FAQ’s

For many people with type 2 diabetes, losing weight can improve how the body uses insulin and regulates blood sugar, and in some cases it reduces the amount of medication needed. How much it helps varies from person to person and depends on things like how long you’ve had diabetes, your medications and how much weight is lost.

Diabetes medication should only be changed with your doctor, because doses often need adjusting as weight changes. Mr Siva Gounder, your GP and your diabetes team can talk through what weight loss may mean for you.

Type 2 diabetes can’t be cured, but some people achieve remission, which means blood sugar returns to a non-diabetic range without diabetes medication. Remission is more likely when diabetes is diagnosed earlier and after significant weight loss, but it isn’t guaranteed and it can return.

That’s why ongoing monitoring with your doctor is still important. It’s best to think of it as managing and improving metabolic health over time.

No. Eating is one of the ways people cope with feelings, and most people do it sometimes. It isn’t about being good or bad. It becomes a concern when it is your main way of coping, when it feels out of your control, or when it leaves you feeling distressed or ashamed.

Understanding what is driving the behaviour is more useful than judging it. A dietitian or psychologist can help you find other ways to meet the same need. If you’re worried about your relationship with food, speak to your GP or our team.

Obesity is recognised as a complex medical condition, not simply a lifestyle choice. While food intake and physical activity play a role, research shows many other factors influence body weight, including genetics, hormones, metabolism, stress and the modern food environment.

In Australia, around 60% of adults live with overweight or obesity, which highlights how widespread and complex this health condition is. Because of this, managing weight often requires more than dieting or exercising more. Medical guidance and the right support can help people find a safe and sustainable pathway for their health.

Hunger is only one of the things that drives eating. Stress, boredom and other emotions, routines such as eating at set times or in front of the TV, the people and places around you, poor sleep and easy access to food all play a part. Eating when you aren’t physically hungry is very common and isn’t a character flaw.

A useful first step is noticing what is happening just before you eat. Our dietitians and psychologists help people work out their own patterns and build strategies that fit real life. If you’d like support, start with a conversation.

Because behaviour is shaped by much more than willpower. Habits, stress, sleep, work and family demands, and how realistic the plan is all affect whether it sticks. Plans that are too strict or all-or-nothing tend to break down when life gets busy.

What helps is making changes small enough to repeat, planning for the days that go wrong, and having regular check-ins. Our dietitians and exercise physiologist build routines around your real week, with a back-up plan for busy days, and adjust them as things change.

Because the condition itself can work against weight loss. Insulin resistance, hormones and metabolism affect how the body stores and uses energy, some diabetes medications can cause weight gain, and swings in blood sugar can affect hunger and energy. It is not a lack of effort.

A plan that looks at your medications, nutrition, movement and sleep together usually works better than dieting alone. Our team works alongside your GP or diabetes team.

Yes. Surgery and medication are not mutually exclusive. In many circumstances they are used together, and your care plan will be designed around what is most appropriate for your individual situation.

They are different tools, and neither is simply better than the other.

Medication is an ongoing treatment. It can help regulate appetite while you take it, it doesn’t involve an operation, and it often suits people who aren’t ready for surgery, don’t need it, or want to try a non-surgical option first. Weight can return if medication is stopped without lasting changes to habits.

Surgery changes how the digestive system works. It involves an operation and a recovery period, needs ongoing follow-up, and on average leads to greater and longer-lasting weight loss than medication.

Cost differs too. Medication is an ongoing private cost, while surgery is a one-off cost with funding options (see What will it cost?). Many people use both at different points. Mr Siva Gounder will help you weigh them up for your situation.

There isn’t one right answer, which is why we start with a conversation rather than a procedure. Most options sit within three broad pathways, and they aren’t mutually exclusive.

Lifestyle and supportive care. Support from a dietitian, exercise physiologist and psychologist to build habits that last. This can be a starting point on its own, or sit alongside either pathway below.

Medical weight management. Prescription weight-management medication, prescribed and monitored by Mr Siva Gounder, alongside nutrition, movement and psychological support.

Weight loss surgery. A range of procedures, including gastric sleeve, gastric bypass, SADI-S/SIPS, SASI-S, gastric band and revisional surgery.

Many people use more than one approach over time. Medication and surgery, for example, are used together in many circumstances. At your first consultation, Mr Siva Gounder will explain which options may be appropriate for you, which may not, and what each involves in time, cost and follow-up.

You don’t need to have decided anything before you get in touch.

Several prescription medicines are approved in Australia for weight management. They work in different ways, for example by affecting appetite and fullness signals, or by reducing how much fat the body absorbs.

Which one, if any, is appropriate depends on your health, medical history, other medications and goals, and that can only be decided with a doctor. Prescription medicines are generally considered for adults with a BMI over 30, or over 27 with a weight-related condition such as type 2 diabetes, fatty liver disease or obstructive sleep apnoea.

Medication works best as part of a plan that includes nutrition, movement and psychological support, and it needs medical monitoring. Mr Siva Gounder can talk you through whether medication is suitable for you.

Progress is usually gradual and varies from person to person. It depends on the medication prescribed, the dose, how your body responds, and the changes you make to nutrition, movement and sleep. Some people notice changes early, and for others it takes longer.

That’s why we review progress regularly, adjust the plan as needed and talk openly about what is and isn’t working. Results can’t be guaranteed. Mr Siva Gounder will discuss realistic expectations for your situation at your consultation.

Mr Siva Gounder performs several weight loss procedures, including gastric sleeve, gastric bypass, SADI-S/SIPS, SASI-S and gastric band surgery, as well as revisional surgery for people who have had weight loss surgery before. Each works differently and suits different people.

There is no single best operation. The right option depends on your health, goals, weight history and circumstances, and Mr Siva Gounder will explain the options that may suit you at your consultation.

Start with one small step, whichever feels right:

•   Not sure yet: book a free 15-minute call with our team.
•   Ready to talk to the specialist: book a consultation with Mr Siva Gounder. A current GP or specialist referral is needed to claim a Medicare rebate.
•   Want to begin with food or movement: book a dietitian or exercise physiologist appointment.
•   Want a first indication of eligibility: use our BMI check, remembering it is a starting point only.

If surgery might be on the table, it is worth asking your insurer about waiting periods early, because they can run while you prepare.

There is no one best surgery. The best operation is determined based on multiple factors and is individualised. After the initial consult and assessing your health and risk factors an appropriate surgery will be determined.

Current guidelines generally consider surgery for adults with a BMI over 35, or a BMI over 30 with a weight-related condition such as type 2 diabetes, high blood pressure or sleep apnoea. Surgery may also be considered at a BMI of 30 to 34.9 when non-surgical approaches haven’t produced substantial or lasting results. Lower BMI thresholds apply for people of Asian background.

BMI is only the starting point. Mr Siva Gounder will also look at your health conditions, your weight history and what you’ve already tried, your readiness for follow-up and lifestyle changes, and your own goals. Our BMI check gives a first indication only. The best way to understand your eligibility is a consultation.

Only use prescription weight management medication that has been prescribed for you by a doctor who knows your health history, and dispensed by a registered Australian pharmacy.

The Therapeutic Goods Administration (TGA) has warned that products sold online and through social media can be counterfeit. Its testing has found imported products labelled as weight loss medicines that contained none of the listed ingredients. Since 1 October 2024, Australian pharmacies have also been unable to compound (make up) copies of the most commonly prescribed weight management medicines.

If you’ve been using a product from another source, let Mr Gounder know at your consultation. It isn’t a judgement. It helps us keep you safe.

Surgery is a major decision, and it isn’t right for everyone. Current guidelines generally consider surgery for people with a BMI over 35, or a BMI over 30 with a weight-related condition such as type 2 diabetes, high blood pressure or sleep apnoea. It may also be considered at a BMI of 30 to 34.9 when non-surgical approaches haven’t produced substantial or lasting results. Lower BMI thresholds apply for people of Asian background.

