Frequently Asked Questions

  • Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health.

    These terms have been used to replace traditionally emotive words such as 'fat' and 'skinny'. They are used in medical language and mainly are reflective of BMI.

    The use of 'fat' as a purely descriptive term is being reclaimed in general society which should be applauded.

  • Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person's weight in kilograms divided by the square of height in metres (kg/m2).

    For adults, WHO defines overweight and obesity as follows:

    • overweight is a BMI greater than or equal to 25; and

    • obesity is a BMI greater than or equal to 30

  • There are so many problems with BMI…

    BMI is old - it was invented in the 1830s (yep!) and made popular in the 1970s. It does not consider: sex, race, age, genetics, difference in muscle mass or importantly, your metabolic health.

    BMI can only and should only be used as a guide. We need to look at the whole person, not a number on the scales.

  • There has been increasing interest in a new marker to determine risk with higher weight. The waist circumference to height ratio distinguishes when weight is of concern in a more accurate way than BMI. There are still flaws, however it is an easy measurement and quick to calculate. >> CLICK HERE to measure.

    Waist-to-Height Ratio = Waist Circumference / Height

    The waist circumference should be measured at the midpoint between the last palpable rib and the top of the iliac crest, using a stretch‐resistant tape.

  • You are not your weight. You are a whole person who needs to be looked at as an individual.

    However, increased weight can be associated with an increased risk of certain diseases.

    Some of the ones we look for are:

    • cardiovascular diseases (mainly heart disease and stroke)

    • diabetes

    • musculoskeletal disorders (especially osteoarthritis);

    • some cancers (including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney, and colon).

    There are symptoms, signs and markers we can measure which can show your risk of these diseases. Losing weight in this context has been shown to help.

  • There are a number of new medications which can be used for weight management. Our doctor, Dr Rosemary Atkinson is happy to discuss these with you and prescribe a medication if appropriate. Medications are not a 'quick fix' however they can help overcome some of the barriers to losing weight. They should be used in addition to addressing diet, exercise, sleep and psychological struggles.

  • Yes! We now have two surgeons working with Noi Clinic. Check out more here.

    We also help people before and after bariatric surgery who have had surgery elsewhere and would like further advice and support.

    We work in close association with Bariatric Surgeons in Sydney and across Australia and have had extensive experience in managing patients who have had Lap Bands (including doing adjustments), sleeve gastrectomy, omega loop gastric bypass or Roux-en-Y gastric bypass.

Diet, Nutrition & Dietitian FAQs

  • Yes. Your dietitian will create a personalised nutrition plan built around your actual life: your health and weight goals, food preferences, schedule, and where you are right now. This is neither a rigid menu that tells you exactly what to eat at every meal nor a generic handout. The goal is to help you genuinely understand how and what to eat to meet your goals. Your plan is updated regularly as your goals, weight, and lifestyle change.

  • Our dietitian has over 20 years of experience in weight management and a clear understanding of what is required for long-term success. Caroline works as part of our medical weight management team, alongside a GP and psychologist, which means your nutrition care can be integrated with your medical and psychological care when needed. This allows for a level of coordination and personalisation that is difficult to achieve in a standalone nutrition setting.

  • No. Dietitian support is valuable whether you are managing weight through nutrition and lifestyle changes, prescription medications, or before or after bariatric surgery. Your care is tailored to your situation.

  • Yes — and this is one of the most important times to have dietitian support. Prescription weight management medications, including GLP-1 receptor agonists, can significantly reduce appetite, increasing the risk of inadequate protein and other nutrient intake, muscle loss, bone loss, and nutritional deficiencies if not managed carefully. Our dietitian specialises in supporting people on these medications to get the best possible outcomes.

  • Most people who have seen dietitians previously were given advice that didn't account for the complexity of their situation — hormonal changes, appetite dysregulation, emotional eating, medication effects, or the specific challenges of their life stage, including a focus on weight maintenance. Our approach starts with understanding why previous attempts have not worked, and builds from there.

  • Our dietitian has specialist experience in women's health such as perimenopause and menopause weight gain, weight management for fertility and preconception,  insulin resistance, type 2 diabetes and prediabetes, PMOS (Polyendocrine Metabolic Ovarian Syndrome), weight management for fertility and preconception, ADHD and neurodiversity-related eating, disordered eating and binge eating, cardiovascular disease, fatty liver disease (MASLD), hypothyroidism, and nutrition support before and after bariatric surgery.

