When weight is affecting your diabetes, sleep, joints or daily movement, it can feel as though what once was helping, is no longer getting you where you need to be. You may have tried changing how you eat, becoming more active or using medical treatment, only to find your weight returns or related health concerns continue.
For some people living with obesity, weight loss surgery, also called bariatric surgery, can be discussed as part of medical care, with the surgical options available based off your specialist’s review. Dr Harald Puhalla provides specialist bariatric surgery assessment for Gold Coast patients from his practice at Pacific Private Clinic in Southport.
When are Surgical Options for Weight Loss Surgery Considered?
Weight loss surgery should be discussed when excess weight is affecting health and previous treatment has not led to lasting change.
People referred for bariatric assessment may be managing concerns such as:
- Type 2 diabetes
- Obstructive sleep apnoea
- High blood pressure
- High cholesterol
- Debilitating joint or back pain caused by weight
- Repeated weight loss followed by weight regain
Am I a Candidate for Weight Loss Surgery?
A referral for specialist review is required to determine if you are a suitable candidate for weight loss surgery.
National bariatric surgery guidelines recommend surgery for people with a BMI of 35 kg/m² or above, and for people with type 2 diabetes and a BMI of 30 kg/m² or above. Surgery can also be considered for some people with a BMI from 30 to 34.9 kg/m² when non-surgical care has not achieved substantial or lasting improvement of weight-related comorbidities.
A referral does not commit you to surgery. It gives you the chance to discuss your health history, previous treatment, procedure options, risks, costs, recovery and long-term care with a specialist.
How Does Bariatric Surgery Work?
Bariatric procedures do not all work in the same way. Some reduce the size of the stomach, to help people feel more satisfied after smaller meals. Others change the route food takes through the digestive system, affecting absorption and metabolic responses.
Bariatric surgery is part of your weight loss management and medical care plan. After surgery, patients still need structured eating changes, nutritional monitoring, blood tests and follow-up care.
What Procedures Are Available?
Dr Puhalla performs several bariatric procedures on the Gold Coast. The operation discussed during consultation is guided by your health history, reflux symptoms, previous surgery and nutritional needs.
A sleeve gastrectomy, commonly called gastric sleeve surgery, removes a large portion of the stomach, leaving a narrow sleeve-shaped stomach.
This reduces stomach capacity and can affect appetite signals. It is usually performed using laparoscopic surgery (keyhole surgery).
A single anastomosis gastric bypass, also known as an omega loop or mini bypass, creates a smaller stomach pouch and joins it to a loop of small bowel.
This procedure changes both food intake and digestion. Follow-up is important because patients need nutritional monitoring and may require long-term vitamin and mineral supplements.
A Roux-en-Y gastric bypass also creates a smaller stomach pouch, but uses a different intestinal arrangement from a single anastomosis bypass.
It may be discussed for patients with obesity and weight-related health concerns, including those whose reflux symptoms need to be considered during surgical planning.
The Loop Duodenal Switch, also called SADI-S or SIPS, combines a sleeve gastrectomy with an intestinal bypass.
This option may be discussed with selected patients after detailed assessment. Because it changes absorption, it requires a strong commitment to daily supplementation, regular blood tests and long-term follow-up.
Some patients who have already had bariatric surgery later need specialist review because of reflux, complications, difficulty eating or weight regain.
Revision surgery is more complex than a first operation because the digestive system has already been changed. Assessment may include previous operation reports, symptoms, investigations and nutritional results before treatment is discussed.
Is Bariatric Surgery a Long-Term Solution?
Bariatric surgery can support longer-term weight reduction in people living with obesity. Evidence also shows benefits for other weight-related health concerns, especially type 2 diabetes.
In a 2024 study that followed adults with obesity and type 2 diabetes for up to 12 years, it was published that, compared with medical and lifestyle treatment alone, bariatric surgery was associated with better blood glucose control, fewer diabetes medications and higher diabetes remission rates in the participants studied.
The Potential Benefits of Weight Loss Surgery
During consultation, your surgical and non-surgical options, as well as potential benefits and risks more specific to your circumstances, will be discussed to support you in making an informed decision. Potential benefits may include:
- Weight reduction over time
- Improved blood glucose management for some patients with type 2 diabetes
- Reduced use of diabetes medication for some patients
- Improved mobility as weight reduces
- Reduced strain on weight-bearing joints
Results vary based on individual circumstances, with outcomes shaped by the procedure performed, medical history, nutrition and follow-up care.
