Dr Ashok Gunawardene

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12 Osburn Pl, Epping VIC 3076

240 Hoppers Ln, Werribee VIC 3030

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Frequently Asked Questions

Important Medical Disclaimer:

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. The information provided below is educational in nature and does not replace personalised medical advice. Individual weight loss outcomes vary depending on personal medical history and adherence to post-operative lifestyle changes.

Eligibility for bariatric surgery in Australia is guided by established clinical criteria, focusing on your long-term health rather than aesthetics. Generally, you may be eligible if you have a Body Mass Index (BMI) of 35 or higher. You may also be eligible if your BMI is between 30–34.9 and you have significant metabolic conditions such as type 2 diabetes that has not responded adequately to medical therapy.

We understand that stepping on a scale or discussing your weight history can feel daunting. Please be assured that our practice is a judgment-free space. Medical science recognises severe obesity as a complex, chronic metabolic condition—not a measure of your willpower. If you have fought your biology for years through diets without long-term success, an initial consultation is a safe place to explore if surgery is the right medical tool to help you reclaim your health.

The decision to undergo weight loss surgery is deeply personal. It is not taking the “easy way out”—it is a courageous, scientifically proven intervention for individuals whose biology has made sustained weight loss incredibly difficult.

If your weight is causing physical pain, driving chronic disease, or holding you back from living the active, fulfilling life you deserve, surgery can offer a profound reset. It provides the mechanical and metabolic support you need to finally break the exhausting cycle of traditional dieting. You do not have to make this decision alone today. We warmly invite you to book a no-obligation consultation. Our goal is simply to provide a safe, supportive space to answer your questions and empower you with the facts to make the best decision for your future.

It is completely natural to feel anxious about having an operation. The reassuring reality is that modern bariatric surgery, performed laparoscopically (via keyhole), is highly refined and statistically very safe. In fact, its safety profile is comparable to routine procedures like having your gallbladder removed or a knee replacement.

However, in the interest of complete medical transparency, no surgery is entirely risk-free. General surgical risks include bleeding, infection, or blood clots. Risks specific to weight loss surgery include leaks from the surgical staple line, internal strictures (narrowing), or long-term nutritional deficiencies. We proactively minimise these risks through rigorous pre-operative testing, meticulous surgical technique, and lifelong aftercare. When considering surgery, it is also vital to weigh these risks against the well-documented, progressive, and life-limiting health risks of leaving severe obesity untreated.

Because every person’s biology is unique, we do not guarantee specific weight loss numbers. However, extensive clinical data provides a highly encouraging and realistic expectation: on average, patients lose between 20 and 30% of their total body weight within the first 12 to 18 months. Most patients maintain substantial weight loss long-term, though some gradual regain can occur after several years. The important thing is to recognise this early on and to re-engage with the team to address and gt you back on track.

It is helpful to view surgery as a powerful “metabolic reset.” It gives you the biological head start needed to make healthy lifestyle habits truly stick. While the numbers on the scale are deeply validating, our patients almost universally tell us that their greatest joys are “non-scale victories”—such as the remission of type 2 diabetes, resolving severe joint pain, and gaining the energy to participate fully in life again.

A very common fear is that you will never enjoy a meal again, or that you will feel constantly “starved” on small portions. The beautiful science behind these procedures is that they fundamentally alter your gut hormones, specifically drastically reducing ghrelin, the primary hunger hormone.

Initially, you will follow a guided diet of liquids and purees to allow your stomach to heal. Long-term, you will eat normal, solid foods, but your portion sizes will be significantly smaller—typically about the size of a small side plate (roughly one cup of food). Because your physical drive to eat is reduced and your stomach capacity is smaller, you will feel profoundly satisfied and comfortably full after these small amounts. You will still enjoy delicious food and dining out; you will simply be in control of your appetite, rather than controlled by it.

Yes, absolutely. Non-surgical options include structured lifestyle modifications, psychological therapy, and modern prescription weight-loss medications (such as GLP-1 receptor agonists). We fully support these avenues, and they are highly effective for many people.

However, clinical evidence shows that for individuals living with long-term, severe obesity, traditional methods often result in temporary weight loss followed by weight regain. This is due to “metabolic adaptation”—a biological survival mechanism where your body actively fights the weight loss by slowing your metabolism and increasing hunger. If you have experienced the exhausting cycle of yo-yo dieting, please know this is a biological reality, not a personal failure. Bariatric surgery permanently alters this biological “set-point,” making it the most durable, evidence-based intervention available for significant, long-term weight loss.

