Last week when we published the weekly digest about Goal Weight Range
rather than pursing a single goal weight we received a tremendous amount of feedback both favorable and critical. One thing I failed to include in the previous newsletter was applying the GWR principles in phases to facilitate weight loss for people who fall in the clinical definition of "Extreme Obesity" having a BMI of greater than 40. Patients faced with a tremendous amount of weight to lose benefit from the behavioral technique called "shaping" in which a series of short-term goals are set and met bringing them closer to the ultimate goal. Below is a Question & Answer from the LivingAfterWLS Neighborhood
that addresses the question of Goal Weight Range as it is applied to the super-morbidly obese:by Kaye BaileyFrom Kath1210 in The Neighborhood: "I just read and used the information from the Goal Weight Range article to try to determine a reasonable and feasible goal weight, but I don't think it works for someone like me (starting with a high BMI). Am I doing something wrong?"
I am so tickled you did the Goal Weight Range worksheet. I am so glad you presented this question. This tool actually is more favorably received and responded to by people with a very high BMI. Often when patients focus on weight loss goals that exceed 200 pounds the journey seems impossible and very long, yet surgeons and nutritionists set these seemingly unattainable goal weights in stone. I'm not sure what your height is, but you may have been told your goal weight is 165-185. That is a tremendous amount of weight to lose. Not impossible. And quite achievable if smaller weight loss phases or goals are identified. I worked some numbers using your beginning weight of 385 and assuming a height of 5'6" -- hope you don't mind.Phase 1 - Initial Weight Loss
Weight Range will be (385 x .10 = 38.5 lbs.) We'll round up to 39 pounds weight range.
Beginning BMI: 62. We want to release enough weight to get your BMI to 52. (62-10=52.)
At 5'6" and BMI of 52 your weight will be 302. This is the high end of your weight range.
Subtract 39 from 302 to find your low weight range of 263.
Goal Weight Range: 263-302
When you reach 282 pounds (a 103 pound loss- GREAT JOB) you will calculate a new GWR. 282 is the middle of your current range of 263-302.Phase 2 - Continued Weight Loss
Weight Range will be (282 x .10 = 28.2 lbs.) We'll round down to 28 pounds weight range.
At your new weight of 282 your BMI is 47. You have the knowledge & power to release enough weight to get you to BMI 37. (47-10=37)
At 5'6" and BMI of 37 your weight will be 222. This will be the high end of your weight range.
Subtract 28 from 222 to find your low weight unit of 194.
Phase 2 Goal Weight Range: 194 - 222 pounds. The middle of this range is 208. When you reach that milestone you have lost 74 pounds in Phase II for a total loss of 177 pounds!! Look at you go. Time to make a new GWR!!Phase 3 - Exiting the "Obese" Category
Weight range will be (208 x .10 = 20.8) We'll round up to 21 pounds weight range.
At your new weight of 208 your BMI is 35. Instead of subtracting 10 from this number we will use your new goal BMI of 30 - which is the lowest number in the "Obese" category and a reasonable and healthy goal with massive weight loss.
So, at BMI 30 your weight will be 180 pounds. That is your new MAINTENANCE high unit of Goal Weight Range.
180 - 21 = 159. 159 is your low weight unit for your MAINTENANCE Goal Weight Range. That will give you a BMI of 25.
You can achieve 34 pounds lost in this phase for a total of 215 pounds lost!!!
So for maintenance you will find your most comfortable weight between 159 and 180. Overall Numbers:
Beginning Weight : 385Maintenance Weight: 170 (median of 159-180)Total Weight Lost: 215Change in BMI: 62 Beginning: 28: Maintenance (34 Unit Drop!)
I apologize that we didn't go into this detail in the newsletter. We felt it was complicated already without adding phases in our first attempt to explain it. But when you are looking at the big picture of 200+ pounds to lose it is more motivating to break it into smaller goals or phases. It is also important to note that each phase is likely to take the same amount of time even though the pounds to lose decreases with each phase. This is due to the body adapting its metabolic process to hold onto body fat rather than release it.
This still seems pretty complicated, but as you did earlier you can play with the numbers and set phases and goals as you desire. The objective with GWR is to create an acceptable range based on data and realistic thinking with some positive confidence building opportunities along the way.Please visit this conversation in the Neighborhood
Read the article below to learn how you can intelligently calculate your Goal Weight Range: