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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.
Changing Expectations
What can be done to change unrealistic expectations? One important approach is to counter the mythology surrounding the establishment, attainment, and benefits of particular goal weights. Several examples are listed below.
Myth: "That’s what I should weigh based on my height."
Fact: It’s a nice idea that everyone who’s the same height should be the same weight, but it’s just not true. Weight is affected by many factors such as genetics, metabolism, number of fat cells, eating habits, and physical activity. Among these, height is probably the least important.
Myth: "I can reach my goal weight because I’ve been there before (when I got married, before I had children, when I was in the military, the last time I lost weight…)."
Fact: That was then, and this is now. Your weight at a previous point in your life gives you limited information about whether that weight can be attained or, more importantly, maintained. Your goal weight is most appropriately based on the here and now. Is the caloric intake and exercise required to reach and/or maintain your goal realistic for you at this time?
Myth: "I won’t get all the benefits of weight loss until I reach my goal weight."
Fact: Many studies have shown that medical conditions like diabetes, high blood pressure and high cholesterol are significantly improved by a 5-10% reduction in weight, and losing more weight doesn’t necessarily result in additional improvements. Our study found that people experienced all of the physical and psychological benefits that they expected to experience from reaching their goal weight, at a weight loss that was actually only 50% of their goal.
Myth: "I could reach my goal weight if I had more will power. I’ve lost my motivation."
Fact: The factors affecting your weight loss are not totally under your control. You can control your eating and exercise, but you can’t control your metabolism, genetics and fat cell number. Not achieving your goal weight is more likely to be attributable to setting an unrealistic goal than to a lack of will power.
Myth: "That was my goal so I have to stick with it."
Fact: No goal is set in stone. In many other areas of your life, you set goals and then modify them as you become aware of what can realistically be achieved. Why should weight loss be different?
Myth: "My actual weight makes a difference."
Fact: Weight, itself, is not important. It’s just a number. What’s important is the effect that weight has on you. Focus instead on whether the negative effects of excess weight been reduced with the weight loss that you have achieved. If this has occurred, and your overall health and quality of life has improved, is your actual weight really that important?
I recommend that you try this myth/fact exercise for your own situation. List below any of your impressions about the importance of reaching your goal weight. Are all these impressions factually based? Are there any facts that may counter these impressions?_
Another method to change unrealistic expectations is to improve body image and self-esteem. Our study found that negative body image and low self-esteem were associated with more unrealistic weight loss goals. Two books are extremely useful in this regard. They are listed after this article (numbers 4 & 5). (Please also refer to Healthology’s Recommended Reading for a selection of reviewed books that you may find interesting).
Summary
A desire to achieve a goal weight doesn’t necessarily mean that it’s possible or beneficial. Everyone’s different, but for most people it’s not realistic to expect more than a 10-15% reduction of your initial weight. Realize that your personal worth is not measured by the scale. Contrary to the messages that our culture conveys, your body weight is not totally under your control. Make modest changes in your eating and exercise, and try to accept (not necessarily like) the weight loss that occurs. Try to keep in mind that your weight is just one factor that describes you. It doesn’t define you.
Additional Readings on This Topic
1. Foster GD. Reasonable weights: Determinants, definitions and directions. In: Allison DB, Pi-Sunyer FX (eds). Obesity Treatment. New York: Plenum Press, 1995:35-44.
2. Blackburn GL. Effect of degree of weight loss on health benefits. Obes Res 1995;3:211s-216s.
3. Foster, GD, Wadden TA, Vogt RA, Brewer G. What is a reasonable weight loss? Patient’s expectations and evaluations of obesity treatment outcomes. J Consult Clin Psychol 1997;65:79-85.
4. Cash TF. What do you see when you look in the mirror? Helping yourself to a positive body image. New York: Bantam Books, 1995.
5. Johnson C. Self-esteem comes in all sizes: How to be happy and healthy at your natural weight. New York: Doubleday, 1995.
