Weight is a medical problem with medical causes, not a willpower problem. A GP-led weight management program starts with a proper assessment of your health, your history and what has already been tried, and continues with structured reviews rather than a single appointment and a leaflet.
The program
- An initial long consultation to go through your history, your previous attempts and your goals
- Blood tests and an examination to check for the medical contributors – thyroid, blood sugar, cholesterol, liver, sleep apnoea, hormones and medicines that cause weight gain
- A body composition (InBody) scan to measure muscle and fat rather than just weight, repeated so you can see what is changing
- An agreed plan, with structured reviews every six weeks
- All suitable treatment options discussed with you at the consultation, with your doctor managing and reviewing whatever is decided
- Referral to a dietitian, exercise physiologist or psychologist where that helps
- Management of the conditions that travel with weight – diabetes, blood pressure, cholesterol, joint pain and sleep apnoea
What to expect
Book a long appointment for the first visit and say what it is about. The first appointment is about understanding the whole picture; the plan is set at the end of it or at the following visit, and reviewed every six weeks after that so it can be adjusted rather than abandoned.
What is right for one person is wrong for another, and the options depend on your health, your history and your preferences. Your doctor will go through all of them with you.
What the first appointment covers
Weight is driven by biology — appetite hormones, genetics, sleep, thyroid and blood sugar, pain, mood and the medicines you already take — so the first visit is spent working out which of those apply to you, rather than handing out advice that assumes none of them do.
- Your history: what you have already tried, what worked, what did not, and why it stopped.
- Blood tests for the medical contributors — thyroid, blood sugar and HbA1c, cholesterol, liver, iron and vitamin D, and hormones where relevant.
- A check for obstructive sleep apnoea, which is common, often missed, and makes weight loss much harder.
- A review of your current medicines — several commonly used ones cause weight gain and can sometimes be changed.
- An InBody body composition scan, which measures muscle and fat separately instead of giving you one number on a scale.
Worth bringing with you
- Everything you take, including supplements and anything bought online.
- Any recent blood test results.
- What you have tried before, and what got in the way.
- What you actually want from this. Fitting into something, getting off a tablet, keeping up with your children and sleeping properly are all reasonable goals, and each of them changes the plan.
The four things that do most of the work
Whatever else is decided, the plan is built on these:
- Protein at every meal, and enough fibre. This is what protects muscle and keeps you full.
- Resistance training at least twice a week. Walking is good for your heart; lifting something heavy is what keeps the muscle you already have.
- Sleep. Short or broken sleep raises appetite the next day, and untreated sleep apnoea works against everything else.
- The behavioural side. Stress eating, night eating, binge eating and low mood are common, treatable and worth naming. Tell your doctor if any of that is part of the picture.
What happens at each six-week review
Six weeks is long enough to see whether something is working and short enough to change course. Each review looks at weight and body composition, how you are eating and moving, blood pressure and blood tests where relevant, anything that is not agreeing with you, and whether the plan needs adjusting. If part of it is not working after a fair trial, it is changed rather than continued.
What this program is not
There is nothing being sold to you here. No shakes, no supplements, no detoxes and no fixed-price packages. What you get is an assessment, a plan you have agreed to, and someone reviewing it with you every six weeks. If part of it is not working for you, say so — it is meant to be adjusted.
The doctors
Weight management is provided by the doctors who work from Health Nexus, including:
- Dr Miyulasi Attanayake – chronic disease, metabolic health
- Dr John Esho – internal medicine, chronic disease
- Dr Asim Razak – chronic disease, cardiovascular risk
- Dr Arsalan (Sam) Mahmud – preventive health, chronic disease
Fees and Medicare
Health Nexus Launceston is a mixed-billing practice. Children aged 12 and under are bulk billed whenever the practice is open, including evenings and weekends. Pension card holders over 65 and DVA Gold Card holders are bulk billed on weekdays between 8am and 5pm. Everyone else pays the consultation fee with the Medicare rebate claimed on the spot. The current fees are on the fees and bulk billing page.
The practice is open 8am–8pm Monday to Friday, 8am–5pm Saturday and 9am–5pm Sunday, every day of the year, and on every public holiday at the standard hours for that day.
Common questions
What happens at the first appointment?
A long consultation: your history, what you have already tried, an examination, blood tests to look for medical contributors, and a body composition scan. The plan follows from what that shows.
How often will I be seen?
The program runs on six-weekly reviews, so the plan is adjusted as things change.
Is it covered by Medicare?
Consultations are billed as usual and attract the Medicare rebate – see the fees page. The InBody scan has its own fee. Allied health visits under a care plan attract a Medicare rebate for eligible patients.
Do I need a referral?
No. Book a long GP appointment directly.
What about treatment options?
Your doctor will discuss all of the options that suit your situation with you during the consultation, and manage and review whatever you decide on together.
How long before I see a change?
Give any plan a fair trial. Six weeks is the first checkpoint and three to six months tells you whether it is working. Weighing yourself daily tells you very little; the six-weekly review and the body composition scan tell you a great deal more.
How much do I need to lose for it to be worth it?
Less than most people expect. A loss of five to ten per cent of your starting weight already improves blood pressure, blood sugar, liver, sleep apnoea and joint pain. The health benefit arrives well before any particular number on the scale.
