presurgical prognostic significance for males only. Discussion of unrealistic weight loss expectations should occur throughout presurgery programs, and may be especially important for male candidates. Postsurgical sex differences should be examined in future research.