What is my goal? Expected weight loss and comorbidity outcomes among bariatric surgery patients

Background: A number of reasons lead patients to choose to undergo weight loss procedures. Previous studies have demonstrated that patients have unrealistic weight loss goals. However, there is a general paucity of information on a patient's expectations in regards to comorbidity improvement and resolution. The purpose of this study is to examine the impact a patient's comorbid conditions have on the motivation to proceed with bariatric surgery. Furthermore, we examined the patient's expectations regarding postoperative weight loss and comorbidity improvement. Methods: Forty-five subjects completed a modified Goals and Relative Weights Questionnaire assessment 1 week prior to their anticipated bariatric surgery. The first portion addressed a patient's personal weight loss goals and factors that influence their procedure selection. The second part assessed the expectations and evaluations of a variety of specifically determined weight loss outcomes. Results: A total of 45 patients completed the survey (laparoscopic adjustable gastric band (LAGB) 23/45; Roux-en-Y gastric bypass (RNYGB) 22/45). The mean goal percentage of excess weight loss was 85.0% (21-130%). This translated to 80.2% (21-127%) in the LAGB group and 90.5% (37-130%) in the RNYGB group. Of 13 possible reasons, "a desire for change in medical comorbidities" was deemed as most important in choosing a goal weight. Comorbidities with the highest dissatisfaction level included urinary incontinence and hypertension. All patients expected some degree of comorbidity improvement at 1 year postsurgery, with 26% (6/23) expecting a resolution of their diabetes, 36% (10/28) expecting a resolution of hypertension, and 40% (10/25) expecting a resolution of obstructive sleep apnea. Conclusion: A dissatisfaction with obesity-related comorbidities, most notably hypertension and urinary incontinence, was a motivating factor in choosing to undergo bariatric surgery. Patients expected improvement in their comorbid illnesses; however, they still possessed unrealistic weight loss expectations for their intended weight loss procedure.