title: What is my goal? Expected weight loss and comorbidity outcomes among bariatric surgery patients.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center for the Advancement of Minimally Invasive Surgery, Department of General Surgery, University of Alberta, Edmonton, Canada.
authors.forename: Shahzeer
authors.initials: S
authors.lastname: Karmali
authors.forename: Huseyin
authors.initials: H
authors.lastname: Kadikoy
authors.forename: Mary L
authors.initials: ML
authors.lastname: Brandt
authors.forename: Vadim
authors.initials: V
authors.lastname: Sherman
mesh_terms: D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D015390:Gastric Bypass / Q000523:psychology*; D005764:Gastroesophageal Reflux / Q000453:epidemiology; D015391:Gastroplasty / Q000523:psychology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D009042:Motivation; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000523:psychology* / Q000601:surgery; D010549:Personal Satisfaction; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology; D015431:Weight Loss