Traditionally, weight loss goals were based on reaching an ideal weight, as defined by height-weight charts. More recently, 10% reductions in body weight have been suggested as successful outcomes. There are many factors that support such a change in thinking. Perhaps the most compelling is that many weight-related conditions, such as diabetes and high blood pressure, are significantly improved with weight losses of 5-10%, even if individuals remain considerably overweight. [Please see our article, “The Health Benefits of Modest Weight Loss.”] Although the success of a 10% weight loss has been endorsed by expert panels and governmental guidelines, it is unclear whether persons attempting to lose weight agree with this view.
Our Patients’ Perspective
Recently, my colleagues and I at the University of Pennsylvania asked 60 women beginning a weight loss program “What is your goal weight?” We also asked them for a weight that fit the following four descriptions:
Dream Weight: A weight you would choose if you could weigh whatever you wanted.
Happy Weight: This is not as ideal as the dream weight. It is a weight, however, that you would be happy to achieve.
Acceptable Weight: A weight that you would not be particularly happy with, but one that you could accept since it is less than your current weight.
Disappointed Weight: A weight that is less than your current weight, but one that you could not view as successful in any way. You would be disappointed if this were your weight after the program.
We compared our patients’ responses to the new modest weight loss recommendations discussed above. What a difference! Our patients, who weighed an average of 218 pounds, chose an average goal weight of 149 pounds — a 69 pound weight loss! This represented a 32% reduction in body weight, an amount three times greater than the 10% recommendation. Even more surprising was the amount of weight loss that participants felt was necessary for success. A 37 pound weight loss (a 17% reduction) was “disappointing and not successful in any way.” and a 55 pound weight loss (a 25% reduction) was only “acceptable, but not one that I would be happy with.” Given these high expectations, it wasn’t surprising that almost half (47%) of our patients did not even achieve their “Disappointed Weight” after 48 weeks of treatment! The average weight loss that our patients achieved was 35 pounds (a 16% reduction). This study suggests that most people beginning weight loss programs have goals that are unattainable. No treatment, except surgery, produces the weight losses (32% reduction) desired by our study participants.
Consequences of Unrealistic Goals
Unrealistic goals leave many people feeling unsuccessful even after significant weight loss. Rather than feeling proud of their weight loss and developing skills to maintain it, many can only focus on how much more they have to lose. Despite feeling better physically and psychologically, the patients in our study were not satisfied with their weight after treatment. This is an example of a well-known psychological truth: satisfaction with any outcome is determined by the difference between what actually happened and what was expected to happen. Our study found that people’s satisfaction with their weight was more related to how close they came to their goal weight (chosen before the program began) than it was to their actual weight loss. So, people 10 pounds from their goal were more satisfied than those who were 20 pounds from their goal, no matter how much weight they lost. We are concerned that dissatisfaction with weight loss, combined with frustration when unrealistic goals are not achieved, will lead to overly aggressive methods to lose weight, perceived failure, abandonment of weight control efforts, and eventual weight regain.