  • This depends on your goals, complexity, and how you are progressing. Most patients begin with fortnightly appointments and transition to monthly or less frequent check-ins as consistency builds. Ongoing support is always available as sustainable change takes time, and we are here for the whole journey. We encourage clients to always reach out when they are struggling. There is never any judgment, only support. Regular review can help with accountability and motivation.

  • Yes. Telehealth appointments are available for patients across Australia. In-clinic appointments are available at our Crows Nest, Sydney location.

  • No referral is required to book a dietitian appointment. However, if you have a GP Management Plan (GPMP) or Team Care Arrangement (TCA) from your GP, you may be eligible for Medicare rebates for dietitian consultations. Ask our team when booking.

  • Yes, and it is strongly recommended. Nutrition support alongside weight management medication helps protect muscle and bone mass, manage side effects, maintain adequate nutrient intake, and build eating habits that support long-term results and maximise the medication. Caroline works closely with Dr Rosie Atkinson to coordinate your nutrition and medical care.

  • Yes. Caroline provides practical, compassionate support for emotional eating, cravings, non-hungry eating, and the habits and patterns that make consistency feel difficult. For patients who would benefit from deeper psychological support alongside nutrition, Caroline works closely with our psychology team.

  • Yes. Dietitian consultations are available in our clinic at Crows Nest, Sydney and via telehealth for patients across Australia.

Psychology FAQs

  • A clinical psychologist has completed postgraduate specialist training (typically a Master's or Doctorate) in assessing and treating complex psychological conditions. In Australia, the title is protected by AHPRA. It can only be used by practitioners who meet that higher training standard. Clinical psychologists also attract a higher Medicare rebate than general psychologists.

    Lareena Brown and Holly Rice of Noi Clinic are clinical psychologists registered with AHPRA.

  • No referral is needed to book a psychology appointment at Noi Clinic. You can book directly via phone or online.

  • Yes. If you have a Mental Health Care Plan (MHCP) or an Eating Disorder Management Plan (EDMP) from your GP, you may be eligible for Medicare rebates on psychology sessions — typically up to 10 sessions (MHCP) to 40 sessions (EDMP) per calendar year. We recommend speaking with your GP about this before your first appointment if cost is a consideration.

  • Yes. If you hold a private health insurance policy with psychology or mental health listed under your extras cover, you may be eligible for a rebate on psychology sessions at Noi Clinic. The amount varies depending on your insurer and level of cover. We recommend checking directly with your fund before your first appointment.

    Medicare and private health insurance rebates cannot be claimed for the same session, so your psychologist or our reception team can help you work out which option is most beneficial for your circumstances.

  • No. Psychology services are available to anyone, whether or not you are seeing other members of our team. You are welcome to book directly. If it becomes relevant, we can coordinate with our medical and dietitian colleagues, always with your consent.

  • Your first appointment is focused entirely on understanding you - your history, your current challenges, your goals, and what sustainable change would look like in your life. Your psychologist will work collaboratively with you to develop a personalised approach. Sessions are 50 minutes long and, available in clinic or via telehealth.

  • Yes. Emotional eating and binge eating are influenced by complex psychological, behavioural and emotional factors, not simply a lack of willpower. Our psychologists work to help you understand your triggers, develop healthier coping strategies, and build a more sustainable and compassionate relationship with food and eating.

  • Yes. Lareena has completed additional training in ADHD assessment and management and has a specialist interest in the relationship between neurodiversity and eating. Both Lareena and Holly provide support for impulsivity around food, inconsistent eating patterns, emotional eating related to ADHD, and building habits that work with, not against, how your brain is wired.

  • A psychological assessment before bariatric surgery helps identify any emotional, behavioural or psychological factors that could affect surgical outcomes or post-surgical adjustment. Some surgeons require a pre-surgical psychology assessment as part of the approval process. Lareena provides bariatric psychology assessments at Noi Clinic for our surgeon and for bariatric surgeons across Sydney.

  • Session fees are available upon request or at the time of booking. Medicare rebates apply with a Mental Health Care Plan or Eating Disorder Management Plan from your GP. Private health insurance extras may also apply. Check your fund for psychology cover.

ADHD

FAQs

  • ADHD affects the brain’s regulation of impulse control, emotional regulation, habit formation, and reward-seeking - all of which directly influence eating behaviour and weight management.

