Weight Loss Expectations in Obese Patients Seeking Treatment at Medical Centers

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

doi:10.1038/oby.2004.251

Cited by 61 publications

(74 citation statements)

References 23 publications

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“…Overall, the associations found in the present study contrast with the findings of Dalle Grave and colleagues, 3,9 who reported smaller reductions and greater attrition among persons with greater expectations for weight loss. The difference in findings may be attributable, in part, to methodological differences.…”

Section: Discussioncontrasting

confidence: 99%

“…[1][2][3][4][5] The losses they expected after 1 year of behavioral 19,20 There was a small positive relationship between participants' expected and achieved weight losses at week 26. Thus, participants with higher expectations lost more weight in the first 6 months of treatment.…”

Section: Discussionmentioning

confidence: 97%

“…[1][2][3][4] Dieters maintain these expectations even when repeatedly informed that they are likely to lose only 5-15% of initial weight, 5 which is the size of the losses typically induced by current behavioral and pharmacological interventions. 6 Investigators disagree concerning the consequences of patients' unrealistic goals and expectations.…”

Section: Introductionmentioning

confidence: 99%

“…Some believe that weight regain is, in large part, attributable to patients' disappointment with failure to reach their goals, which leads patients to abandon efforts to maintain the modest weight losses that they did achieve. [7][8] In support of this hypothesis, Dalle Grave and colleagues 3,9 found that greater weight loss goals and expectations were associated with earlier attrition from therapy and smaller reductions in body mass index (BMI) after 1 year of treatment. Other investigators, however, have failed to observe adverse effects of large weight loss goals.…”

Section: Introductionmentioning

confidence: 99%

“…3,9 It is possible that the importance of goals and expectations differs across treatment approaches. In addition, most studies have focused only on how much weight patients ultimately wanted to lose (that is, weight loss goals) rather than on how much weight they realistically expected to lose during a given time with a specific treatment (that is, weight loss expectations).…”

Section: Introductionmentioning

confidence: 99%

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The role of patients' expectations and goals in the behavioral and pharmacological treatment of obesity

et al. 2007

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Objective: To investigate weight loss expectations and goals among obese treatment seekers and to examine the relationships of these expectations and goals to treatment outcomes. Method: Participants were 180 obese men and women (age 43.8710.1 years; body mass index 37.674.2 kg/m 2 ) who received one of four-year-long treatments that combined behavioral and pharmacological methods. Before treatment, they reported the amount of weight they realistically expected to lose after 4, 12, 26 and 52 weeks of treatment, as well as their ultimate weight loss goals. Expectations and goals were compared across treatment groups and examined in relation to previous weight loss efforts, weight loss and regain in treatment, attrition, satisfaction with treatment and mood. Results: Participants in all treatment groups expected reductions at week 52 that were significantly greater than the 5-15% of initial weight they were told was realistic and significantly more than they had ever lost before. Weight loss expectations were unrelated to achieved weight loss in all groups but one, in which greater expectations were associated with greater losses. Failure to meet weight loss expectations for the first 26 weeks of treatment was related to lower satisfaction ratings, but was not related to weight regain or attrition over the next 26 weeks. Symptoms of depression were reduced from baseline, regardless of whether participants achieved or failed to achieve their expected weight losses. Conclusion: Across groups, we observed no negative consequences of having (and failing to meet) unrealistic expectations for weight loss.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The role of patients' expectations and goals in the behavioral and pharmacological treatment of obesity

et al. 2007

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Obesity Management: Considerations for the Gastroenterologist

Gramlich

Zeman

Sharma

2010

Evidence‐Based Gastroenterology and Hepatology

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Outcome research in obesity: lessons from the QUOVADIS study

Marchesini

Marzocchi

Grave

2006

Drug Development Research

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Outcome research in obesity is aimed at the identification of clinically meaningful goals. Over the years, the focus has moved from surrogate health markers to cardiovascular risk and survival. The 7-10% weight loss recommended by guidelines is a target easily attained with any treatment, but does not guarantee physical and psychological benefits unless it is accompanied by weight loss maintenance, a target very difficult to achieve with either behavior treatment or pharmacological intervention. A reduced cardiovascular risk profile is associated with weight loss, irrespective of the treatment program. In contrast, no controlled studies have so far documented an increased survival, but evidence has been provided by epidemiological surveys. Also bariatric surgery, promoting a larger weight loss and good weight loss maintenance, has failed to demonstrate an improved survival. Health-related quality of life is an additional significant outcome, approved by international agencies. Concern regarding a possible detrimental effect of dieting on mood and depression is not substantiated by the results of controlled studies. The high prevalence of obesity and its consequences pose a serious and unresolved challenge to the medical community and the definition of outcome measures is a key issue for the assessment of results. Drug Dev.

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Weight Loss Expectations in Obese Patients Seeking Treatment at Medical Centers

Cited by 61 publications

References 23 publications

The role of patients' expectations and goals in the behavioral and pharmacological treatment of obesity

The role of patients' expectations and goals in the behavioral and pharmacological treatment of obesity

Obesity Management: Considerations for the Gastroenterologist

Outcome research in obesity: lessons from the QUOVADIS study

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