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Objective: To examine relationships between the demographic characteristics of subjects with obesity seeking pharmaceutical-assisted weight loss and their weight loss expectations and perceptions of the causes of their obesity. Methods: 225 adults with obesity completed an Obesity Perceptions Questionnaire (OPQ), which includes four attribution subscales – biological, psychological, environmental, and lifestyle. Relationships between OPQ subscales, subject characteristics, and self-perceived “ideal” 12-month weight loss were analyzed. Results: Subjects desired to lose 26.4 (7.7)% of their body weight (“ideal weight loss”). Ideal weight loss correlated positively with the OPQ ‘biological’ subscale (P = .008), BMI (P < .001), female sex (P < .001), and past weight loss attempts (P < .001). Cronbach’s α was only good (>.70) for the psychological subscale. White race (P = .02), being married (P = .01) and high school or higher education (P = .02) were negatively correlated with ideal weight loss. Conclusions and Implications: When designing interventions for preventing and treating obesity, patient perceptions should be considered.