You do not need to make this decision alone; your surgeon will carefully review your medical history, eating habits, and anatomy to recommend the safest and most effective option for you. Both are exceptional, life-changing procedures:

  • Gastric Sleeve: Involves removing about 80% of the stomach, leaving a narrow “tube” or “sleeve.” It works primarily by restricting the volume of food you can eat and significantly reducing hunger hormones. It is a highly effective, straightforward option for most patients.
  • Gastric Bypass: Involves creating a small stomach pouch and gently rerouting a portion of your small intestine. It restricts food intake, powerfully alters gut hormones, and mildly reduces the absorption of calories. It is often considered the clinical “gold standard” if you suffer from severe acid reflux (GORD) or poorly controlled type 2 diabetes.

Both gastric sleeve and gastric bypass procedures are highly established procedures grounded in decades of scientific data. This means the techniques have been refined to optimise long-term outcomes.

Newer more malabsorptive procedures such as SADI-S are sometimes offered elsewhere and may have a role particularly in patients with very high BMI (above 60) but come with increased risks of malnutrition.

We believe in complete financial transparency so you can make an informed decision without unexpected stress. In Australia, the cost varies depending on your level of Private Health Insurance.

If you have appropriate cover (typically a Gold tier policy), your fund covers the hospital bed and theatre fees, aside from an excess charge typically $500-750. We quote you the out-of-pocket “gap” surgeons fee ($3500-5000 including assistant fee) and put you in touch with the particular anaesthetist you will be allocated to depending on the date of surgery who provide their own quote. You generally need to have been on Gold tier cover for a waiting period of twelve months but can do your consultations and work-up during that time.

If you are uninsured and choose to self-fund the surgery in a private hospital, the cost is significantly higher as you must also cover the hospital, theatre consumables and theatre fees (typically $20 000-25 000 including surgeon & anaesthetic fees). Following your initial consultations, we will arrange an itemised financial quote tailored to your exact circumstances.

Other fees include that of your dietician. We highly recommend experienced, specialised bariatric dieticians who ensure your nutritional safety and help especially with the initial adjustment period. We partner with trusted dietitian colleagues who we would typically refer you to for pre- and post-op care. A typical year-long bariatric dietitian package with our partners cost around $1000.

To comply with ethical medical guidelines, clinics generally do not offer direct, in-house financing, as a patient’s medical decisions should never be pressured by financial agreements.

However, many patients successfully utilise independent, third-party medical finance companies that specialise in funding elective surgeries. These providers offer payment plans that allow you to spread your out-of-pocket costs over time. If you explore this route, we gently encourage you to carefully review the interest rates and terms to ensure the plan fits comfortably within your household budget.

Yes. Under the Australian Taxation Office (ATO) guidelines, you may be eligible to apply for the Early Release of Superannuation (ERS) on compassionate grounds to fund your surgery.

This is a legally supported and highly common pathway for bariatric patients. The ATO may approve your application if the surgery is deemed necessary to treat a life-threatening illness (such as severe obesity and its related metabolic conditions) or to alleviate chronic pain. Our partner team AccessMySuper is highly experienced in this process and will provide the precise medical documentation and support you need for your application.

Yes, you will be required to follow a Very Low Energy Diet (VLED)—usually consisting of specially formulated meal replacement shakes—for weeks prior to your surgery date.

We understand this phase requires immense discipline and can be mentally challenging, but it is one of the most critical steps for your safety. When carrying excess weight, the body naturally stores fat in the liver, causing it to become enlarged. Because your liver sits directly over your stomach, the pre-op diet forces your body to rapidly burn this liver fat, significantly shrinking and softening the organ. This allows your surgeon safe, easy access during the keyhole surgery, which drastically reduces the risk of operative complications and promotes a much smoother recovery.

It is very common to experience temporary hair thinning—a condition known clinically as telogen effluvium—starting around 3 to 6 months after surgery.

We understand this can be a highly distressing thought, but please be deeply reassured: Permanent hair loss is extremely rare after bariatric surgery when nutritional needs are met. Rapid weight loss and the stress of surgery signal your body to temporarily divert nutrients away from non-essential functions, pushing some hair follicles into a resting phase. As your weight stabilises, your hair will shift back into its normal growth cycle. You can actively minimise this thinning by strictly following your dietitian’s advice, hitting your daily protein targets, and consistently taking your prescribed bariatric multivitamins.

