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?

Wow CATWOMAN, everything you do for exercise are things I love to do (or used to love to do) as well. That is so encouraging for me because it feels “doable” for me too. I was worried that significant weight loss would require heavy, sweaty workouts, which I just cannot do anymore at my age (54) due to joint pain and fatigue. The calorie thing seems to vary person to person, like you said.

I always thought 20 was the LOW end of healthy BMI, with 25 being the top end of "normal". But also, BMI is seriously flawed, because it doesn't take into account our muscle mass, which should be high for many/most bariatric patients because we needed more muscle in our legs to hold us up. Unless you lose a lot during weight loss.

It was the psychologist who talked about expected weight loss with me, not the surgeon. She said, "here is what we think is what we predict you will weigh after this. Will you be okay with that?" I was not okay with that! But, it is just an average. Now that I am about 6 pounds from what she said, I realize that if my body tones up a bit, I would be okay - not thrilled - with it.

Remember, if you have to struggle every day to keep your "perfect" weight, you will likely not be happy. This is going to be a life-long battle, and you can't spend all of your energy every minute focused on it

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?

I would probably change therapists. That would irk me too. When I was younger, I had an opinionated therapist, and it affected my life in a negative way. They need to look at your situation without their own opinions/biases and above all, never ever tell you how to live your life but give you the tools to succeed.

My surgeon doesn't tell me a goal weight. He just monitors my health and tells me to eat more .. Etc. and gives me a target for calorie level... Etc. So I just picked a general healthy weight for my goal and see how things go month to month

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On 1/30/2022 at 4:37 PM, suzannethemom said:

Who decided on your goal weight?

I did.

I was 235 lbs at the start of my 2 wk pre-op diet (I’m 5’2”). My surgeon said losing 60% of my excess weight would consider me as a “success”…so for me, that meant a 60 lb weight loss, based on a BMI 25 “normal” weight. Anything over that was just gravy.

But I chose 120 as an arbitrary goal weight only because it was in the mid range of normal BMI for my height (meaning a 115 lb weight loss)..

By the time I got to 127, I decided that was enough as I didn’t like how my face was looking so gaunt.

Ended up getting down as low as 109 anyway.

These days, I hover around 115-120 and have been basically within that range for over 2 years. My actual surgery was 3+ years ago. Funnily enough, I actually look less gaunt now than I did immediately after weight loss phase despite weighing less today.

Long story short, your body and your lifestyle will determine your final weight, goals are just numbers. What’s important, in my humble opinion, is to be at peace with whatever weight you feel good at AND can maintain. It may not be worth the loss in quality of life to achieve some magic number. Goals are great, but being able to adapt and accept is even better.

Good Luck! ❤️

Edited February 1, 20224 yr by ms.sss

Neither my surgeon nor my PCP ever mentioned BMI when working with me to set a goal weight. I will never be a "healthy" BMI because that, for me, would be 184 lbs. and I have almost 200 lbs. of lean body mass. So I picked a number based on body fat. For a man, below 25% is average, below 20% is good, and 15% is fit (as in flat stomach, at least for people who don't have a ton of excess skin). So I took my pre-surgery muscle mass, subtracted 10% since I knew I'd lose muscle mass as I lost fat, then added back in 20% body fat, and came up with my goal.

Every three months I get a DXA scan because as I work out and lift weights, my muscle IS coming back, so I adjust my goal. Next scan is in March.

5 hours ago, lizonaplane said:

I always thought 20 was the LOW end of healthy BMI, with 25 being the top end of "normal". But also, BMI is seriously flawed . . .

Here is what the range looks like (see below). Technically, a BMI of 21 would be right in the middle of the healthy weight range. I get what you’re saying that the BMI scale is flawed, but let’s face it, it dictates everything regardless. Our surgery approval is based on the BMI scale. The minute we are born, doctors assess our health according to the BMI scale. It’s kind of a dumb way to determine what is healthy, but oh well.

BMI	Weight Status
Below 18.5	Underweight
18.5—24.9	Healthy
25.0—29.9	Overweight
30.0 and Above	Obese

If your doctor is assessing your physical health based on the BMI scale, and not other health markers (A1c, blood pressure, circulation, etc.), then it's time for a new doctor.

On 2/1/2022 at 6:02 PM, lizonaplane said:

I always thought 20 was the LOW end of healthy BMI

It is.

Goal weight, goal BMI and excess weight have never been mentioned at all. I had RNY 10 days ago and while I was weighed prior, that's all over now. I won't be weighing myself much if at all.

3 hours ago, Pollito said:

Goal weight, goal BMI and excess weight have never been mentioned at all. I had RNY 10 days ago and while I was weighed prior, that's all over now. I won't be weighing myself much if at all.

Really? I agree that the BMI scale is flawed, but your weight should not be ignored. Your weight loss is a one of the markers of your progress after surgery. Body measurements are also important. They are going to weigh you at every follow up appointment after surgery.

2 hours ago, suzannethemom said:

Really? I agree that the BMI scale is flawed, but your weight should not be ignored. Your weight loss is a one of the markers of your progress after surgery. Body measurements are also important. They are going to weigh you at every follow up appointment after surgery.

They aren't and I don't subscribe to that.

41 minutes ago, Pollito said:

They aren't and I don't subscribe to that.

It’s a bit hard to believe they’re not going to weigh you or ask for your weight. Literally the two questions my surgeon asks first when I have a checkin are how much do I weigh, and how long does it take me to eat a meal.

I do agree that BMI is crap. It was never intended as a measure of individual fitness.

1 hour ago, Pollito said:

They aren't and I don't subscribe to that.

I don’t Agree it is a good measure either but I think your doctor is going to want your weight at follow up appointments because it is unfortunately the only measure we have and it is how they measure whether the surgery was a success or not. For the statistics that they gather post surgery. If they want it you can always step on the scale and not look though if you don’t want to know.

Certainly before the operation they weighed me multiple times. They needed to know that I qualified for the surgery and then they needed to know that I was keeping tot he pre-surgery diet for safety reasons. But beyond that: no. Most, if not all, people who become morbidly obese have psychological problems relating to food and self image. I don't believe it's healthy to weigh oneself constantly, if at all, and moreover, I'm not trying to lose weight, I'm trying to lose fat. No only is it very clear to me if I'm doing that or not, but if I am eating below my basal metabolic rate (x1.2 for sedentary etc) then I know I'm losing weight. On the part of my surgeon: he says that the bypass is a tool and that it must be coupled with eating high quality foods and daily exercise (and not drinking with or after meals). He says that doing this will create a healthy body and mind by itself. I agree.

3 hours ago, Pollito said:

but if I am eating below my basal metabolic rate (x1.2 for sedentary etc) then I know I'm losing weight.

…but how will you calculate your (hopefully decreasing) BMR without weighing yourself?