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How do they pick your goal weight?



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Posted (edited)

How does the team determine what your goal weight is? I get confused silence when I ask.

I ask because my surgeon, who had the most supportive conversation about BMI I've ever had with me, says I should be aiming for 250-275 lbs. I am six feet tall and currently weigh 370. But it was a Zoom call and he never even saw me other than from the chest up.

I know everyone says they're big-framed, but in my case it does seem to be true. I have had DXA scans done and, depending where I am in a training cycle (I was a strongman and now am trying to do more functional stuff), I may have anywhere from 205 to 218 lbs. of lean body mass. So 275 lbs. would be somewhere between 20-25% body fat, which seems a little bit high for a goal weight. 250 lbs. would be 13-18%, which seems about right. I know I will lose some muscle while I can't train, and hopefully will be able to get it back.

Or do they just use the bl00dy BMI chart? Just wondering, because to be "successful", you're supposed to lose 60-70% of your "excess weight".

Edited by vikingbeast

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Posted (edited)

My doctor has never mentioned a goal weight at all. And I appreciate that. I probably wouldn't listen to him anyway, because I know where I like my body to be. My guess is they are kind of just eyeballing it based on the hundreds or thousands of other patients they've had in the past. You definitely know your own body the best, though, so make your own goal your primary focus.

Edited by Maribelle76

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Thank you Maribelle! I don't even know how to go about picking one. I've been so fat for so long that I can't imagine myself thin, and since it's been so hard to lose consistently picking some random number that's waaaaaaay down there feels like fraud... maybe just me.

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I'm 470lbs or at least I was prior to pre-op diet. I haven't weighed since but I'm told I'm shrinking by those who see me. I think realistically they say to expect 30% body weight loss but up to 50%. I'm personally hoping to hit 285lbs.. I'm 6'4. But if I calculated 30% I would end up around 320. They asked us a similar question early on but I felt like it was more to guage our concept of what we expect to lose. Because some people go into this with unrealistic expectations. They like to make sure your feet are planted firmly in reality to what the surgery will be able to do for you. The rest will have to come from patience and hard work.

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30% of my current weight would put me at 255, which on my current frame (assuming no loss of muscle, LOLOLOL) would be about 17.6% body fat. I'm trying to picture that and it... is a stretch. But! I would absolutely love it.

Wishing you the best as you start your post-surgery loss!!

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Posted (edited)

10 minutes ago, vikingbeast said:

30% of my current weight would put me at 255, which on my current frame (assuming no loss of muscle, LOLOLOL) would be about 17.6% body fat. I'm trying to picture that and it... is a stretch. But! I would absolutely love it.

Wishing you the best as you start your post-surgery loss!!

Thanks!

Everyone is different so it's really hard to say. A friend of mine was well over 600lbs about 10 years ago when he had the surgery. He dropped down to about 375lbs. That was nearly half his body weight. He has gone up a bit since then because he hasn't followed the lifestyle changes the way he should have. But even still he is only maybe 450 now. Still probably 150-20bs less than what he was. I think maybe how much you lose not only depends on how dedicated you are but also how big you were. At 370 and 6' I don't think 255 is at all unrealistic. At 470 and 6'4 I'm hoping for 285 which would be much more than 30% but I think that would be my goal weight. I'd still be the size of a wwf wrestler. I've seen other guys my height who weighed between 215-235lbs and some of them look really good and really fit. I personally couldn't see myself at that size, I'm so used to seeing a bear in the mirror. But I would be a little disappointed if I only lost 120lbs after everything I just went through. Would it be better than nothing? Sure, but still much bigger than I hope to be.

Edited by John M

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The truth is the average weight loss at three to five years is about 65% of the weight you have to lose (that is the weight that puts you in the healthy BMI range - higher end if you are a larger frame, lower if you’ve a smaller frame). Your surgeon may have given you a goal weight of where you may end up at based on these averages. Better to under promise & over deliver thinking.

Some medical teams discuss where you’d like to be. Mine did. Mine was based on the lowest weight I could always get down to before gaining again which was on the upper end of the BMI range (cause I thought I had a larger frame - turns out I don’t). It was deemed a reasonable, healthy & attainable goal based upon my history.

I know many people poo poo BMI but look at it as a guide, not a hard & fast rule. Amend it based on your body type, frame, muscle mass, etc. Plus you know how your body works & functions best - it may be at a higher or lower weight. You know you functioned well at a lower weight when lifting so that may be somewhere for you to aim as against what your surgeon suggested.

