About our metabolic obesity service
Obesity is a complex, chronic, relapsing condition and is unlikely to benefit from a 'one size fits all' approach.
The management of obesity requires a team approach with ongoing support and monitoring. The MOS team offer this through individualised recommendations from our qualified health professionals to achieve the best opportunities for health improvement.
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Metabolic obesity service
Read transcriptWhy choose bariatric surgery
Compared with non-surgical approaches like diet and exercise, there is international consensus that bariatric surgery is by far the most effective intervention for sustained weight loss and improvements in obesity related health conditions.
Surgery is irreversible and is a tool to manage obesity and improve health and wellbeing.
Who are we
We provide support from health professionals including:
- doctors
- nurses
- dietitians
- physiotherapists
- clinical psychologists
- social workers
- administration support.
We are the first, regionally based, award winning and publicly funded surgical obesity service in NSW.
What to expect
Initially you will attend an information session where you will learn about our service, the surgery, expectations and an opportunity to ask questions.
From here you elect to see the Metabolic Obesity Service (MOS) doctor for suitability and planning.
MOS uses a combination of virtual appointments and face to face. This can help you remain in touch with us without the inconvenience for some of losing a day to travel and interrupting work and home life. You can read more about Virtual Care.
The appointment phases are:
- Phase 1: Appointment with the team, weekly workshops in small groups.
- Phase 2: Putting new skills into practice, monthly appointments with MOS team and the ability to demonstrate behaviour change, up to 12 months.
- Phase 3: When the MOS team and you agree to proceed to surgical consultation.
- Phase 4: Post surgical follow-up, support and coaching for at least 2 years.
Commitment to all phases is essential for long term weight loss and long term improvement to your health.
Weight loss through surgery is not easy. It requires commitment and hard work. The team are here to support you through all phases of the program.
The MOS will help you identify barriers to behaviour change to support you to improve your health and quality of life.
Inclusion criteria and referrals
Referrals will only be accepted from your General Practitioner (GP).
GPs can access the referral form on our Information for Clinicians page.
Inclusion criteria:
- Medicare eligible
- patient is willing to consider surgery as a management tool for obesity
- recently tried and optimised lifestyle or medical treatments for weight loss that resulted in insufficient weight loss (within the last two years)
- resides in a rural or remote area of NSW
- patient is 18-55 years of age
- Body Mass Index (BMI) greater than or equal to 40-55 kg/m2
- patient is willing to participate in a long-term healthy lifestyle program
- non-smoker or ex-smoker who has quit for longer than six months prior to referral
Exclusion Criteria:
- previous bariatric surgery
- patient is on another public bariatric surgery waitlist
- pregnant or planning pregnancy in two years post-surgery
- history of poor compliance with lifestyle, medical, or mental health interventions
- mental health conditions that are not fully treated or stabilised
- current alcohol/opioid/illicit drug dependence
- cognitive or behavioural disorders without adequate social/carer support.
Incomplete referrals will not be accepted.
All referrals are assessed and prioritised according to associated medical conditions using the Edmonton Obesity Staging System (EOSS).
The referral form is available to complete. It is to be accompanied by a medication summary and patient health summary.
Where to send the referral form?
The completed form should be sent to Murrumbidgee LHD Community Care Intake Service at: MLHD-CCIS@health.nsw.gov.au
Waiting times after you are referred
There is currently a 10 to 12 month wait to be invited to an initial information session.
There is a further 7 to 8 month wait to see the doctor for an initial medical consultation.
Depending on existing health conditions and medication, there may be up to a further 6 to 12 month wait to enter the group education workshops.
Total wait time can be 2 years to begin the education component.
On completion of education you are not automatically transitioned to see the surgeon for consideration.
You will then be in the program supported by the clinical team to help you adjust to lifestyle behaviour change. There is no guarantee you will transition to surgery as there is only 50 places per year. You must be able to commit to small lifestyle behaviour changes that become embedded for life for bariatric surgery to have the long term health benefits. You have up to 12 months to demonstrate these changes.
There is no fast track to surgery. The process is long and well supported to ensure your long term success.
It may take between 3 and 4 years from the time your referral is received to having surgery.
Thank you for your patience.
Frequently asked questions
How do I get referred and what lifestyle criteria do I have to meet to be eligible?
Referrals are only accepted through your GP. Please ask your regular GP to refer you.
You will need to meet the following lifestyle criteria to be eligible for the program:
1. In general, to be considered for the program, you should have a body mass index (BMI, calculated as weight in kilograms divided by height squared) more than 40 kg/m2.
2. You should expect to move to healthy lifestyle changes that are able to be achieved for the long term. A high level of motivation is required.
