Success, Defined?

                                                                   Photo by M Clock

Success   \suk-'ses\

1a :  degree or measure of succeeding

1b :  favorable or desired outcome

2.  one that succeeds


Even Webster's took a stab at it, but it's still not all that clear.  Especially in the Bariatric / Weight Loss Surgery world.

I had an interesting talk with a patient the other day, that revolved around her goal weight / BMI, and a recent comment from her PCP at a recent office visit there.  She had told her that she wasn't a "success" because she hadn't lost 100# yet.

This patient was somewhat taken aback by the comment, as she is 9 mos out from her Bypass, down 80#, BMI reduced to 31, and much improved with her Co morbidities (HTN, OSA, Back Pain -DJD now off regular analgesics), and genuinely enjoying a new lease on life in her body and current renewed state of health have given her from her daily efforts at diet and exercise.

We had a general discussion about goal weights, how we should not pay attention to the BMI wheel of "healthy weight"  that ends at 24.9, or the potentially elusive hard and cold 100 # mark.

In fact, determining success after surgery is hard thing to do indeed.  In the office, we give general goals for weight if asked, but that's only one determinant.  Each procedure, as studied, has ranges of accepted amounts of weight loss to be expected in certain time frames.  If Lance Armstrong was obese, he may have written a book entitled, "It's not about the weight".  Weight loss is an easy, concrete, definable, "attainable" statistic, and it certainly is part of the success-journey.  Just ask any patient what they want their weight to be, and they will give you a very specific response.  The answer gets in to much more depth when you ask why that certain weight, and what it means to them.  Sometimes it's reasonable and attainable, sometimes it is not.

But there is more, much more, that goes in to determining the level of success a patient attains after surgery.  Next post I will put up a few, attained somewhat pragmatically, as a search for a formal definition, and a discussion about 'success' with 'high-ranking' officials at the Bariatric Center, left the issue still a bit murky.

So, Part 2, to follow soon... But before you see the next post, think of yourself as the referral source of your patient to us at the Bariatric Center.  Did you have clear-cut ideas regarding how you wanted this patient to be revamped by the surgery? What were the different areas of his /her health did it involve?  What time frame did you envision for those changes to reasonably occur?

Referring someone for Weight Loss Surgery is a big deal for you and a big deal for your patients.  Having a good idea of what you, and your patient, want to get out of the surgery is the backdrop, the starting point, for defining success. Part 2 will get into that in more detail...