    Adults with ADHD are significantly more likely to experience impulsive eating, binge eating, and difficulty sustaining healthy habits over time. These are neurobiological patterns, not character flaws. Understanding and treating ADHD is often the missing piece for people who have struggled with weight despite significant effort.

  • A comprehensive psychological assessment by Lareena provides a thorough, multi-source diagnosis based on national and international guidelines, including careful consideration of other conditions that can present similarly to ADHD. 

    The detailed written report can be used directly with a psychiatrist as the basis for a medication discussion, saving you the time and cost of a separate, lengthy psychiatric assessment. You also benefit from Lareena's specialist expertise in managing ADHD, eating, and weight, meaning assessment and behavioural support are connected from the start.

  • In NSW, GPs have regulatory restrictions on independently initiating stimulant medication for adult ADHD. At Noi Clinic, Dr Rosie Atkinson works collaboratively with a psychiatrist to navigate this pathway for appropriate patients, coordinating medication type, dosing, timing and ongoing review as part of your integrated care. You do not need to find a psychiatrist independently. Dr Rosie manages this coordination on your behalf.

  • Yes. The diagnostic interview and feedback session are both available via telehealth for patients who cannot attend in person. The questionnaire stages are completed online. Please contact our team to discuss telehealth options when booking.

  • Not at all, and you are far from alone. ADHD is significantly underdiagnosed in women and girls, partly because it often presents differently than the stereotypical picture, and partly because many women develop effective coping strategies that mask the underlying pattern for years or decades. Perimenopause frequently causes a significant deterioration in previously managed ADHD symptoms, which is often when women first seek assessment. There is no age at which an accurate diagnosis stops being valuable, and for many women, a late diagnosis is genuinely life-changing.

Bariatric

FAQs

  • No, you do not need a referral to enquire or to book an initial appointment. Our team can assist you with the referral process if needed.

  • There is a Medicare rebate for the surgical procedure; however, private hospital admissions are not covered by Medicare.

    As bariatric surgery is performed in the private hospital system, private health insurance is required to cover the costs. You must have held gold-level private health insurance for at least 12 months in order for your health fund to subsidise the cost of the admission to hospital.

    Alternatively, you can self-fund your surgical procedure.

    Our team will give you further details, provide a full fee estimate and explain your entitlements before any procedure is booked.

  • Both procedures achieve significant weight loss, but they work differently.

    Gastric sleeve surgery removes a large portion of the stomach to reduce its capacity and appetite signalling.

    Gastric bypass creates a small stomach pouch and reroutes the digestive pathway, bypassing part of the small intestine. Bypass typically achieves slightly greater weight loss and has stronger outcomes for type 2 diabetes and reflux, but is a more complex procedure.

    Dr Budge will discuss which option is most appropriate for your individual circumstances at your surgical consultation.

  • Revision surgery refers to a second surgical procedure performed on a patient who has previously had bariatric surgery, and has developed complications from the original procedure. 

    Conversion surgery may be needed because of inadequate weight loss or significant weight regain, or a desire to convert from one procedure to another (for example, from lap band to sleeve or bypass). 

    Revision and conversion surgery are more technically complex than primary bariatric surgery and require a surgeon with specific expertise. Dr Budge has extensive experience in revision procedures.

  • Recovery varies depending on the procedure. Most patients spend 1-2 nights in the hospital and return to work within 1-2 weeks, depending on the nature of your work. Most individuals can resume light activity within 2–4 weeks. Return to full physical activity occurs within 4–6 weeks. This can vary, so Dr Budge will discuss specific recovery expectations for your procedure at your consultation.

  • A pre-surgical psychological assessment is strongly recommended and in some cases required as part of the surgical process. This is not a barrier to accessing the surgery, rather it helps identify any psychological, emotional or behavioural factors that could affect your readiness for surgery or your outcomes and adjustment afterwards. 

    At Noi Clinic, pre-surgical psychology assessments are available with Lareena Brown, our clinical psychologist, as part of your integrated surgical preparation.

  • Nutritional preparation before surgery and ongoing dietitian support after are core parts of the care pathway at Noi Clinic. Caroline Shannon, our Accredited Practising Dietitian, provides pre-surgical nutrition optimisation, post-surgical progression support, supplement management, and long-term maintenance planning. Lifelong nutritional monitoring is recommended following bariatric surgery, and we provide that support as part of your ongoing care.