I’ve lost way more than my goal & have been working at maintaining it for about 10 months - so I’ve got a long way to go. Looking at my stats, you may expect me to be bony but I’m not. But that’s me. Someone with a different body shape & frame may be very bony at the same BMI. As long as the weight you reach is healthy & sustainable everything is great.

The surgery will rest your basal metabolic rate & that will dictate how much weight you lose too. This video by Dr Matt Weiner may be helpful. He has a lot on this topic.

Good luck.

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BMI is really just a guide…the only one we could use easily with basic data (height & weight). There are better predictors of ideal weight that take into account age, gender, bone density, fat percentage, bmrs, etc. etc.

BMI Is not perfect, but its a satisfactory starting point.

With that said, I started out at BMI 43. Doc said he would consider me a success if i lost 60-70% of my excess body weight (based on a “normal” BMI of 25) within A YEAR. Anything over that was just bonus.

Now losing 60-70% of my ecess body weight would have put me in the low BMI 30’s, which is still considered overweight, and doc was perfectly happy with that.

Anyhoo, I reached doc’s goal at 3 months, and my own personal goal (bmi 23) in 7. Lost a little bit more adjusting to maintenance and then settled in at BMI 21. Been at 21 pretty much for over 2 years now.

I too thought I was big boned, but turns out i am not. With all padding (i.e., fat) gone from my wrist, it actually measures at 5.25” in circumference (i’m 5’2” female).

but really, in the end, your goal weight is what YOU says it is, wherever it may fall on the BMI scale.

Good Luck! ❤️

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a lot of surgeons don't even give you a goal weight. Mine never did. He asked me what I'd like to weigh and then told me by personal goal (which at the time was 200 lbs) was definitely do-able if I worked at it (I ended up losing much more than that).

average weight loss on these surgeries is about 60-70% of excess weight. However, that's just an average - there are always people who fall on either side of that. Some people are extremely successful and end up losing 90% or 100% - others not so successful and may only lose 20% or 30%. If you're very committed, you should be able to at least lose the average - if not quite a bit more.

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Doctor's will sometimes give what they consider a successful average goal weight for you surgery. My surgeon's office didn't give me a set goal, instead they asked me what MY goal was. I told them 180. I, honestly, thought they'd tell me that my expectations were too high , but instead, they told me that was a good realistic goal weight. Several people on this site have said that their surgeons set goal weights that they weren't happy with, so they were determined to surpass their surgeons goals. And many have succeeded. Personally, I feel like a goal weight is something personal and you just have to reflect on what weight you can see yourself being happy at. That's how I decided my goal weight and I'm happy that I got there (I think it'd just be like icing on the cake if I could even get down to 170. I'd be okay if I hit maintenance before then because I AM happy where I'm at, but 170 would be really nice).

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I think you more or less establish your goal weight. Not your providers... it's what you would like your weight to be when it's leveled out at the end. You should think of your goal as a sliding scale - subject to change based on your personal growth and progression.

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I think you have to set intermediate goals that are relatively difficult but reasonable to reach. I am currently 276 from a high of 293. I am still in pre op diet stage for 2 more weeks. My intermediate goal would be to be at 260-265 for surgery date then get down to 210 within a year. As I progress and get closer to that goal, I can change my goal to a more challenging number like 185. I set my goal at 210 because that was my weight at age 40 (I am 57 now).

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1 hour ago, Tony B - NJ said:

I think you have to set intermediate goals that are relatively difficult but reasonable to reach. I am currently 276 from a high of 293. I am still in pre op diet stage for 2 more weeks. My intermediate goal would be to be at 260-265 for surgery date then get down to 210 within a year. As I progress and get closer to that goal, I can change my goal to a more challenging number like 185. I set my goal at 210 because that was my weight at age 40 (I am 57 now).

I agree. I set my first goal at 180 because that’s the heaviest weight where I am still confident in my body (more comfortable going out and liked my clothes, etc). I think if I reach and maintain this I will consider surgery a success. But my goal goal is 160.

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5 hours ago, Tony B - NJ said:

I think you have to set intermediate goals that are relatively difficult but reasonable to reach. I am currently 276 from a high of 293. I am still in pre op diet stage for 2 more weeks. My intermediate goal would be to be at 260-265 for surgery date then get down to 210 within a year. As I progress and get closer to that goal, I can change my goal to a more challenging number like 185. I set my goal at 210 because that was my weight at age 40 (I am 57 now).

How tall?

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