BMI is only the starting point. Mr Siva Gounder will also talk with you about:

•   your health conditions and current medications
•   your weight history and what you’ve already tried
•   your readiness for follow-up appointments, vitamin supplements and lifestyle changes after surgery
•   your mental health and the support around you
•   your own goals and preferences

For some people the answer is yes. For others it is “not yet”, or “try something else first”. You’ll get an honest view either way, and there is no pressure to decide at your first appointment.

All surgery carries risk. Your individual risk will be explained to you at consultation.

Bariatric surgery has a strong safety record, and most procedures today are done with keyhole (laparoscopic) techniques. Like all major surgery, it carries risk, and that risk is different for every person.

In the data Mr Siva Gounder uses, major complications occur in about 0.3% of cases, and the risk of death is below 0.04%, which is comparable to routine operations such as gallbladder surgery.

Your own risk depends on things like your health conditions, your weight, any previous surgery and the procedure you have. At your first consultation, Mr Siva Gounder will explain the risks specific to each procedure, what we do to reduce them, and your individual risk level, so you can decide with full information.

First, this doesn’t mean you’ve failed. Weight-management medication affects people differently, and “didn’t work” can mean different things: limited weight loss, progress that has stalled, side effects that made it hard to continue, or weight returning after stopping. Each points to a different next step, so the best starting point is a review rather than a guess.

A review with Mr Siva Gounder will usually look at:

•   what you were prescribed, the dose, how long you took it and any side effects
•   what else was happening, such as sleep, stress, other medications and eating patterns
•   whether the supporting pieces were in place. Medication tends to work best alongside nutrition, movement (including strength training to protect muscle) and psychological support
•   whether a different medical approach may suit you. That is a decision for you and your prescriber
•   whether surgery is worth discussing. Guidelines support considering surgery for some people who haven’t achieved substantial or lasting results with non-surgical approaches, and medication and surgery aren’t mutually exclusive

You don’t need a plan before you come in. Bring what you know, and we’ll work out the next step together.

That is completely normal, and it is a good reason to talk to someone, not a reason to stay quiet. You don’t have to be ready for surgery. Just ready for a conversation.

Booking a call or a consultation doesn’t commit you to anything. If you’d like to start small, you can book a free 15-minute call with our team, join our community group to hear from others, or begin with a dietitian appointment to focus on nutrition first. Bring someone you trust if that helps. We’ll go at your pace.

In limited circumstances, you may be able to apply for early release of superannuation on compassionate grounds to pay for medical treatment. Super doesn’t automatically cover surgery, and approval isn’t guaranteed.

The Australian Taxation Office (ATO) assesses these applications, not your super fund. You need written statements from two registered medical practitioners, at least one of them a specialist, certifying that the treatment meets the ATO’s requirements. If the ATO approves your application, your fund pays the released amount to you.

The ATO recommends waiting for the outcome before you book treatment. Our team can guide you through the process and connect you with SuperCare. You can also read the ATO’s guidance on compassionate release of super before you start.

Private health insurance can make a big difference to the cost of surgery, but only if you hold the right type of cover.

Hospital cover, not extras. Surgery is covered by hospital policies. Weight loss surgery is a defined category of hospital cover. Gold tier policies must include it. Policies in other tiers may or may not, so check your policy’s Private Health Information Statement, or ask your insurer whether weight loss (bariatric) surgery is included.

Waiting periods. When you join or upgrade, insurers can apply a waiting period of up to 12 months for pre-existing conditions. Because obesity-related signs and symptoms are usually present before people join or upgrade, a 12-month wait is common. The decision is made by the insurer’s medical practitioner, so check with your insurer before you book anything.

Gaps and excess. Even with the right cover you may have out-of-pocket costs, such as your hospital excess and the anaesthetist’s gap. Our Costs page lists estimates for each procedure.

Extras cover. Depending on your policy, extras may contribute to dietitian and exercise physiology appointments.

Medicare. Rebates apply to eligible consultations with a current GP or specialist referral, and Medicare Safety Net thresholds may apply.

