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It's not just about eating less. It's about changing how the body regulates weight.One of the most important things to u...
25/10/2026

It's not just about eating less. It's about changing how the body regulates weight.

One of the most important things to understand about bariatric surgery is that it does much more than reduce the size of the stomach.

It also triggers powerful biological changes that influence hunger, fullness, metabolism and the way the body responds to food.

Remember Obesity Set Point Theory? The idea that our bodies have biological mechanisms that defend a certain weight range?

Bariatric surgery can help change these weight-regulating mechanisms, making significant, sustained weight loss more achievable than with dieting alone for many patients.

So what actually changes after surgery?

1. GLP-1 levels increase

Following procedures such as gastric bypass and sleeve gastrectomy, the body's response to food changes. Increased GLP-1 activity helps promote feelings of fullness and supports blood sugar regulation.

2. Hunger hormones can decrease

Ghrelin, often called the hunger hormone, can decrease significantly after sleeve gastrectomy, helping reduce appetite. The effect varies depending on the type of surgery.

3. Fullness hormones increase

Peptide YY (PYY) is another important gut hormone. Increased PYY responses after bariatric surgery can help people feel satisfied with smaller portions.

4. Bile acid signalling changes

Bariatric surgery can alter how bile acids circulate and communicate with the body's metabolic systems, potentially contributing to improvements in glucose regulation and energy metabolism.

5. The gut microbiome changes

Surgery can change the composition of bacteria living in the digestive system. Researchers are continuing to investigate how these changes contribute to metabolic health and weight regulation.

6. The way food is consumed changes

A smaller stomach capacity helps limit portion sizes, while changes in appetite and fullness signals can make eating less feel more manageable.

What does this mean for long-term success?

Unlike dieting alone, bariatric surgery can influence several of the biological systems involved in defending body weight.

This helps explain why bariatric surgery is one of the most effective treatments available for achieving substantial, sustained weight loss in appropriately selected patients.

But surgery is not a quick fix. Good nutrition, physical activity, psychological wellbeing and ongoing multidisciplinary support remain essential for long-term success.

💚 Bariatric surgery doesn't simply change the size of your stomach. It changes the way your body responds to food.

📌 Save this post if you're considering bariatric surgery.

📌 Note: We offer surgical and medical weight loss solutions.

👨‍⚕️ Dr Suheelan Kulasegaran
Consultant Oesophago-gastric, Bariatric, General Surgeon and Endoscopist
☎️ 09 200 4849
✉️ [email protected]
🌐 Message "link" for a link to our website

Have you ever lost weight through dieting, only to find yourself slowly gaining it back?You're certainly not alone. And ...
22/10/2026

Have you ever lost weight through dieting, only to find yourself slowly gaining it back?

You're certainly not alone. And there's a biological reason why this happens.

It's called Obesity Set Point Theory.

Think about your body temperature. Your body works constantly to keep it within a relatively narrow range.

Your body weight is also regulated by complex biological systems that influence how much you eat, how hungry you feel and how much energy you burn.

When you lose a significant amount of weight, your body can respond in three important ways:

1. Your metabolism adapts

As you lose weight, your body requires less energy. But it can also reduce energy expenditure beyond what we'd expect from simply being smaller. This is called adaptive thermogenesis.

2. Your hunger hormones change

Weight loss can trigger hormonal changes that increase hunger and reduce feelings of fullness. Suddenly, eating less can feel much harder than it did at the beginning.

3. Your genetics play a role

Genetics influence appetite, metabolism, fat storage and how your body regulates weight. Some people are biologically more susceptible to weight regain than others.

So what does this mean?

Losing weight is one challenge. Maintaining that weight loss long term can be an even greater one.

And it's not simply a matter of willpower.

At Surgical Weight Solutions, we recognise obesity as a complex, chronic disease influenced by biology, genetics and environment.

Modern treatments, including medical weight management and bariatric surgery, can help address some of the biological mechanisms that make sustained weight loss so challenging.

