I met with the psychologist for the first time on Friday. The very first thing he asked me was “what is your comfortable goal weight.” My current weight is 223, BMI of 38. A perfect BMI is 20 with a weight of 120 lbs (which was my weight before I had kids). I told him my comfortable goal weight is 140 lbs. He said that is too low and I should set my goal to a reasonable weight of 155 lbs. It kinda bugged me afterwards because he is a therapist, not a surgeon or dietitian. When I met with the surgeon on Monday, he didn’t mention a goal weight, but I figured HE would decide on my goal weight when I have the pre-surgery visit (no surgery date yet). Who decided on your goal weight?

Others can suggest goals but … it’s your body and ultimately your goals. My surgeon didn’t give me a target either. Just shared stats on average weight loss for my procedure.

I have two goals. One is how much weight I need to lose to be healthier and feel like I can move freely.

Another is a lower weight that I used to be a while ago. As I get closer I’ll find out how achievable that second goal was and adjust as needed.

I’m sure that the psychologist wanted to make sure that you don’t have unrealistic expectations for the surgery because some people don’t even get out of the overweight category but they still reduce alot of their comorbidities by getting out of the obese BMI. That being said, many people reach even the lower end of normal BMI. My doctor didn’t give me a goal weight and I set a few for myself. The first being a weight where I at least feel good enough to go out and do things, the second is the top of a normal BMI and the third is lower. I am almost to the second and am starting to think that my body might be happy here since I am no longer losing. I can probably add more exercise and reach the second but may not ever reach the third.

Ultimately, your surgery decides your goal weight.

It seems pretty settled in the science that you wake up with a new set point. Your body has a weight it tries to get down to.

You help it get there, and if you dare to listen, you'll know when you're there. You'll 'start falling off the wagon' (aka you'll need more than the 1200 calories you're eating) and you then have two choices:

A: Listen and settle in, start maintenance. No matter if that's at BMI 32 or BMI 22.
B: Look at an arbitrary number and start a new cycle of diet --> overeating --> more dieting --> more overeating.

Lots of people don't know how hungry we fatties have been in our lives. I, for one, will never be hungry again. I'll probably gain the usual 5-10-15 lbs the next year, and that's totally fine. I will not start a new cycle of beating myself over the head based on what my scale happens to say.

So with all the love and kindness in the world, why not explore dropping the 'perfect' in front of BMI 20?

Who says you're not perfect at BMI 26? Or 30? I get that BMI 38 is probably not great for your health, but ultimately, your body already knows where it wants to be. Help it along

Sounds like your psychologist may have dealt with a lot of disappointed patients in the past. I have never had an ideal weight suggested to, or discussed with me by surgeon, nutritionist, or psychologist. I've been told repeatedly that the average loss at 5 years after sleeve gastrectomy is 70% or thereabouts of excess weight. Big ballpark. I want to be much lighter than that so I have set my goal for a weight I have been at various points in my life and felt suited me. If I don't reach that, or anything near it, I might be be a bit miffed, but I'll still have lost loads of weight and be way healthier than when I started out, and that's what really matters to me. My body has a new set weight as of surgery day, and my job is to find that and make my peace with it, or consign myself again to a life of fighting my own body to lose weight it wants to hold on to!

1 minute ago, MiniGastricBypassDude said:

Ultimately, your surgery decides your goal weight.

It seems pretty settled in the science that you wake up with a new set point. Your body has a weight it tries to get down to.

You help it get there, and if you dare to listen, you'll know when you're there. You'll 'start falling off the wagon' (aka you'll need more than the 1200 calories you're eating) and you then have two choices:

A: Listen and settle in, start maintenance. No matter if that's at BMI 32 or BMI 22.
B: Look at an arbitrary number and start a new cycle of diet --> overeating --> more dieting --> more overeating.

Lots of people don't know how hungry we fatties have been in our lives. I, for one, will never be hungry again. I'll probably gain the usual 5-10-15 lbs the next year, and that's totally fine. I will not start a new cycle of beating myself over the head based on what my scale happens to say.

So with all the love and kindness in the world, why not explore dropping the 'perfect' in front of BMI 20?

Who says you're not perfect at BMI 26? Or 30? I get that BMI 38 is probably not great for your health, but ultimately, your body already knows where it wants to be. Help it along

Oh you said it much more eloquently than I (and at the same time!!) LOL.

1 minute ago, Spinoza said:

Oh you said it much more eloquently than I (and at the same time!!) LOL.

I don't think this point can be stated enough!

My bariatric therapist said to me when I was talking about the idea of what 'perfect' looks like that the strive for perfect is the same mental prison as being a morbidly obese, socially isolated, overeater was. And that clicked with me. My journey to BMI 50 started by not listening to my body, ignoring hunger, and talking down to myself.