Because bariatric surgery facilitates significant and rapid weight loss, your skin may not have enough elasticity to shrink back entirely to your new body size. The degree of loose skin varies greatly and depends heavily on your age, genetics, and the total amount of weight lost.

We validate that loose skin can cause physical chafing or self-consciousness. However, many of our patients proudly view it as a physical “badge of honour”—a testament to the life-saving health journey they have undertaken and the heavy burden they have left behind. If loose skin becomes a concern for you down the track, compression garments are very helpful, and we can refer you to a trusted plastic surgeon to discuss body contouring options once your weight has fully stabilised.

It is incredibly common to worry that you might somehow “ruin” your surgery or that your stomach will simply stretch back to its pre-surgery size. If you have spent years experiencing weight regain after traditional dieting, this fear of failure is completely valid and understandable. Please take a deep breath and be reassured: anatomically, it is virtually impossible for your stomach to grow back to its original capacity.

During a sleeve gastrectomy, we permanently remove approximately 80% of your stomach. Crucially, the portion that is removed—called the fundus—is the most highly elastic, “stretchy” part of the organ, biologically designed by nature to expand like a balloon to accommodate large volumes of food. The remaining stomach, which forms your new “sleeve,” is constructed from much thicker, less pliable muscular tissue.

In the first 12 to 18 months post-surgery, your new sleeve will naturally relax, mature, and “accommodate” slightly as internal surgical swelling subsides. This is not a failure; it is a normal, healthy biological process. It is exactly what allows you to safely transition from the tiny post-operative puree portions to comfortably enjoying a sustainable, satisfying meal (usually about the size of a small side plate) for the rest of your life.

When patients experience weight regain years down the track, it is very rarely because the stomach has physically stretched out. Instead, it is almost always due to “grazing” (eating small amounts constantly throughout the day) or consuming “slider foods”—highly processed, melt-in-the-mouth foods or liquid calories (like chocolate, chips, or milky coffees) that slide straight through the sleeve without triggering your physical restriction. The wonderful news is that your surgical tool is permanent. If life throws you off track, a simple return to the dietary basics with the help of our support team will immediately re-engage the power of your sleeve and help you regain control.

Adjusting to life after bariatric surgery is a learning curve, and it is entirely normal to feel a bit overwhelmed by the idea of new “rules.” We encourage you to view these guidelines not as a strict, punishing diet, but as the “owner’s manual” for your powerful new metabolic tool. Because the surgery significantly turns down your biological hunger, you will find these new habits much easier to adopt than when you were fighting your anatomy on standard diets.

While our multidisciplinary team of dietitians and nurses will guide you step-by-step, the foundational principles include:

What you SHOULD do:

  • Do prioritise protein: Because your portion sizes will be small, every single bite counts. Eating your high-quality protein first ensures you maintain healthy muscle mass as you lose fat, promotes beautiful healing, and gives you a strong, prolonged sense of fullness.
  • Do eat mindfully and chew thoroughly: Your new stomach anatomy requires food to be well broken down. Taking small bites, eating slowly (aiming for 20-30 minutes per meal), and chewing your food to a paste consistency will prevent physical discomfort and help you easily recognise your body’s subtle new “fullness” signals.
  • Do take your bariatric vitamins: Because you are eating significantly smaller amounts of food (and slightly altering absorption if you have a bypass), taking your prescribed, bariatric-specific multivitamins every day is a non-negotiable, lifelong commitment to protect your bone density, hair, and nerve health.
  • Do lean on your support team: Obesity is a complex chronic condition, and surgery is the beginning of the journey, not the end. Keeping your follow-up appointments ensures we can celebrate your victories, catch any nutritional dips early, and provide ongoing psychological and medical support.