No private cover? Surgery is still possible as a private patient. The costs are higher (see What will it cost?), and payment plans and, where eligible, early release of superannuation may help.

Prescription weight-management medication is generally not covered by private health insurance. It is also generally not subsidised under the PBS for weight management, although a narrow PBS listing for adults with obesity and established cardiovascular disease has been progressing. We’ll confirm the current position at your consultation.

A good first step: ask your insurer in writing, “Does my policy cover weight loss surgery, and would a waiting period apply to me?”

The cost depends on the pathway and, for surgery, the procedure and your level of private hospital cover. This is a guide. The full breakdown is on our Costs page.

Consultations

•   Initial consultation with Mr Siva Gounder: bulk billed with a current GP or specialist referral.
•   Follow-up consultations with Mr Siva Gounder: $90 (Medicare rebate $43.35).
•   Dietitian: $180 initial, $90 follow-up. Exercise physiologist: $180 initial, $90 follow-up. Rebates depend on your extras cover.

Surgery

•   Surgeon and assistant fees range from $4,400 to $6,800, depending on the procedure.
•   With appropriate private hospital cover, estimated out-of-pocket costs after rebates range from about $3,350 to $5,210, plus any hospital excess. The anaesthetist’s gap is a maximum of $500 for patients with the appropriate level of cover.
•   Without private hospital cover, estimated total costs after rebates range from about $18,330 to $22,500, including hospital and anaesthetist fees.
•   Pathology is billed separately by the laboratory.

Medication

•   Prescription weight-management medication is a private cost. Ongoing costs depend on what is prescribed and for how long, and we’ll talk through this at your consultation.

You will receive your exact out-of-pocket estimate in writing well before your surgery date. Payment options include Zip, Total Lifestyle Credit and, where eligible, early release of superannuation.

The weight management medicines most commonly prescribed in Australia are not recommended during pregnancy. If you could become pregnant, you will need to use effective contraception while you are on treatment.

Some of these medicines may make the contraceptive pill less reliable when you first start or when the dose goes up, so a non-oral or back-up method may be advised for a few weeks at those times.

If you’re planning a pregnancy, tell Mr Gounder before you start, or as soon as your plans change. Medication usually needs to be stopped some time before trying to conceive, and the timing depends on what you take. If you become pregnant while on treatment, contact your prescriber or GP straight away.

You don’t need to have anything worked out before you come in. A few things help us make the most of the time:

•     a list of your current medications and supplements, including anything you have taken for weight management before
•     any recent blood test results, if you have them
•     a short history of your weight and what you’ve already tried
•     your questions, and what you’d like to get out of treatment

Mr Gounder will talk with you about your health, whether medication may be suitable, and how it would fit with nutrition, movement and psychological support. If medication isn’t the right fit for you, we’ll talk about what might be.

This depends on your circumstances. As a general guide, if you have a specific timeframe in mind, such as school holidays or a planned event, it is worth contacting the clinic two to three months in advance. For those who want to plan carefully around life commitments, beginning the conversation twelve months ahead is also a reasonable approach for some patients.

Tell your surgeon, your anaesthetist and the hospital as early as possible, including what you take and when you last took it. Some of these medicines slow how quickly the stomach empties, which matters when you have an anaesthetic or sedation.

Current Australian clinical guidance generally recommends continuing the medication and following a specific preparation plan, such as a clear-fluid diet the day before. Your team will give you instructions for your situation, so please don’t stop or change your medication on your own.

Before surgery, patients follow a pre-operative diet using meal replacement products such as Optifast. The purpose is not primarily about weight loss. It is designed to reduce fat stored in the liver, which makes surgery safer and easier to perform. Your dietitian will guide you through this stage.

Psychological support is not compulsory. The team tailors each patient’s care to their individual needs. Some patients benefit from seeing a psychologist before surgery, others after, and some at both stages. This is discussed and assessed as part of your personalised care plan.

When your appetite is lower, it’s easy to eat too little of what your body needs. Losing weight can also mean losing some muscle along with fat, and muscle matters for strength, mobility and metabolism. Protecting it is part of the plan.

