Weight Loss Expectations in Obese Patients Seeking Treatment at Medical Centers

Riccardo Dalle Grave,Massimo Cuzzolaro,Giulio Marchesini,Nazario Melchionda,Lucio Lucchin,Elisabetta Dall'Aglio,Simona Calugi,Flavia Magri

doi:10.1038/oby.2004.251

Abstract

To investigate weight loss expectations (expected 1-year BMI loss, dream BMI, and maximum acceptable BMI) in obese patients seeking treatment and to examine whether expectations differ by sex, weight, diet and weight history, age, psychological factors, and primary motivations for weight loss. 1891 obese patients seeking treatment in 25 Italian medical centers (1473 women; age, 44.7 +/- 11.0 years; BMI, 38.2 +/- 6.5 kg/m2) were evaluated. Diet and weight history, weight loss expectations, and primary motivation for seeking treatment (health or improving appearance) were systematically recorded. Psychiatric distress, binge eating, and body image dissatisfaction were tested by self-administered questionnaires (Symptom CheckList-90, Binge Eating Scale, and Body Uneasiness Test). In 1011 cases (53.4%), 1-year expected BMI loss was > or = 9 kg/m2, dream BMI was 26.0 +/- 3.4 kg/m2 (corresponding to a 32% loss), and maximum acceptable BMI was 29.3 +/- 4.4 kg/m2 (-23%). BMI and age were the strongest predictors of weight goals. Weight loss necessary to reach the desired targets was largely in excess of weight loss observed during previous dieting. Psychiatric distress, body dissatisfaction, and binge eating did not predict weight loss expectations. The primary motivation for weight loss was concern for future or present health; women seeking treatment to improve appearance had a lower grade of obesity, were younger, and had first attempted weight loss at a younger age. Obese Italian patients had unrealistic weight loss expectations. There were significant disparities between patients' perceptions and physicians' weight loss recommendations of desirable treatment outcome.

Highlights

The goal of obesity treatment is to reduce body weight to normal, as indicated by height-weight charts [1]
Unsatisfactory results have prompted a change in the final outcome from large weight loss to moderate weight loss and control of obesity-related risk factors, namely hypertension, dyslipidemia, and diabetes
QUOVADIS is an observational study on quality of life in obese patients seeking treatments at medical centers accredited by the Italian Health Service for the treatment of obesity

Summary

Introduction

The goal of obesity treatment is to reduce body weight to normal, as indicated by height-weight charts [1]. In the large majority of obese patients, no treatment is effective in achieving the desired goal to normalize body weight [2]. Unsatisfactory results have prompted a change in the final outcome from large weight loss to moderate weight loss and control of obesity-related risk factors, namely hypertension, dyslipidemia, and diabetes. These studies have shown that the morbidity related to obesity-associated risk factors is significantly decreased by a 5% to 10% reduction in weight, even if patients remain in the obesity range [2,3,4,5].

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