3. Patients should not be a current smoker and should have quit at least six months from the time of enrolment in the program. Patients who want to quit smoking should speak to their GP, visit iCanQuit, download the ‘My QuitBuddy’ app or call the Quitline on 13 78 48.
I don't live in the Wagga Wagga area. Can I still enrol in the program?
Yes, but please note you will be expected to travel to Wagga Wagga for certain appointments.
Does everyone who is referred get weight loss surgery?
No. There are only a limited number of publicly funded surgeries available. Patients are assessed and triaged according to disease progression.
How do I know if me referral is accepted and what is the wait time?
You will receive an SMS to advise you when your referral has been received. You will then be invited to an information session once a spot is available for you.
The wait time is 12 months to the information session and up to another 12 months to enter education.
What happens after the information session?
If you wish to proceed with the program after the information session, you will need to call and book an appointment with the MOS Doctor. The doctor will assess your medical situation and if you meet further criteria, you will be allocated into a group to start the education phase.
There are many reasons why you may not be suitable for surgery through our program and the Doctor will discuss this with you.
What do I have to do in the program?
Once accepted into the program you will need to attend small group workshops in person or virtually (if attending virtually you will need a stable internet connection, camera, and microphone from a computer or mobile device). You will also need to attend one on one consultations with the MOS team either virtually or in person.
How much will it cost?
The program and surgery is fully funded under Medicare, however there will be expenses for travel to/from Wagga Wagga, special dietary requirements and nutritional supplements leading to and after surgery.
IPTAAAS- Travel assistance is available through the Isolated Patient Travel Accommodation and Assistance Scheme and can be accessed at: http://www.iptaas.health.nsw.gov.au/
The MOS program does not cover skin removal or other cosmetic surgeries.
How long will it take and what happens after the surgery?
From referral to surgery, the time can vary, after initial appointments and education workshops, we wouldn’t expect you to be in the active phases of the program for more than 12 months. Each patient is different, and every patient’s journey is individual.
After the surgery you will continue to see the MOS health professionals for at least two years after receiving surgery. Ongoing connection with the team is important for your long-term success.
What if I don't want to have surgery?
The MOS program is strictly for patients considering surgery for weight loss. If you’re not sure if surgery is right for you, we encourage you to attend the information session and the initial Doctor consultation. If you do not want bariatric surgery, you are not eligible for the program and will be discharged.
If discharged from the program MOS will welcome a new referral.
What if I'm pregnant or planning to become pregnant?
Guidelines recommend delaying pregnancy for two years after surgery due to weight loss and the risk of developing nutrient deficiencies that will impact on your baby.
How long do I need to have off work after surgery?
You will need a minimum or two weeks off work, and up to six weeks if your job is of a physical nature.
If I do all the education, will I definitely get the surgery?
Due to the limited number of available surgeries unfortunately not all patients will proceed to surgery. The most suitable patients are chosen based on the benefit to their associated medical conditions and their readiness for surgery.
MOS aims to proceed the right patient at the right time getting the right results.
If discharged from the program MOS will welcome a new referral.
What happens if I am discharged?
The MOS team may feel there may be a risk to your long-term health and safety and bariatric surgery success. If you are discharged from the service, you will have a plan to work on specific areas alongside your GP and other health professionals in your community with a view that you may be referred back to us by your GP.
Why do I need a therapeutic relationship with my GP?
Your GP plays a very important role in your long-term success before and after bariatric surgery. You will be discharged from our service two years after your surgery.
If you need help with things like weight regain, your first step should be to your GP. They can refer you to other health professionals. If you need any additional help or are unsure, then certainly you can contact the MOS team for advice or more information.
Remember that it’s normal to regain some weight after your initial weight loss following bariatric surgery. When you have struggled with the dieting mindset for a large part of your life, sometimes these thinking patterns can return after bariatric surgery especially in times of stress. It is important to recognise that this is common, and this is a good time to reach out to your GP or other health professionals.
We know it can be difficult to reach out for help – don’t be afraid to ask for help - you’re not a failure! - and this is a normal part of the bariatric surgery journey.
It is often helpful to think back to your original reasons for seeking bariatric surgery. Often it wasn’t about losing weight but rather to improve your health, move more freely, be more active, live a less restrictive life and live longer.
Service contacts
| Service | Address / Location | Contact |
|---|---|---|
| General enquiries administration | Health Services Hub Level 1 Wagga Wagga Base Hospital | Phone: 0436 680 199 Fax: 02 6933 9215 Email: MLHD-MOS@health.nsw.gov.au |
| Clinical Nurse Consultant, Health Professional Enquiries | Phone: 0436 680 198 |
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Virtual care appointments
Virtual care (telehealth), uses technology to offer patients and consumers a convenient way to connect with health professionals. Virtual care has many benefits for patients, carers and health professionals. Learn more about virtual care.