Surgical Weight Solutions

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

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

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

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

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

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

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

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.

08/08/2026

Always great catching up with good friends.

A pleasure to spend some time with my good friend Mr Ravi Aggarwal at St Mary's Hospital, Imperial College London.

We spent the day sharing ideas, discussing techniques, and talking all things bariatric surgery.

St Mary's is an exceptional unit, performing more than 450 bariatric procedures each year, including complex revisional surgery. It was also the first bariatric unit in the UK to be recognised as an International Centre of Excellence.

Always inspiring to spend time with people who are passionate about improving patient care.

Surgical Weight Solutions has an experienced and supportive team to assist their patients on their weight loss surgery journey.

06/08/2026

Good friends. Great surgeons.

It was fantastic to catch up with good friends from Norfolk and Norwich University Hospital, where I had the privilege of working for two years.

These weren't just colleagues. They became lifelong friends who I genuinely enjoyed working alongside every day.

Not only are they world class surgeons and clinicians, they're also genuinely good people.

It's always a pleasure catching up, sharing stories, and seeing where our journeys have taken us.