25 minutes ago, MiniGastricBypassDude said:

So with all the love and kindness in the world, why not explore dropping the 'perfect' in front of BMI 20?

Who says you're not perfect at BMI 26? Or 30? I get that BMI 38 is probably not great for your health, but ultimately, your body already knows where it wants to be. Help it along

I did not choose the “perfect” BMI of 20 as my goal weight. I mentioned 140 pounds to the psychologist which is a BMI of 24. That is my “I feel happy weight” but 150 lbs is my “I feel healthy” weight. I get what you’re saying and I agree that too many WLS patients pick an unrealistic goal weight and are disappointed when they only lose a small amount, so they give up.

7 minutes ago, suzannethemom said:

I did not choose the “perfect” BMI of 20 as my goal weight.

I know But why is BMI 20 perfect? I never heard this before.

the psychologist asked me what my goal weight was at my first appt with him, I think so he'd know if I was being realistic or not. I blurted out 199 lbs, which at the time seemed like a pipe dream to me after weighing over 300 for 20 years. I was shocked when he said "that sounds do-able". The surgeon never gave me a goal weight, he just said that the average patient loses about 70% of his/her excess weight.

as I got closer to 199, I told the dietitian I wanted to try to get down to 170. She said if I worked really hard at it, I could probably get there. When I got to 170, I told her I wanted to shoot for 150. She told me that was kind of unrealistic, only about 10-15% of their patients get down to a normal BMI. But...I made it.

so anyway, the point of this is, your goal weight can change as you go along in your journey.

48 minutes ago, MiniGastricBypassDude said:

I know But why is BMI 20 perfect? I never heard this before.

Isn’t 20 smack dab in the middle of “normal” for BMI.

YES, a BMI of 20 or 21 is right in the middle. I should have said “normal” instead of perfect. Anyhow, I like the idea of multiple goal weights. I will do that. I meet with the dietician and exercise physiologist on Thursday. Maybe they will ask me about my goal weight and I will be better prepared.

3 hours ago, catwoman7 said:

as I got closer to 199, I told the dietitian I wanted to try to get down to 170. She said if I worked really hard at it, I could probably get there. When I got to 170, I told her I wanted to shoot for 150. She told me that was kind of unrealistic, only about 10-15% of their patients get down to a normal BMI. But...I made it.

Catwoman, you are amazing! That’s such a huge accomplishment. Did you exercise a lot? How many calories did you stick to?

Edited January 31, 20224 yr by suzannethemom

Aah the debate over BMIs. Think of them as a guide only. There are too many other factors that influence your weight & what is healthy for you. If you carry a lot of muscle you will weigh more & will have a higher BMI. You may have a small frame & so a lower BMI may be more appropriate. Neither means you’re not at healthy weight for you. So who can really say what’s perfect or not.

At the end of my first appointment with my surgeon, when he had gone over my weight loss & gain cycles, my eating habits, general health, lifestyle, etc, he asked me where I thought I’d like to be. I told him 60kg as it was always my lowest weight. Honestly I would have been happy at 70kg. Anything was better than being 91. He told me he thought it was achievable. It was, plus more which was reached without trying to lose more. Which is where my body must have wanted to be.

Instead of setting a lowest goal weight, set a couple of happy weight points like @ShoppGirl then see where your body settles. You can lose more if you want to be more restrictive with your diet & are willing to undertake more activity. As long as that’s sustainable you’re golden

All the best.

The only person who can decide your goal weight is you. Others can suggest a reasonable or practical number, but it's ultimately up to you.

10 hours ago, suzannethemom said:

Catwoman, you are amazing! That’s such a huge accomplishment. Did you exercise a lot? How many calories did you stick to?

I do exercise - I'm not a gym rat, but I always tried to exercise 5-6 days a week. At first it was mostly walking and water aerobics, since I was too heavy to do much of anything else. I still do those - but I also now do Zumba and bicycling as well. I've also strength-trained off and on (twice a week) - but unfortunately not consistently because I don't really like it. But I recently started using resistance bands, which I like a lot more than the weight machines at my gym - so hopefully I'll keep up with it this time!

as for calories, by the end of the first year, I was up around 1000 per day. Second year I was eating around 1200 until I hit maintenance at 20 months out. I then experimented with different ranges to determine my "maintenance range", which is 1500-1700 per day. As long as I stay within that range, I can maintain my weight. But of course that's going to vary for everyone depending on how much muscle you have, how active you are, etc. I know some women who have to eat around 1200 to maintain, and others who can eat 2000....