•     including protein at each meal
•     choosing nourishing foods when you are eating less, and keeping up your fluids
•     strength (resistance) training a few times a week, built up gradually
•     regular reviews, so we can pick up any problems early

Our dietitians and exercise physiologist build this around your appetite, routine and goals.

Most patients spend one to two nights in the hospital, with a maximum of three nights in most cases.

The three priorities after bariatric surgery are protein, fluids, and vitamins. Your dietitian will support you through each stage of your nutritional progression, from fluids through to purées, soft foods, and eventually regular textures.

Weight management medication needs regular medical review. Follow-up appointments with Mr Gounder look at how you’re progressing, how you’re tolerating the medicine, whether the dose or plan needs adjusting, and how nutrition, movement and sleep are going.

How often you’re seen depends on where you are in treatment, and it’s usually more often early on. Between appointments, you can be supported by our dietitians, exercise physiologist and psychologist. Follow-up fees are listed under What will it cost?

Side effects depend on the medicine, the dose and the person. The most common are digestive, such as nausea, reflux, constipation or diarrhoea. They are often more noticeable when you first start or when the dose goes up, and for many people they ease over time. Smaller meals, eating slowly and staying hydrated can help.

Let us know if side effects are making it hard to continue, as the plan can often be adjusted. Please also tell us about any changes in mood, including low mood or thoughts of self-harm. Seek urgent medical help for severe or ongoing abdominal pain, repeated vomiting or signs of an allergic reaction.

Mr Gounder will go through the side effects of anything he prescribes, so you know what to expect and what to watch for.

Difficulty with fluid intake is common in the early weeks following surgery and is a recognised part of the recovery process. The dietitian team will work with you to find alternatives that keep you adequately hydrated during this period.

Recovery timelines vary depending on your role. People in office-based jobs can typically return to work within ten days. Those in physically demanding roles, such as mine site work, are generally advised to wait around three weeks before returning.

Surgery is done with laparoscopic or key hole technique. The largest cut is usually only 15mm in size. Most patients have very tolerable pain that is well managed with analgesics.

It can, for some people. Weight can return after surgery for many reasons, and medication is one of the tools that may be considered alongside nutrition, movement and psychological support. Other options include changes to your eating plan and, in some cases, revisional surgery.

The first step is a review with Mr Gounder to understand what’s changing and what the right next step is. Medication and surgery aren’t mutually exclusive.

There’s no set timeframe, and it’s different for everyone. Obesity is a long-term condition, and for many people medication works while they are taking it, in a similar way to treatment for blood pressure or cholesterol.

Some people stay on medication long term, some use it for a period, and some move to another approach, including surgery. Mr Gounder will review whether medication is still the right tool for you at your follow-up appointments, and any decision to continue, change or stop is made together.

Loose skin is a possibility following significant weight loss, and it is something the team addresses openly. Exercise, particularly resistance training, is an important part of managing this as part of your overall journey.

Weight often returns after medication is stopped, particularly if the supporting changes aren’t in place. Research shows that much of the weight lost is commonly regained within a year of stopping. That isn’t a personal failure. It reflects how the body regulates appetite and weight.

If you’re thinking about stopping, whether because of cost, side effects, pregnancy plans or reaching your goal, talk to us first. We can plan how to do it, strengthen nutrition, movement and psychological support, and look at other options if needed. Please don’t stop or restart medication without speaking to your prescriber.

Resistance training is the most important form of exercise for preserving muscle mass and bone density during weight loss. The recommended approach is two to three sessions per week, focusing on compound movements at moderate effort. In the first three weeks after surgery, activity is kept very gentle, such as walking and light movement. A structured exercise plan is introduced from around the six-week mark.

Weight regain can occur over time and is most commonly associated with returning to old habits such as increased snacking, higher liquid calorie intake, or reduced activity levels. This is why the program includes ongoing follow-up, dietary support, and exercise guidance well beyond the operation itself. The goal is to help you build sustainable habits that protect your results long term.