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By Carey Brown, MD


Why should overall weight loss expectations be discussed with the patient during the preoperative period? In most cases, there is a difference between the surgeon’s and patient’s expectation of weight loss after surgery. The surgeon bases expectations on published surgical weight loss data, whereas the patient may base their expectations from unrealistic or inflated goals. This can lead to frustration and anger since the patient may not be meeting these lofty goals.


Depending on the bariatric procedure, the general range of weight loss is fifty to sixty percent of the total body excess weight after five years. This means if a patient is one hundred pounds over his or her ideal body weight, the expected weight loss is fifty to sixty pounds. When the surgeon evaluates a patient regarding overall weight loss, several factors are considered.


1. Bariatric procedure type. Within individual programs there may be a difference in achieved weight loss between gastric bypass, band and sleeve.

2. Ability to exercise. If there are physical limitations such as arthritic knees, hips and back that prevent strenuous exercise, this can decrease the overall weight loss.

3. Patient’s commitment to a healthy lifestyle. Over time the surgeon will notice certain phrases or comments by the patient that gives insight to the patient’s commitment. When the patient admits to overeating, eating too fast or not exercising and this occurs at repeated follow up visits, the doctor will note this and make adjustments regarding the expected weight loss.


Your bariatric surgeon wants his or her patients to be healthy, happy and successful. To achieve these goals, the anticipated weight loss must match the patient’s expectation. The patient and the surgeon must work together to establish these expectations. Your bariatric program is here to help you succeed in meeting and maintaining your goals. Therefore, you must be responsible for your actions, take ownership of your commitment and play an active role in your own success.