What’s ideal?


At some point in time during your WLS journey you have to decide on what your goal is… What, pray tell, would your ideal weight be?

For some it’s a number on the scale.

For others it’s a milestone.

For others it’s a size on a piece of clothing.

For others it’s being able to do or NOT do something.

A lot of us have lists of 100 things. They are lists of things that you want or hope to do during the course of your weight loss and eventual completion of your weight loss. You know, things like:

1. Cross my legs.
2. Fly on a plane without a seatbelt extender.
3. Buy clothes in a regular size department.
4. Close my Lane Bryant charge card account.
5. Ride a horse.
6. Blend into the crowd…

I wish I’d kept the many I’ve read in the past seven or eight years. They’re amazing! I wish I’d made one!

Goals are amazing. They’re incredible motivators. They’re a really healthy way of saying, “Hey! Look! I’ve accomplished something!” They keep you mindful of where you started and where you hope to go.

They make you feel amazing when you accomplish them.

And they can make you feel like crud if you don’t.

So – how do you decide what ideal is? How do you know what your goal should be?

There’s the whole BMI thing – a normal BMI falls somewhere between 18.5 to 24.9. When you start as someone with a BMI of 64 that seems laughable. Strangely appealing and mythical and alluring – but laughable when compared to – well, me!

Wanna figure out what percentage of your excess weight you’ve lost? Here’s the formula:

Starting weight (SW) minus Goal Weight (GW) equals Excess Weight (EW)

Starting weight (SW) minus Current weight (CW) equals Weight Lost (WL)

Weight Lost (WL) divided by Excess weight (EW) multplied by 100 equal percentage of excess weight (PEW) lost


Jane’s SW: 330
Jane’s GW: 180
Jane’s CW: 215

SW – GW= EW330-180= 150 lbs. excess weight

SW – CW= WL330-215= 115 lbs. weight lost

WL / EW*100= PEW115/150*100= 76.67% excess weight lost

Statistically Jane is a raging WLS success. They (the ubiquitous they) say anyone who loses 50% of their excess weight and keeps it off is statistical success.

But how does Jane feel about where she’s landed at the 5 year post-op mark? Is she happy to weigh 180 pounds? Does she FEEL like a success? Is she happy where she lands? Does she stare wistfully at clothes that are 2 or 3 or 4 sizes smaller than her own?

Or does she count her blessings?

Does she decide to look at it differently – remembering to look back to where she started and say with resolution, “I’m so much better off than I was! My weight starts with a ONE, for heaven’s sake!”

The new way of qualifying your success or failure as a WLS post-op is the excess of BMI lost equation. It goes like this:

Percent BMI Loss = [(Operative BMI – Follow-up BMI) / Operative BMI] x 100.

Percent Excess BMI Loss (% EBMIL)

Since the NIH/NIDDK defined excess weight as starting at a BMI > 25, BMI units >25 have been defined as % EBMIL = 100 – [(Follow-up BMI – 25/ Beginning BMI – 25) x 100]

For example, if an individual has an initial BMI of 45, then the 20 BMI units above the upper limit of the normal of 25 BMI units represents a %EBMIL of 100; a loss of 10 BMI units (to a BMI of 35) would be a %EBMIL of 50. It is possible that %EBMIL may become the standard to present weight loss data in clinical studies of the overweight and obese.

Complex, isn’t it?

It’s one thing to look at it clinically, but it’s completely different when you factor in emotions, isn’t it?


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