Bariatric surgery5 min read
Which Doctor Treats Obesity? Endocrinologist, Dietitian, Psychologist or Bariatric Surgeon
Many people who want to lose weight do not know where to start: with a family doctor, an endocrinologist, a dietitian or a surgeon. The honest answer is that obesity is usually best treated by several specialists, each covering a different part of the problem. This guide explains what each of them does, which tests to expect and when it makes sense to talk to a bariatric surgeon.
The main points in 30 seconds
- Obesity is best treated by a team, usually starting with a GP.
- An endocrinologist checks hormones and metabolism and treats complications.
- A dietitian and a psychologist help change eating habits and behaviour for the long term.
- A bariatric surgeon is consulted when BMI is 40, or 35 with weight-related illness.
- Before surgery, several specialists assess your health and readiness.
Key facts about the procedure
- Back to work2–4 weeks
- Stay in clinic1–5 days
- Final result18–24 months
- Price
$4,800from $3,600
Why Obesity Needs a Team
Obesity is a chronic disease with many causes: appetite hormones, genes, metabolism, sleep, stress, eating habits and other illnesses. It also affects many organs, from the heart and liver to the joints and airways. No single specialist covers all of this, which is why guidelines recommend a team approach.
A family doctor or GP is usually the first step. They measure weight, height and waist size, calculate BMI, check blood pressure, order basic blood tests and look for conditions linked to weight. Depending on the findings, they refer you to the specialists described below.
Endocrinologist: Hormones and Metabolism
An endocrinologist looks for hormonal causes of weight gain and treats metabolic complications. They check for problems such as an underactive thyroid, excess stress hormones, polycystic ovary syndrome or low sex hormone levels, and assess blood sugar control and blood fats.
Typical tests include:
- fasting blood sugar and a long-term blood sugar marker (HbA1c);
- thyroid function tests;
- cholesterol and triglycerides;
- liver and kidney function;
- other hormone tests depending on symptoms, sex and age.
If a hormonal disease is found, it is treated first. The endocrinologist may also discuss weight-loss medicines or injections and whether surgery is worth considering.
Dietitian: Nutrition and Habits
A dietitian builds an eating plan you can actually keep. The aim is not a short, strict diet but lasting changes: regular meals, enough protein and fibre, smaller portions, fewer sugary drinks and less ultra-processed food. A food diary often reveals patterns such as snacking in the evening or skipping breakfast and overeating later.
Dietitians also play a key role around bariatric surgery. Before the operation they help with a preparatory diet, and afterwards they guide the staged move from liquids to solid food, protein targets and the vitamin and mineral supplements that most patients need.
Psychologist: Behaviour Change
Eating is closely linked to emotions, stress and routine. A psychologist helps you notice triggers such as boredom, tiredness or low mood, and find other ways to cope. Cognitive behavioural approaches are well studied and help many people keep new habits.
Psychological assessment is a standard part of preparing for bariatric surgery. It checks whether a person understands the changes involved, identifies eating disorders or depression that need treatment first, and makes sure support is in place after surgery, when life and body image change quickly.
Bariatric Surgeon: When Surgery Is Indicated
A bariatric surgeon decides whether an operation is suitable and which one fits best. Surgery is usually considered when:
- BMI is 40 or more;
- BMI is 35 or more with a weight-related condition such as type 2 diabetes, high blood pressure or sleep apnoea;
- serious attempts at weight loss without surgery have not lasted.
The surgeon reviews your history and test results, explains the options, their risks and expected outcomes, and plans preparation and follow-up together with the other specialists. You do not need to wait until every other method has failed for years before asking a surgeon for an opinion.
Signs It Is Time to See a Doctor
It is worth seeing a doctor about your weight if:
- your BMI is 30 or more, or your waist is large for your height;
- you have high blood pressure, raised blood sugar, sleep apnoea, fatty liver or painful joints;
- you gain weight quickly without a clear reason;
- you have lost weight several times but it keeps coming back;
- your weight limits daily activities, work or fertility plans.
Sudden weight gain with swelling, breathlessness or marked fatigue needs prompt attention, because it can have causes other than fat.
The Multidisciplinary Approach at City Medical Centre
City Medical Centre performs bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass, one-anastomosis gastric bypass and SADI-S. Preparation includes a surgeon's consultation, laboratory tests, an ECG, a chest X-ray, an ultrasound, gastroscopy and consultations with a GP, endocrinologist, psychiatrist, cardiologist and, for women, a gynaecologist. After surgery, the clinic's specialists provide medical and psychological support during weight loss.
The clinic does not offer separate non-surgical weight-loss programmes, does not prescribe weight-loss injections and does not place intragastric balloons; whether a gastric band is performed at the clinic is clarified at the consultation. These methods are mentioned here for general information. The first consultation is free and can take place online: share your height, weight, weight history, the conditions you are treated for and recent results, and the surgeon will tell you whether surgery is an option for you. A personal coordinator supports you from the first message, and you can send questions on Telegram. Read more on the bariatric surgery page.
How recovery usually goes
- First hoursYou may sit up, stand and drink fluids
- 1–5 daysObservation at the clinic, depending on the extent of surgery
- 2–4 weeksReturn to office work; physical work after about 1.5 months
- 1–2 monthsStaged diet from liquids to solids to let the stomach adapt
- Every monthOn average 10% of excess weight lost per month
- 1.5–2 yearsFinal result, stable eating habits prevent the weight from returning
Sources
Frequently asked questions
Which doctor should I see for weight loss?
Start with a family doctor or GP, who can assess your weight, blood pressure and blood tests and refer you on. An endocrinologist checks hormonal causes, a dietitian helps with eating habits and a psychologist with behaviour. If obesity is severe, a bariatric surgeon assesses whether an operation is suitable.
What tests does an endocrinologist order for obesity?
Usually fasting blood sugar and a long-term blood sugar marker, thyroid function, cholesterol and triglycerides, and liver and kidney tests. Depending on symptoms, they may add tests for stress hormones or sex hormones. The results show whether a hormonal cause or a metabolic complication needs treatment.
When should I see a bariatric surgeon?
When your BMI is 40 or more, or 35 or more with a weight-related illness such as type 2 diabetes, high blood pressure or sleep apnoea, and lasting weight loss has not worked without surgery. A consultation does not commit you to an operation; it helps you understand your options.
Do I need a psychologist before bariatric surgery?
A psychological or psychiatric assessment is a standard part of preparation. It checks readiness for the changes after surgery and identifies conditions such as depression or binge eating that should be treated first. Support after the operation also helps people keep new habits.
Can a dietitian help instead of surgery?
For overweight and milder obesity, a dietitian's plan combined with activity and support can be enough. In severe obesity, diet alone rarely gives large, lasting weight loss because the body defends its weight. In that case a dietitian works alongside the surgeon rather than instead of them.
Have a question about your case? Get a free consultation
Message a coordinator on Telegram: we reply right in the chat, and you can send photos and questions there too.
- The first consultation is free, online consultations are available
- The doctor names the cost after the assessment, and it is fixed in the contract
- A personal coordinator guides you from the first message to recovery
Message our coordinator on Telegram
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