Excess Weight Calculations

I did a search on this subject and it was about a year ago and still really didn't answer my question. Soooo...

I went to my surgeon last week and she was calculating my goal as a successful WLS patient. She went by my highest weight 273 x 60% putting me at about 190. Ok, wait a second here...I lost 38 lbs by myself before surgery. The surgery is supposed to help me lose x% of my excess weight. Shouldn't she be basing that number off what I weighed the day of surgery? That would put me to around 170. I know it doesn't matter either way because I'm getting 100% of this weight off, period but I'm wondering how your surgeon calculated your goal surgery weight.

my surgeon goes by BMI.  Once your in the range of a healthy BMI then he considers you to be at goal.  He gave me a range for a goal weight   107-131  I just picked the middle of 125.  My main reasons for getting surgery was to get off all the medications I was taking for Diabetes and High blood Pressure.  Im 15 days out and have not taken any medication except for what he has prescribed.   I take one medication twice a day.   I asked him yesterday if that was a life long thing.  He said no just for 6 months and that I can live with. 

Good luck on finding out what your goal is. 

 To calculate what your "excess body weight" is, you need to know a couple things. You need to know your starting weight (that can be your highest or your surgery day weight, whatever you want it to be). You also need to know your "ideal" weight -- this is different than your goal weight.  

Ideal weight is what the science people say you should weigh. This is usually an unrealistic number that's based on never being obese in  your life and being a perfect BMI weight. So need to look at the BMI calculator and figure out what you would weigh if you fell exactly in the middle of the "Normal BMI" range. Normal BMI is 18.5 to 24.9 ... so the middle would be 21.7.

I don't know how tall you are, so I'll use mine. I'm 5'6, so my ideal weight is 135 pounds. (I'll never see that weight in my life, but that's what the mad scientists say I should be.)

So you need to subtract your starting weight from your ideal weight. For me that is:

299 - 135 = 164

This gives you the "excess body weight" figure you need to do the calculations. So in a perfect, fairytale world, I would need to lost 164 to be my ideal weight. Ha! 

Statistics for RNY show that we can expect to lose 60% to 80% of our excess body weight. Surgeons add us to their "success list" if we lose 50% of our excess body weight. So you need to know what those numbers are for your own weight so you can celebrate whenever you hit a milestone. So here's what mine would be:

164 x 50% = 82 pounds lost = new weight of 217
164 x 60% = 98.5 pounds lost = new weight of 201
164 x 80% = 131 pounds lost = new weight of 168

It is unrealistic for us to expect to lost 100% of our excess body weight. Why? Because statistically it doesn't happen very often. And it's also unhealthy to set a goal for yourself that you may never reach -- it can be setting yourself up for emotional distress. It is much better to set goals that are attainable and then when you reach that point, you can set a new goal for the next milestone on your journey. 

So my advice is to first reach for 50% of your excess body weight lost, Then when you reach that mark re-evaluate where you are and set a new goal for the next milestone. When you get to 80% lost, you can decide if 85% is realistic and work toward that. You should never set the goal to 100% until you have at least reached the 95% mark. 

HTH
Pam

Thanks for the info. I'm 5'6" also but I'm shooting for 140. I'll reconsider as I go. I have a nice spreadsheet I made with all my weight loss info that has how much weight I've lost weekly, total, since surgery and the percentages. My surgeon set my healthy weight at 154 but for them to check off the successful surgery box it's 190. I was just curious as to how other surgeons calculated weight loss by either the first weigh-in or surgery day weigh in because in my head the -surgery- should be helping me lose 60% of excess body weight. Why should they include the weight I lost by myself?  As of now I'm down 59% EBW since surgery.

Come to think of it, I'm down 71 lbs total but 34 lbs since surgery. From my research, most people that started at the same height/weight at surgery day are down 50-60 lbs since surgery. Some of these people havent exercised a day since surgery and I'm working my butt off for this loss. So I'll just say I have 30 lbs of muscle they don't have... riiiiiight...

I say I'm getting 100% of my excess weight off because I'm working for it but I'm being realistic on timelines. I celebrate my mini goals (2 lbs to onederland) but my goal weight is in my sights and I'm willing to work for it to obtain it.

 Hillery is correct. You need to adjust your calculations to be based on excess weight lost... not actual weight lost. 

As for which weight to START with. It doesn't really matter. Each surgeon is different. My surgeon weighed me on the day I went for my pre-admission testing, 2 weeks before my surgery... which was also the day I started my pre-op liquid diet. That's the weight he uses for my chart. I was never weighed on surgery day. 

And NO.... the surgery doesn't help you lost a certain percentage after the surgery itself. You need to stop thinking of WLS as a single event in time. Yes, you're on the operating table on a certain date, but your WLS journey begins when you start losing weight in preparation of your surgery date. 

Those calculations that you posted don't give a percentage of EXCESS weight....they give a percentage of your TOTAL weight...two diffent things. 

My goal weight was calculated as follows (my surgeon didn't give me a goal..I calculated this based on my own research):

For my height, for a healthy BMI (>24.9) my highest weight would be about 160 pounds.

My starting weight was 363 so my excess weight was 203 pounds (363-160).

Typically, RNY patients will lose between 60-80% of the excess weight...so my "goal range" was determined as follows

203*.60 = 121.8 pounds lost if I lost 60% of my excess weight for a new weight of 242
203*.80 = 162.4 pounds lost if I lost 80% of my excess weight for a new weight of 201

So my "Goal Range" is between 242 and 201. 

Now all of you have me thinking about this EWL thing. When I went for my pre op visit I weighed 365 pounds my doc said my EWL should be 170 pounds. Reading the post above somehow my docs numbers don't seem right

Sorry for the confusion. When I posted those stats I didnt do the calculations in the post. What I meant was that my surgeon is saying my EBW was 117 lbs from my highest weight so the surgery should help me lose 60-80% of that which would put my "successful range" at 179-203. If I use my calculations from my surgery day weight I would have 95 lbs of EBW and my weight range should get to 159-178. We'll see how it goes. I'm just trying to get to onederland!!!

I lost 68 lbs pre op and my doc has always done all of his calculations from my starting weight months before surgery! So my highest recorded weight is what he calculates from.
Good luck to you!!!

 Mine has not given me a goal weight. I just chose one for myself.