Weight Loss Expectations and Goals in a Population Sample of Overweight and Obese US Adults

Abstract

The purpose of this study was to investigate weight loss expectations and goals in a population sample of US adults who planned to make a weight loss attempt, and to examine predictors of those expectations and goals. Participants were 658 overweight and obese adults (55% women, mean age = 47.9 years, BMI = 31.8 kg/m 2 ) who responded to a telephone survey about weight loss. Respondents reported weight loss expectations (i.e., reductions they realistically expected) and goals (i.e., reductions they ideally desired) for an upcoming "serious and deliberate" weight loss attempt. They also reported the expectations they had, and the reductions they actually achieved, in a previous attempt. Respondents' weight loss expectations for their upcoming attempt (8.0% reduction in initial weight) were significantly more modest than their goals for that attempt (16.8%), and smaller than the losses that they expected (12.0%), and achieved (8.9%) in their most recent past attempt (Ps ≤ 0.003). Women and participants with higher BMIs had greater weight loss expectations and goals. After controlling for BMI, age, and gender, previous weight loss was unrelated to expectations (but was inversely related to goals) for the upcoming weight loss attempt. Results suggest that overweight and obese individuals can select realistic weight loss expectations that are more modest than their ideal goals. BMI and gender appear to be more important than previous weight loss experiences in determining expectations among persons planning a weight loss attempt.

Impact of Weight-Related Discrimination, Body Dissatisfaction and Self-Stigma on the Desire to Weigh Less

“…This goes align with recent findings from a meta-analysis on obesity and discrimination [53]. Our results reveal that female participants, younger participants, and participants with higher BMIs wanted to lose more weight than their counterparts, going align with the literature [12,18,23]. The discrepancy between current weight and desired weight was greater when participants reported discrimination due to their weight as well as internalized stigma.…”

“…However, there is evidence that improving body image or body appearance (rather than health) may be an influential factor for weight loss desire [19,20], since higher weight loss goals result from greater body image concerns among obese individuals in general, and among women with obesity in particular [21]. The perceived need of losing weight and the wish to achieve greater body weight reductions might be linked to anxiety about body image concerns [20,23], resulting in disordered health behavior [22]. The question remains whether body image concerns are grounded on social or cultural floors, especially since higher levels of body dissatisfaction have been shown to be associated with social pressure to be slim [24].…”

Sample Size in Obesity Trials: Patient Perspective Versus Current Practice

“…Hence, to expect this study group to anticipate and realistically entertain a 20–50% weight loss may not have been reasonable. Indeed, Fabricatore et al30 recently reported that “Respondents' weight loss expectations for their upcoming attempt (8.0% reduction in initial weight) were significantly more modest than their goals for that attempt (16.8%), and smaller than the losses that they expected (12.0%), and achieved (8.9%) in their most recent past attempt… Results suggest that overweight and obese individuals can select realistic weight loss expectations that are more modest than their ideal goals.” Thus, while obese people may desire large weight losses, in most cases, they do not realistically expect them. With this in mind, the initially counterintuitive results may make sense from a perspective of how individuals determine how much they would be willing to pay for a benefit like weight loss (i.e., an inquiry into subjective valuation as practiced by economists).…”

Visceral adiposity and cardiometabolic risks: epidemic of abdominal obesity in North America

“…[33][34][35][36] Meanwhile, interventions that achieve a sustainable weight loss in the range of 7% to 10% of initial body weight are known to cause significant reduction in the cardiometabolic risks and obesity-associated conditions, including T2D, hyperlipidemia, and hypertension, and hard outcomes such as stroke, myocardial infarction, and death. 22,32 Thus, lowering excess weight in obese patients has major beneficial outcomes, including improving quality of life and cost reductions. In this regard, nonrandomized studies of obese patients treated with fenfluramine/mazindol, fenfluramine/phentermine, caffeine/ephedrine, or mazindol for weight loss reported that the pharmaceutical cost savings arising from a reduced need for medications to treat diabetes, dyslipidemia, and hypertension because of weight loss more than offset the cost of the weight-loss medications.…”

“…2,19 From a nonfinancial perspec tive, BMI negatively correlates with quality of life 20 positively with and mortality. 21,22 The number of problems associated with being overweight is numerous, but the most serious comorbidities are metabolic syndrome, hypertension, dyslipidemia (high quantities of triglycerides, and low-density lipoprotein [LDL]) and lower amounts of highdensity lipoprotein [HDL], T2D, cardiovascular disease, stroke, myocardial infarction, peripheral vascular disease, cancer, and sleep apnea.…”