Understanding Patients' Value of Weight Loss and Expectations for Bariatric Surgery

Background: Few studies examine patients' expectations for bariatric surgery or the value patients place on weight loss. Methods: 44 patients planning to undergo bariatric surgery were surveyed to examine patients' expectations and motivations for surgery. We also quantified how much patients valued different health and weight loss states using the standard gamble, an approach that estimates an outcome's value based on a patient's willingness to risk death to achieve the outcome. Utilities ranging from 0 to 1.00 were calculated where 1.00 represented the most desired state. Results: Mean age of the patients was 42.6 years, and mean body mass index was 47.1 kg/m². The majority were women (n=42) and white (n=29), and reported poor quality of life. Most patients considered surgery for health reasons. Patients expected to lose 38% of their total body weight and would be disappointed if they did not lose at least 24% of their body weight. Significantly more patients were willing to risk death to achieve their "dream" weight (n=40) than to lose 20% (n=32) or 10% (n=17) of their total body weight. The respective utilities for these weight states were 0.98, 0.94, and 0.92. More patients were willing to risk death to undergo surgery (n=42) than to achieve a permanent weight loss of 20% (n=32), P<0.004. Conclusion: Patients appeared to value weight loss highly but had unrealistic expectations for bariatric surgery. Future studies should examine whether patient expectations, motivations, and value for realistic weight losses might predict outcomes and satisfaction after surgery.