💚 Your body may resist weight loss, but understanding why is the first step towards finding a more sustainable solution.

📌 Save this post if you're trying to understand why maintaining weight loss can be so difficult.

📌 Note: We offer surgical and medical weight loss solutions.

👨‍⚕️ Dr Suheelan Kulasegaran
Consultant Oesophago-gastric, Bariatric, General Surgeon and Endoscopist
☎️ 09 200 4849
✉️ [email protected]
🌐 Message "link" for link to website

🟢 Gallstones & Bariatric Surgery: What You Need to KnowRapid weight loss after bariatric surgery can increase the risk o...
08/10/2026

🟢 Gallstones & Bariatric Surgery: What You Need to Know
Rapid weight loss after bariatric surgery can increase the risk of developing gallstones.

For some people, gallstones cause no symptoms at all. For others, they can lead to:

✔️ Severe upper abdominal pain
✔️ Nausea and vomiting
✔️ Inflammation of the gallbladder (cholecystitis)
✔️ Jaundice or stones in the bile duct
✔️ Pancreatitis

So what happens if you develop gallstones after a sleeve gastrectomy or gastric bypass?

This is where specialist experience matters.

At Surgical Weight Solutions, we have expertise across bariatric surgery, upper gastrointestinal surgery and advanced endoscopy.
This can be particularly important after weight loss surgery because changes to the digestive anatomy, especially following some types of gastric bypass, can make the investigation and treatment of bile duct problems more complex.

Our team can provide care throughout the journey, from investigating symptoms and determining whether treatment is needed, through to laparoscopic or robotic gallbladder surgery and the management of more complex gallstone and bile duct problems following bariatric surgery.

💚 Developing gallstones after bariatric surgery doesn't necessarily mean another operation. The first step is getting the right diagnosis and understanding the best treatment for you.

📌 Save this post if you are considering bariatric surgery.

📌 Note: We offer surgical and medical weight loss solutions.

👨‍⚕️ Dr Suheelan Kulasegaran - Consultant Oesophago-gastric, Bariatric, General Surgeon and Endoscopist
☎️ 09 200 4849
✉️ [email protected]
🌐 www.surgicalweightsolutions.co.nz

⚖️ Your weight is only one number. Your health is much more than that.At Surgical Weight Solutions, we believe BMI is us...
02/10/2026

⚖️ Your weight is only one number. Your health is much more than that.

At Surgical Weight Solutions, we believe BMI is useful, but it doesn't tell the whole story.

Two people can have exactly the same BMI and very different body compositions.

One may have more lean muscle. Another may carry more body fat or visceral fat around the organs. Their health risks, physical function and treatment needs can therefore be very different.

That's why we incorporate body composition analysis into our comprehensive multidisciplinary assessment and follow-up.

Because successful weight management isn't simply about losing kilograms.

We look at the bigger picture:

✔️ Reducing excess body fat
✔️ Preserving lean muscle and bone
✔️ Improving metabolic health
✔️ Building strength and physical function
✔️ Creating sustainable long-term outcomes
✔️ Helping you enjoy a healthier, more active life

The number on the scales matters, but it is only one measure of progress.

💚 Our goal is not simply to help you become lighter. It is to help you become healthier, stronger and more capable while protecting your long-term wellbeing.

BMI is a useful starting point. It is not the whole picture.

📌 Save this post if you are considering medical or surgical weight loss.

📌 Note: We offer surgical and medical weight loss solutions.

👨‍⚕️ Dr Suheelan Kulasegaran - Consultant Oesophago-gastric, Bariatric, General Surgeon and Endoscopist
☎️ 09 200 4849
✉️ [email protected]
🌐 www.surgicalweightsolutions.co.nz

It was a privilege to spend time with my good friend and colleague, Professor Nunobe, a world renowned Gastric Cancer Su...
24/09/2026

It was a privilege to spend time with my good friend and colleague, Professor Nunobe, a world renowned Gastric Cancer Surgeon at the Cancer Institute Hospital of the Japanese Foundation for Cancer Research (JFCR) in Tokyo, Japan.

