Kim L. Lavoie

Summary Many patients (20%–30%) experience suboptimal weight loss (WL) after bariatric surgery (BS), and unrealistic preoperative WL expectations may be a contributing factor. This study aimed to describe the nature of patients' general expectations of BS during the pre‐surgical period, and how patients determined whether their expectations and WL goals (WLGs) were realistic. The extent to which patients' expectations and WLGs were met and/or changed during the post‐surgical period was also assessed. Semi‐structured interviews were conducted with 15 preoperative patients recruited approximately 6‐months before surgery. Focus groups were also conducted with 14 post‐operative patients recruited approximately 6‐months after surgery. Interviews and focus groups were audio‐recorded, transcribed verbatim and analysed using qualitative content analysis. Preoperative patients reported expectations that BS would positively impact physical and psychological health, social relationships, as well as quality of care. Preoperative patients perceived that they and their health care professionals had unrealistically high expectations of WL. Post‐operative patients reported being generally satisfied with the outcomes of surgery, even though many did not reach their expected WL. Finally, most post‐operative patients reported changing their expectations from pre‐ to post‐surgery. This study provides data that may help inform the development of preoperative interventions focusing on helping patients set realistic expectations for WL and related outcomes, which could better prepare patients for the challenges they will face after surgery.