WHAT IS A REASONABLE WEIGHT-LOSS - PATIENTS EXPECTATIONS AND EVALUATIONS OF OBESITY TREATMENT OUTCOMES

Expert panels and governmental guidelines now recommend that obese per sons seek modest (i.e., ''reasonable'') reductions in body weight rath er than striving for ''ideal'' weights. Little is known, however, abou t patients' views of what is a ''reasonable'' weight loss. This study assessed patients' goals, expectations, and evaluations of various out comes before, during, and after 48 weeks of treatment. Before treatmen t, 60 obese women (99.1 +/- 12.3 kg; body mass index of 36.3 +/- 4.3 k g/m(2)) defined their goal weight and 4 other weights: ''dream weight' '; ''happy weight''; ''acceptable weight''; and ''disappointed weight. '' Goal weight averaged a 32% reduction in body weight. A 17-kg weight loss was defined as disappointed; a 25-kg loss, was acceptable. After 48 weeks of treatment and a 16-kg weight loss, 47% of patients did no t achieve even a disappointed weight. These data illustrate the dramat ic disparity between patients' expectations and professional recommend ations and the need to help patients accept more modest weight loss ou tcomes.