An invaluable opportunity to discuss complex gastric cancer cases, observe advanced robotic surgical techniques, and exchange insights into the evolving role of robotic surgery in upper gastrointestinal oncology.

As robotic surgery continues to transform the management of upper GI cancers, learning from international leaders and centres of excellence is essential to advancing surgical practice and improving patient outcomes.

I am grateful to Professor Nunobe and his team for their generosity in sharing their expertise and experience.

👨‍⚕️ Dr Suheelan Kulasegaran - Consultant Oesophago-gastric, Bariatric, General Surgeon and Endoscopist
☎️ 09 200 4849
✉️ [email protected]
🌐 www.surgicalweightsolutions.co.nz

🔥 Still getting reflux despite taking omeprazole?Here’s something many people don’t realise:PPIs reduce acid. They don’t...
22/09/2026

🔥 Still getting reflux despite taking omeprazole?

Here’s something many people don’t realise:

PPIs reduce acid. They don’t necessarily stop reflux.

Omeprazole and other PPIs work by reducing the amount of acid your stomach produces. But if stomach contents are still travelling back up into your oesophagus, the underlying reflux may still be happening.

So, while the burning might improve, you may still experience:

• Regurgitation or a sour taste
• Coughing or throat clearing
• Choking at night
• Symptoms when lying down
• Ongoing reflux despite medication

In some cases, there may be another factor contributing, such as a hiatus hernia or a weakened anti-reflux barrier.

That doesn’t mean surgery is necessarily needed. But persistent symptoms are worth investigating rather than simply assuming stronger or longer-term medication is the answer.

Still getting reflux despite treatment? It may be time to find out why.

📌 Save this post

📌 Note: We offer surgical and medical weight loss solutions.

👨‍⚕️ Dr Suheelan Kulasegaran - Consultant Oesophago-gastric, Bariatric, General Surgeon and Endoscopist
☎️ 09 200 4849
✉️ [email protected]
🌐 www.surgicalweightsolutions.co.nz

🧠 What does a GLP-1 medication actually do inside your body?It doesn't simply "kill your appetite".The science is much m...
06/09/2026

🧠 What does a GLP-1 medication actually do inside your body?

It doesn't simply "kill your appetite".

The science is much more interesting than that.

GLP-1 is a hormone involved in the communication between your gut, brain and pancreas.

GLP-1 receptor agonist medications mimic aspects of this natural hormone and influence several systems involved in hunger, digestion and blood sugar control.

1. Your brain gets stronger fullness signals

GLP-1 medications act on areas of the brain involved in appetite and satiety.

For many patients, this means they feel satisfied with less food and experience fewer persistent thoughts about eating.

2. Food moves through the stomach more slowly

GLP-1 medications can slow gastric emptying, particularly during treatment initiation, helping contribute to feelings of fullness.

3. Blood sugar control improves

GLP-1 stimulates insulin release when glucose levels are elevated and suppresses glucagon, a hormone that can increase blood glucose.

Together, these effects help explain why this family of medications was originally developed for Type 2 diabetes and has become such an important tool in modern obesity treatment.

But here's the important part.

💚 These medications work because they influence biology.

That's another reason we need to move away from the idea that obesity simply comes down to "willpower".

Hunger, satiety, hormones, metabolism, genetics, psychology and environment all play a role.

Modern obesity treatment recognises that complexity and gives us more ways to work with the body's biology rather than continually fighting against it.

📌 Save this post or share with a friend.

📌 Note: We offer surgical and medical weight loss solutions.

👨‍⚕️ Dr Suheelan Kulasegaran - Consultant Oesophago-gastric, Bariatric, General Surgeon and Endoscopist
☎️ 09 200 4849
✉️ [email protected]
🌐 www.surgicalweightsolutions.co.nz

Post Two:📉 How good are GLP-1 weight loss medications?The short answer?For the right patient, they can be remarkably eff...
05/09/2026

Post Two:

📉 How good are GLP-1 weight loss medications?