Recovery and Follow-Up
Many bariatric procedures are performed using keyhole surgery, which is associated with shorter recovery times, but recovery still takes planning.
After surgery, patients generally progress through stages of eating, beginning with fluids before progressing under the guidance of our healthcare team. Blood tests, dietary support and follow-up appointments help monitor nutrition and recovery.
When discussing surgery in consultation, Dr Puhalla and our team will provide you with the details more specific to the procedure recommended and your circumstances. This will include information about your hospital stay and recovery time, returning to work and driving, lifting and exercise restrictions, supplements and blood tests and symptoms that indicate you need to seek medical attention.
The Conversation Starts with Your GP
You do not need to be at the point of considering surgery to speak to your GP about your weight management or diabetic concerns.
Start by discussing with your GP how the weight is affecting your health and daily life. You may be finding diabetes harder to manage, relying on treatment for sleep apnoea, avoiding movement because of sore joints or feeling discouraged after weight regain.
Your GP can review your health, discuss non-surgical care and provide a referral for Dr Harald Puhalla, to make sure you get a full explanation of non-surgical and surgical weight loss options.
Frequently Asked Questions
Speak with your GP first if you are considering weight loss surgery. A referral allows you to access applicable Medicare rebates for specialist appointments and provides Dr Puhalla with important information about your health history, medications and previous treatment.
No. Bariatric surgery can support significant weight reduction, but it does not guarantee a set result. Ongoing eating changes, medical review, follow-up and consistency should all play a part in your ongoing health and weight management.
Research involving adults with obesity and type 2 diabetes has found better long-term blood glucose control, lower diabetes medication use and higher remission rates after bariatric surgery compared with medical and lifestyle treatment alone.
The procedure discussed with you will be based on medical assessment, your symptoms, previous treatment, nutritional needs, treatment goals and surgical risks.
Surgical Weight Loss Options on the Gold Coast
Dr Harald Puhalla is a Specialist Bariatric and General Surgeon based on the Gold Coast, with over 20 years of surgical experience.
He consults from Pacific Private Clinic in Southport and performs surgery at Gold Coast Private Hospital and Pindara Private Hospital. In-person and telephone consultations are available.
If weight is affecting your health and you would like to understand your surgical options, speak with your GP about referral to Dr Harald Puhalla for specialist assessment.
Dr Harald Puhalla
MD | FRACS | MED0000976858
Suite 4, Level 6, Pacific Private Clinic
123 Nerang Street
Southport QLD 4215
Already have a referral?
Book Your Consultation
References
Eisenberg, D., Shikora, S. A., Aarts, E., Aminian, A., Angrisani, L., Cohen, R. V., Luca, M. D., Faria, S. L., Goodpaster, K. P. S., Haddad, A., Himpens, J. M., Kow, L., Kurian, M., Loi, K., Mahawar, K., Nimeri, A., O’Kane, M., Papasavas, P. K., Ponce, J., & Pratt, J. S. A. (2022). 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery. Surgery for Obesity and Related Diseases, 0(0). https://doi.org/10.1016/j.soard.2022.08.013
Courcoulas, A. P., Patti, M. E., Hu, B., Arterburn, D. E., Simonson, D. C., Gourash, W. F., Jakicic, J. M., Vernon, A. H., Beck, G. J., Schauer, P. R., Kashyap, S. R., Aminian, A., Cummings, D. E., & Kirwan, J. P. (2024). Long-Term Outcomes of Medical Management vs Bariatric Surgery in Type 2 Diabetes. JAMA, 331(8), 654–664. https://doi.org/10.1001/jama.2024.0318
Gupta, S., & Chen, M. (2023). Medical management of obesity. Clinical Medicine, 23(4), 323–329. https://doi.org/10.7861/clinmed.2023-0183
Gulinac, M., Miteva, D., Peshevska-Sekulovska, M., Novakov, I., Antović, S., Peruhova, M., Snegarova, V., Kabakchieva, P., Assyov, Y., Vasilev, G., Sekulovski, M., Lazova, S., & Velikova, T. (2023). Long-term effectiveness, outcomes and complications of bariatric surgery. World Journal of Clinical Cases, 11(19), 4504–4512. https://doi.org/10.12998/wjcc.v11.i19.4504
Dr Harald Puhalla (MED0000976858) MD FRACS is a Specialist Bariatric and General Surgeon. This article provides general information only and is not intended to replace professional medical advice. All surgery carries risks and individual results may vary. Healthcare decisions should always be made in consultation with a qualified medical professional.
