Introduction: Addressing motivation to lose weight among morbidly obese patients increases successful weight management outcomes. We aimed to understand the motivations and reasons why morbidly obese patients attending hospital-based weight management programmes wanted to lose weight. Methods: A qualitative thematic content analysis was used to analyse responses from a self-administered open-ended question, “What is the main factor why you want to lose your weight?”. A total of 225 new patients attending obesity clinics program run by endocrinologists, dietitians and occupational therapists in two tertiary hospitals in Klang Valley responded to the questionnaire. Results: Patients’ mean BMI was 45.6±8.05 kg/m2 . Four themes emerged and they are health, function, appearance and perceived stigma. Health, the most commonly inferred theme (84%), highlighted concerns over obesity complications and concomitant morbidities, which include infertility, impact on surgical procedures as well as general physical and psychological well-being. Patients regard being functional to care for themselves, family members, religious and career needs as the next most crucial theme (25.8%). They relate to the theme appearance (12.9%) by wanting to look and feel beautiful. The theme perceived stigmatization recount the time when they were mocked and laughed at for their appearance (3.1%). Conclusion: Patients with morbid obesity in this study had expressed their main personal motivational reasons to lose weight. Identifying and addressing these unique personal motivations in a focused approach is vital for health care professionals to manage the complexity of the health, social and psychological needs among patients with morbid obesity.