Unrealistic Weight Loss Goals Result in Feelings of Failure
November 13, 2000
MedscapeWire


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A study presented at the annual meeting of the North American Association for the Study of Obesity (NAASO) in Long Beach, California, suggests that patients continue to set weight loss goals that are unattainable, even when counseled, resulting in disappointment and perceptions of failure. The finding demonstrates the need for increased education among patients and physicians about how to redefine success by setting expectations focused on health benefits rather than appearance.

"This study underscores patients' continued desire to lose much more weight than can be achieved by the best behavioral and pharmacological treatments available today. It is important for physicians to emphasize and reiterate to patients that a 10% weight loss is a treatment success," said Leslie Womble, PhD, lead investigator and instructor in the Department of Psychiatry, University of Pennsylvania School of Medicine in Philadelphia, Pennsylvania. "Practitioners should work with patients to readjust expectations with a focus on health to avoid what patients label as 'another failed weight loss attempt.' "

The study was designed to determine whether patients' weight loss expectations changed when they were informed about how much they could expect to lose in 1 year of lifestyle modification combined with medication (sibutramine). The 53 women included in the study completed a questionnaire asking them how much weight they expected to lose after 4, 12, 26, and 52 weeks of treatment. In a meeting with an investigator, women were told they could expect to lose 5% to 15% of their initial weight during treatment. This fact was repeated in 2 separate sections of the consent form. After signing the consent form, the women completed a second questionnaire on their weight loss expectations. Patients' weight loss expectations essentially remained unchanged, with patients expecting to lose weight at a faster rate than is realistic. The only reduction in weight loss expectations before and after counseling was seen after 52 weeks, with patients predicting that they would lose 25% vs 28% of their starting weight.

"Obesity is a serious disease in the US that carries severe health risks," said Arthur Campfield, PhD, vice president of NAASO and department head and professor of Food Science and Human Nutrition at the College of Applied Human Sciences at Colorado State University in Fort Collins, Colorado. "There is clear clinical evidence that a modest weight loss of 5% to 10% can improve risk factors for diabetes and heart disease, including high blood pressure, and high cholesterol. People whose weight puts their health at risk should seek help from their physician to set realistic expectations for weight loss that will reduce their future health risks."


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MedscapeWire is prepared by Deborah Flapan, associate editor at Medscape. Send press releases and comments to medscapewire2~mail.medscape.com.

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I think this is a really interesting article. Unfortunately, it's hard to be 'realistic,' rather than despairing around the issue of weight when:

1) Western society worships extreme thinness
2) Most weight-loss routines (eg low calorie) are impossible to sustain over the long term
3) Even people who should know better - like Atkins - emphasize the rapid weight loss possible - but probably not all that common! - when low-carbing.

From what I've been reading in this forum and on the Atkins board, slow weight loss (1-4 pounds a month) seems to be the norm, rather than the 10 pounds a month averages Atkins goes on and on about in his book. I know extreme promises sell books, but I wish he'd used a broader spectrum of 'case studies.'

My partner, a male one, has indeed lost 12 lbs in a month. As for myself, doing the same routine/diet as him, and doing more exercise and drinking more water and taking vitamins (and lithium, but that's another story), I lost 10 lbs in 6 weeks.

I was told men are just "wired" that way...

So perhaps the case studies were on men, as are most clinical studies?

I'm getting tired of hearing this one. The reason is that people, in general, don't keep that 5-10% of weight loss off. They regain it and more. Then the health benefits are not only lost, but the risks are made worse as they yo-yo their weight higher and higher.

To me the emphasis needs to be on weight and nutrition management, not weight loss. I figure the only reason I wasn't sicker than I was when I started LC-ing is that I had stopped dieting years before and maintained my weight instead of yo-yoing. My diet sucked, but at least I wasn't gaining weight.