Why is it so hard to lose weight? What is metabolic adaptation? (Part 1/2)

Which is the Safest Weight Loss Surgery?

‍Exploring the Laparoscopic Gastric Sleeve, Roux-en-Y Gastric Bypass, and One-Anastomosis Gastric Bypass at rfynd Weight Loss

If you’re considering bariatric surgery, safety is likely one of your top concerns—and rightly so. At rfynd Weight Loss, we’re often asked:
“Which weight loss surgery is the safest?”

The good news is that all three of the surgical procedures we offer—Laparoscopic Gastric Sleeve, Roux-en-Y Gastric Bypass (RNYGB), and One-Anastomosis Gastric Bypass (OAGB)—are safe, well-established options when performed by an experienced surgical team with the right pre- and post-operative support.

That said, “safest” doesn’t always mean the same thing for everyone. The safest option for you will depend on your medical history, lifestyle, and goals.

Here’s how the three procedures compare.

1. Laparoscopic Gastric Sleeve (Sleeve Gastrectomy)

Often considered the safest first-line surgical option

What it involves:
About 80% of the stomach is removed, leaving a narrow “sleeve” that limits food intake and reduces hunger hormones.

Safety profile:

• No rerouting of the intestines = fewer anatomical changes
• Shorter surgery and hospital stay
• Lower risk of nutrient malabsorption compared to bypass procedures

Risks to consider:

• Can worsen or cause reflux in some people
• Irreversible (as part of the stomach is permanently removed)

Who it may be safest for:
People looking for a simpler procedure with a solid safety profile and effective long-term results, especially if they don’t have severe reflux or diabetes.

2. Roux-en-Y Gastric Bypass (RNYGB)

Tried-and-tested, especially for diabetes or reflux

What it involves:
A small stomach pouch is created and connected to the small intestine, bypassing most of the stomach and the first section of the intestine.

Safety profile:

• Decades of clinical use with well-documented outcomes
• Often improves or resolves type 2 diabetes quickly
• Can help with severe reflux or heartburn
• May provide more weight loss than sleeve in some cases

Risks to consider:

• Longer surgical time and slightly higher risk of complications
• Requires lifelong vitamin and mineral supplementation
• Small risk of internal hernia or marginal ulcer

Who it may be safest for:
People with reflux, diabetes, or who need significant weight loss and have no issue with a more complex procedure.

3. One-Anastomosis Gastric Bypass (OAGB or Mini Bypass)

A newer, simplified alternative to RNYGB with growing popularity

What it involves:
Similar to RNYGB, but with just one connection (anastomosis) between the stomach pouch and the intestine.

Safety profile:

• Shorter operation time than RNYGB
• Effective weight loss and diabetes resolution
• Slightly fewer surgical steps than RNYGB

Risks to consider:

• Can cause bile reflux in some people
• Nutrient deficiencies are still a consideration
• Long-term data is growing but not as extensive as RNYGB

Who it may be safest for:
People who want the effectiveness of a bypass with a simpler surgical approach—provided they are carefully screened for reflux risk.

So... Which Is the Safest?

In general terms:

• Gastric Sleeve is safest in terms of simplicity and fewer long-term nutritional concerns.
• RNYGB is safest for those with reflux or diabetes who need metabolic benefits.
• OAGB offers a middle ground—simpler than RNYGB, with strong results—but requires careful patient selection.

The safest surgery is the one tailored to you. That’s why at rfynd, every client goes through a full clinical review with a bariatric surgeon before making a decision.

How rfynd Prioritises Safety

Your safety is at the heart of everything we do. When you choose Rfynd, you can count on:

• Expert surgical teams in accredited private hospitals
• Pre-surgical assessments to determine the right procedure for your health
• Ongoing post-op support including medical, nutrition, and coaching follow-up
• A New Zealand-based team who understands your health system and lifestyle

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Thinking About Weight Loss Surgery?

If you're wondering which weight loss surgery is safest for you, the best next step is to book a consultation with our expert bariatric surgeon, Dr Peter Carr-Boyd. During your consult, Dr Carr-Boyd will assess your individual health needs, explain your options, and guide you toward the procedure that offers the best balance of safety and long-term success.

👉 Book a consult with Dr Peter Carr-Boyd today

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Wegovy is now available in Aotearoa New Zealand— and at rfynd Weight Loss, we’re ready to support you with expert-led, compassionate medical weight loss care. Whether you're curious about semaglutide, comparing Wegovy and Ozempic, or wondering how to get started, here’s everything you need to know.

Wegovy vs Ozempic: What’s the Difference?

Both Wegovy and Ozempic contain the same active ingredient: semaglutide.
They’re both GLP-1 receptor agonists, which means they help regulate appetite and blood sugar — but they’re approved for different purposes:

• Ozempic is approved by Medsafe in NZ for the treatment of type 2 diabetes.
• Wegovy is also approved by Medsafe — but specifically for weight loss and obesity.

Although some people have used Ozempic “off-label” for weight loss, Wegovy is the correct formulation, dosage, and indication for treating obesity. That’s why Wegovy’s arrival in Aotearoa is such a big deal.

Wegovy has officially launched in NZ and is now available through rfynd Weight Loss. You can start today by booking a consultation with Dr Nicole Wilde.

