How Do You Measure Weight Loss Success?April 16, 2013
by Bo McCoy, ObesityHelp VP of Operations
The adage “one man’s trash is another man's treasure” comes to mind. One man looks at a piece art and sees trash from his vantage point. However, another man standing beside him looks and sees a treasure. Both are right and both are wrong and this paradox defines the subjective nature of how we define standards of art and treasure but also success and failure.
Failure, weight regain, shame, and depression are all words that any person who has ever suffered from obesity can easily define but even more so when these words begin to describe a persons life after gastric bypass. About a year ago I was at a conference with some post-operative patients and I overheard the following conversation.
Patient A, an athletic post-op who began the journey around 250 lbs. and now weighs around 150 lbs. (60%)
Patient B, a lessor athletic post-up than Patient B, who began the journey around 350 lbs. and now weighs around 200 lbs. (57%)
Patient B speaking to Patient A, “I am just so upset that I haven’t reached my goal weight. I’ve tried very hard but I cannot seem to reach goal”
Patient A's response, “How do you live with yourself?”
Let’s review some basic math so that we can truly see the reality of this conversation and the level of judgment that was being used against Patient B. Surgical and medical professionals view weight in terms of excess body weight or EBW. In order to measure efficacy, most medical professionals use a simple standard of measurement by taking the amount of weight loss and dividing it by the beginning weight. [Weight loss maintained / beginning weight = % of weight loss]
Patient A, began at 250 lbs. and now weighs around 150 lbs. Take 250 lbs. (beginning) weight and subtract 150 lbs. (current weight) equals 100 lbs. Now divide 100 / 250 and you have the amount of weight loss as a percentage. [250 -150 = 100] [100 / 250 = .40 or 40%]. Patient A lost 40% of their body weight.
Patient B began at 350 lbs. and now weighs around 200 lbs. Take 350 lbs. (beginning) weight and subtract 200 lbs. (current weight) equals 150 lbs. Now divide 150 / 350 and you have the amount of weight loss as a percentage. [350 -200 = 150] [150 / 350 = .43 or 43%]. Patient B lost 43% of their body weight.
Are you surprised to learn that Patient B has actually lost a greater percentage of weight than Patient A? Most people would be. In fact, most people will deem Patient A more successful because they most likely look “thinner’ than Patient B. We judge each other and ourselves on standards like this all time. However, in reality both patients have done very well.
If we were judging purely on weight then Patient A would be a greater success story. However, what If I told you that Patient A is five foot tall and Patient B is nearly six foot tall. Would that change your opinion? It should because now we are talking about the BMI for each patient. In this scenario, I do not know the exact height of each of the two patients but BMI can be calculated and used to determine weight loss efficacy if the data is known.
Now what if I told you that Patient B, while not athletic, is very healthy and enjoys an active social life and was once featured in a national advertising campaign. How would you feel now about Patient B? Do you think Patient B has any reason to be feeling down-in-the-dumps? If not; then why do you think people like Patient B get depressed? Could it be because of the judgmental attitudes of their peers?
Success and failure is in the eye of the beholder. If you allow the Patient A’s of the world to define your success then you might be very depressed indeed. However, if you define your success not just by weight loss but lifestyle improvement, social activity, general health, co-morbidity resolution, and improved life expectancy you are truly successful. You are a success if you want to be.
Questions to consider:
- How would you respond to Patient A?
- What would you say to Patient B?
- What does it mean to be successful weight loss patient to you?