The role of patients' expectations and goals in the behavioral and pharmacological treatment of obesity

Abstract

Objective: To investigate weight loss expectations and goals among obese treatment seekers and to examine the relationships of these expectations and goals to treatment outcomes. Method: Participants were 180 obese men and women (age 43.8710.1 years; body mass index 37.674.2 kg/m 2 ) who received one of four-year-long treatments that combined behavioral and pharmacological methods. Before treatment, they reported the amount of weight they realistically expected to lose after 4, 12, 26 and 52 weeks of treatment, as well as their ultimate weight loss goals. Expectations and goals were compared across treatment groups and examined in relation to previous weight loss efforts, weight loss and regain in treatment, attrition, satisfaction with treatment and mood. Results: Participants in all treatment groups expected reductions at week 52 that were significantly greater than the 5-15% of initial weight they were told was realistic and significantly more than they had ever lost before. Weight loss expectations were unrelated to achieved weight loss in all groups but one, in which greater expectations were associated with greater losses. Failure to meet weight loss expectations for the first 26 weeks of treatment was related to lower satisfaction ratings, but was not related to weight regain or attrition over the next 26 weeks. Symptoms of depression were reduced from baseline, regardless of whether participants achieved or failed to achieve their expected weight losses. Conclusion: Across groups, we observed no negative consequences of having (and failing to meet) unrealistic expectations for weight loss.

Initiation and Maintenance of Weight Loss after Laparoscopic Adjustable Gastric Banding. The role of Outcome Expectation and Satisfaction with the Psychosocial Outcome

“…In general, patients tend to have unrealistic expectations with respect to the outcome of bariatric surgery [18]. In nonsurgical weight loss interventions, these unrealistic expectations have been shown to be linked to higher attrition [19], lower satisfaction [12], and less healthy psychological and eating behavior characteristics [13] but not to maintenance of weight loss [12,17]. In the current study, the prognostic effects of expectations, satisfaction and unfulfilled expectations are disentangled.…”

“…These theories, as well as the observation that positive outcome expectations predict the outcome of nonsurgical weight loss interventions [12][13][14], led to our first hypothesis that favorable preoperative expectations with respect to the psychosocial outcomes after LAGB would promote postoperative weight loss at 1 year. As shown in another study on bariatric surgery patients [15], the hypothesis was not confirmed.…”

Weight expectations, motivations for weight change and perceived factors influencing weight management in young Australian women: a cross-sectional study

“…BMI differed by age, education level and income. Younger respondents (18)(19)(20)(21)(22)(23)(24) Comparison with 2011 Australian Census data indicated that the sample was reasonably representative of the population of women of the same age in Australia. There was some response bias in terms of over-representation of those with higher education levels (52) , lower incomes (53) , as well as the number of single women (54) .…”

“…Despite initial weight-loss recommendations of 5-10 % (15,16) , research suggests that adults expect to lose 21-28 % of their starting weight within the first year of treatment (17)(18)(19)(20) , with desired weight losses as high as 34 % (18,20) . Most of these studies examined weight-loss expectations among middle-aged cohorts (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) or the general population (17,(29)(30)(31)(32)(33)(34) . A small (n 44) Italian study of 18-35-year-old women reported that non-obese women would need to lose 18 % and obese women 23 % of their current weight to reach their ideal weight (35) .…”

“…Women (mean age of 38·2 years) who enrolled in a weight management intervention were more likely to report appearance rather than improving health as the key motivation for enrolment, when compared with males (17) . Findings from the US National Weight Control Registry suggest that young adults (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) years) who maintained a weight loss for at least 1 year were more likely to report improved appearance or social factors as their primary motivators for weight loss and less likely to report health concerns as their motivation, when compared with older adults (36-50 years) (39) . These findings suggest that young women have different motivations for wanting to control their weight; however, these studies were restricted to individuals already enrolled in a weight-loss intervention or who had achieved successful weight-loss maintenance and therefore may not be representative of young women generally.…”