The short answer?

For the right patient, they can be remarkably effective.

Modern obesity medications have changed what can realistically be achieved without surgery.

Clinical trials have demonstrated substantial average weight loss with medications such as semaglutide and tirzepatide.

In a major head-to-head trial in people with obesity without Type 2 diabetes, participants receiving tirzepatide lost an average of approximately 20% of their starting body weight over 72 weeks, compared with approximately 14% with semaglutide at the doses studied.

That's a significant medical advance.

But there are some important realities.

GLP-1-based medications aren't magic injections.

Results vary between individuals. They work best alongside good nutrition, physical activity and ongoing clinical support, and gastrointestinal side effects such as nausea, vomiting and diarrhoea can occur.

And importantly, obesity is a chronic disease.

For some patients, medication may be the most appropriate treatment.

For others, bariatric surgery may provide greater and more durable weight loss.

And increasingly, we use medications and surgery as complementary tools rather than viewing them as competitors.

💚 The question isn't simply, "How much weight can this medication make me lose?"

The better question is:

"What treatment gives me the best chance of improving my health long term?"

That's where individualised specialist care matters.

📌 Save this post or share with a friend

📌 Note: We offer surgical and medical weight loss solutions.

👨‍⚕️ Dr Suheelan Kulasegaran - Consultant Oesophago-gastric, Bariatric, General Surgeon and Endoscopist
☎️ 09 200 4849
✉️ [email protected]
🌐 www.surgicalweightsolutions.co.nz

💉 GLP-1 injections vs tablets: does it really make a difference?For years, most of the conversation around GLP-1 weight ...
04/09/2026

💉 GLP-1 injections vs tablets: does it really make a difference?

For years, most of the conversation around GLP-1 weight loss medications has centred around injections.

But that landscape is changing.

GLP-1-based treatments can now be delivered in different ways internationally, including weekly injections and, for some treatments, daily tablets.

So which is better?

The answer isn't necessarily as simple as choosing a needle or a pill.

Injectable treatments

Modern injectable treatments such as semaglutide are generally taken once weekly. Tirzepatide, which acts on both GIP and GLP-1 receptors, is also administered weekly.

They have produced substantial weight loss in major clinical trials and have transformed the medical treatment of obesity.

Oral treatment

Oral semaglutide has also demonstrated substantial weight loss in clinical trials, and an oral formulation of Wegovy has now been approved in the United States.

However, tablets aren't automatically "better" simply because there is no injection. They have different dosing requirements, and the right treatment still depends on the individual.

Here in New Zealand, Wegovy is currently approved as a weekly injection for weight management.

Note: Oral tablets are not currently available in NZ, but are on the way!

The bigger message?

💚 Obesity medicine is evolving quickly. We now have more tools than ever before, but choosing the right medication, dose and treatment strategy should be done with experienced medical guidance.

At Surgical Weight Solutions, we look at the complete picture, including medical treatment, lifestyle intervention and bariatric surgery, to determine the most appropriate approach for each patient.

📌 Save this post or share with a friend

📌 Note: We offer surgical and medical weight loss solutions.

👨‍⚕️ Dr Suheelan Kulasegaran - Consultant Oesophago-gastric, Bariatric, General Surgeon and Endoscopist
☎️ 09 200 4849
✉️ [email protected]
🌐 www.surgicalweightsolutions.co.nz

One of the best parts of being a surgeon are the friendships you make along the way.Medicine is a small world.It's alway...
09/08/2026

One of the best parts of being a surgeon are the friendships you make along the way.

Medicine is a small world.

It's always special to reconnect with friends and colleagues from different parts of the world, share ideas, learn from one another, and remember where the journey began.

Grateful for the friendships, the conversations, and the opportunity to keep learning together.

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17 Shea Terrace, Takapuna
Auckland
0622

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Monday 9am - 5pm
Tuesday 9am - 5pm
Wednesday 9am - 5pm
Thursday 9am - 5pm
Friday 9am - 5pm

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