For decades, weight loss surgery in Australia carried a public perception as a cosmetic shortcut, a last resort chosen only after every other option had failed. That perception has shifted. Leading Melbourne bariatric surgeon Mr. Niruben Rajasagaram says the national conversation around procedures such as gastric sleeve surgery in Melbourne and across Australia is moving toward a more accurate framing: obesity as a chronic medical and metabolic condition, and bariatric surgery as an evidence-based treatment for it, not a cosmetic choice.
A Shift From Stigma to Science
“For a long time, patients told me they felt they had to justify wanting weight loss surgery, as though it reflected a lack of willpower rather than a medical decision,” Mr. Niruben Rajasagaram said. “Framing has never matched the clinical evidence. Obesity is a chronic disease influenced by genetics, hormones and environment, and for many patients, surgery is simply the most effective treatment available, in the same way we would treat any other chronic condition with the intervention best supported by evidence.”
The shift in public understanding has been supported by a wider conversation in Australian healthcare about obesity as a chronic disease requiring long-term, medically supervised management, rather than a personal failing to be resolved through diet alone. Increased public discussion of medical weight loss treatments in recent years has also opened the door to more informed conversations between patients and their GPs about surgical options such as gastric sleeve surgery, gastric bypass and gastric balloon placement.
Leading the Conversation
Mr. Niruben Rajasagaram, a Consultant Bariatric, Upper Gastrointestinal and General Surgeon consulting from Knox Private Hospital in Wantirna, Peninsula Private Hospital in Frankston and Berwick Integrated Care in Melbourne’s south-east, said the change in tone has practical implications for patients considering treatment.
“Patients are coming into consultations better informed and less apologetic about wanting help,” Mr. Niruben Rajasagaram said. “That is a genuinely positive shift. It means we can spend more of the consultation on what matters, understanding a patient’s health history, their weight loss journey, and whether surgery is clinically appropriate for them, rather than addressing stigma before we even get to the medicine.”
More Than Just Surgery
He noted that a multidisciplinary approach remains central to good outcomes regardless of how the public conversation evolves. His practice works alongside Ms. Stefania Basso, Bariatric Dietitian, and Dr. Monica Devanand, Habits and Transformation Coach, to support patients through the full journey from consultation and assessment to long-term follow-up care.
What to Do Next
Mr. Niruben Rajasagaram encourages anyone considering weight loss surgery, including gastric sleeve surgery in Melbourne, to start the conversation with their GP, who can provide a referral for a formal consultation and assessment.
About Mr. Niruben Rajasagaram
Mr. Niruben Rajasagaram is a Consultant Bariatric, Upper Gastrointestinal and General Surgeon based in Melbourne, consulting from Knox Private Hospital, Peninsula Private Hospital and ST John of God Berwick. His practice provides gastric sleeve, gastric bypass, mini gastric bypass, gastric balloon, gastric band and revisional bariatric surgery, alongside hernia repair and gallbladder surgery.