Our Expert Team at rfynd

Whether you’re keen to try Saxenda, exploring Ozempic, waiting for Wegovy, or just want safe, effective support for weight loss, rfynd is here to help — with the right people by your side.

👩‍⚕️ Dr Nicole Wilde – Specialist Obesity Doctor

Dr Nicole Wilde is an Obesity Medicine Specialist and leading expert in medical weight management. Dr Nicole prescribes Wegovy and other weight management medications safely and appropriately, as part of a comprehensive treatment plan. She understands obesity is a complex, chronic condition — not a lack of willpower — and tailors medical care to your unique needs.

🥗 Kylie Russell – Specialist Dietitian

Medication works best when paired with nutrition and lifestyle support, and that’s where Kylie Russell comes in. With her expertise in gut health, weight loss, and sustainable eating, Kylie helps clients build confidence with food and manage any side effects from medications like Wegovy or Ozempic.

💬 Our Health Coaches

Making lasting change takes more than medication — and that’s where our health coaches come in. Our coaches provide practical tools, mindset support, and weekly accountability to help you stay on track. They work alongside our doctor and dietitian to guide you through every step of your journey, making healthy habits feel achievable and sustainable.

Together, the rfynd team provide evidence-based, whole-person care — because we know real success takes more than a script.

The rfynd Weight Loss Difference

We’re not a one-size-fits-all clinic. At rfynd, we offer:

• Online consults with our NZ-based team of specialists
• Ongoing support from our health coaches, nurse, dietitian and doctor
• Access to tools, apps, and personalised plans
• A supportive, stigma-free environment

We’re here to help you take control of your health.

Want to get started?

👉 Your next step is booking a consult with Dr Nicole Wilde, our specialist obesity doctor. Appointments are available online across New Zealand.

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👉 Follow rfynd Weight Loss on Instagram or Facebook for updates on Wegovy, Ozempic, and other medical weight loss options in NZ.
📧 Prefer email? Contact us at support@rfynd.co.nz and we’ll be happy to help.

Your journey doesn’t have to wait — and we’re here to walk it with you.

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We all have desires and wants, goals and dreams!  These are what motivates us. The great news is that we all have potential to bridge the gap between our current state and our desired state. It often just requires a change in our behaviour. Easy right??. Not always. This is where a coach comes in.

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Many studies have found that merely instructing someone to make behavioural changes often leads them feeling frustrated, depressed, and angry when the desired result is not achieved. We can all relate to this in some way, I’m sure. Human behaviour cannot easily be changed unless there is internal motivation to do so.  Internal motivators are the  fuel source for peak performance and positive change. A coach specialises in drawing on your internal motivations and helps develop strategies to help you achieve your goals.

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Let’s dive into behaviour and explore how a coach can help change certain behaviours that might be doing us harm, and  stopping us reaching our potential.

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It would be great if new 'desirable' behaviours would just appear, and the undesirable ones disappear; unfortunately they often do not. Behaviours are ‘learned’ which means neural connections have been made in our brains that enable us to easily recall and carry out the behaviour. Some of these are helpful like not touching a hot object or running away from a lion, but some are harmful like eating too much sweet food even though it tastes so good!

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A little science about food and energy to whet the appetite. While there are centres in the brain (the hypothalamus) that regulate energy intake within narrow limits, there are other areas (the mesolimbic system) that provide the emotional, pleasurable and rewarding aspects of eating: here is where we can be led astray!  This “reward” centre can greatly influences us and allows our brains to crave and to enjoy food even when we’re completely full. We all indulge!  Because of the power of these pleasure centres, the desire to eat can be triggered by emotions such as sadness, or environmental triggers, such as the smell or sight of delicious fast food, rather than just energy depletion.  And here is where we need to think what might trigger the drive to eat in us individually. Are we feeling down? Are we influenced too much by that freshly baked cake? Are we working too hard? Probably.

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The reward that is associated with eating can become an addictive behaviour and a nasty cycle can ensue resulting in weight gain, unless we unlock the triggers behind these behaviours. Enter the health coach.

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For any undesirable behaviour to be changed we need to first look at the parts that make up the behaviour. Firstly,  the triggers (called Antecedents) that prompt or cue the behaviour. Secondly, the action, or the Behaviour itself. And thirdly, the Consequences (or outcome) that reinforce the behaviour. In short, it’s all about the ABCs (antecedents, behaviour and consequences). When an individual and their coach has identified a behaviour they’d like to change, the initial focus is on identifying and understanding  the ABCs of that specific behaviour.

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Embarking on a journey to change long-standing habits, particularly around food and weight loss, can be challenging and sometimes overwhelming. But remember, you don’t have to do it alone. Health coaches are here to guide you every step of the way. They understand the complexities of behaviour change and are trained to help you uncover the internal motivations that drive you. With their support, you can develop personalised strategies that align with your goals, making the path to a healthier you not only achievable but sustainable. Stay encouraged—positive change is within your reach, and your health coach is here to support you on this journey.

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At rfynd, we have a range of programs that have the option of health coaching support. We know habit change is hard, and we want to support you the best we can to make the changes stick.

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By Lexi Andrews, Health Coach at rfynd.

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