What you SHOULD NOT do:

  • Don’t drink fluids with your meals: You will learn to separate your food and fluids by stopping drinking 30 minutes before a solid meal and waiting 30 minutes after. Drinking while you eat acts like a “flush,” washing the food out of your new stomach pouch too quickly. This can leave you feeling hungry sooner and defeats the restrictive benefit of the surgery.
  • Don’t rely on “slider foods” or liquid calories: Foods that melt in your mouth (like crackers or ice cream) and high-calorie drinks (like juices, alcohol, or sweet coffees) bypass your surgical restriction entirely. Relying on them is the most common cause of unwanted weight regain.
  • Don’t drink carbonated beverages: The bubbles from soft drinks, sparkling water, or beer introduce excess air into your small stomach pouch. This can cause severe bloating, stretching sensations, and unnecessary physical discomfort.
  • Don’t expect perfection from yourself: You will occasionally eat a little too quickly, try a food that doesn’t quite agree with you, or slip into an old habit. That is completely okay. This is a journey of progress, not perfection. Bariatric surgery gives you the grace to learn, adapt, and make mistakes without the overwhelming biological drive of starvation pulling you backward. Be kind to yourself as you step into this healthier chapter of your life.

Because the surgery is performed laparoscopically (via keyhole), recovery is generally much faster than traditional open surgery. Most patients stay in the private hospital for 1 to 3 nights, allowing our nursing team to manage your comfort and ensure you are safely tolerating your initial fluid diet. Everyone heals at their own pace. Generally, if you work in a sedentary or desk-based role, we recommend taking 10 to 14 days off work to allow your body to rest and adjust. If your job involves heavy physical labour, you will need 3 to 4 weeks before safely returning to full duties. You will be up and gently walking the very same day as your surgery—in fact, daily walking is highly encouraged to support your healing.

One of the most thrilling parts of this journey is that many patients are able to safely reduce or completely stop medications for type 2 diabetes and high blood pressure within weeks of their surgery. We will work closely with your GP to carefully monitor and adjust your dosages as your metabolic health improves. Immediately after surgery, large tablets may need to be crushed or switched to a liquid form to protect your healing stomach.

If you undergo a gastric bypass, you must strictly avoid NSAID pain relievers (such as Nurofen, Ibuprofen, Voltaren, or Naproxen) for the rest of your life, as they carry a severe risk of causing stomach ulcers. Paracetamol (Panadol) will become your safe, go-to option.

Yes, absolutely. In fact, bariatric surgery is one of the most effective medical interventions for resolving obesity-related fertility issues, such as PCOS. As your metabolic health improves, your fertility can increase very rapidly. However, for your safety and the healthy development of your baby, it is a strict medical requirement that you actively avoid pregnancy for the first 12 to 18 months following your procedure. During this period of rapid weight loss, your body undergoes immense nutritional shifts and simply cannot safely support a developing pregnancy. Once your weight has stabilised and your blood tests confirm your nutrient levels are excellent, your body will be in a wonderfully healthy, primed state to support a baby.

We advise strictly avoiding alcohol for at least the first six months after surgery while your stomach heals and your liver metabolises your rapid weight loss. Long-term, you can enjoy an occasional drink socially, but you must do so with extreme caution. Bariatric surgery fundamentally changes how your body absorbs alcohol. It enters your bloodstream much faster, meaning a single drink can elevate your blood alcohol concentration well over the legal driving limit in a matter of minutes. Furthermore, we gently urge our patients to be mindful of ‘transfer addiction’—a psychological phenomenon where the emotional comfort once provided by food is transferred to alcohol. We discuss this openly because your mental health is just as important as your physical health; our judgment-free team is always here to support you.

Dumping syndrome is a physical reaction that primarily affects gastric bypass patients. If you consume foods that are very high in refined sugars or dense fats (like milk chocolate or ice cream), the food empties—or ‘dumps’—too rapidly into your small intestine. This can cause a temporary rush of hormones leading to nausea, cramping, sweating, dizziness, and a rapid heart rate. While it sounds intimidating, many of our bypass patients actually view dumping syndrome as a highly positive tool. It acts as a built-in biological ‘policeman’ that effectively trains you to avoid highly processed sweets and protects your long-term weight loss goals.

Yes. If you had a gastric band placed years ago and are now experiencing complications like severe heartburn, difficulty swallowing, or weight regain, please take a deep breath and know you are not alone—and you have not ‘failed.’ The global medical consensus has shifted away from Lap-Bands precisely due to these long-term mechanical issues. We routinely perform revision bariatric surgery, commonly converting old bands or previous sleeves into a highly effective gastric bypass. Revision surgeries are technically more complex due to internal scar tissue, so your surgeon will carefully review your anatomy (often via an endoscopy, CT scan, barium swallow and/or oesophageal manometry) to recommend the safest path to restore your health and comfort.