Since January, the obesity clinic, run out of the Western Hospital in Footscray, has changed from a respiratory focus to a metabolic one.

The new focus comes after it was announced last month that Brimbank has the highest number of people living with diabetes in the state.

Losing weight can help manage the symptoms of diabetes.

The health provider's catchment covers Brimbank, Maribyrnong, Hobsons Bay and Melton.

Headed by endocrinologist Professor Peter Ebeling and divisional surgery director Claire Culley, the clinic ensures all obese patients are referred for treatment by it before being considered for lapband surgery.

"We were finding patients were just being referred for surgery without really even facing their issues for being obese," Ms Culley said.

"We needed to find a way to deal with the demand for lapband surgery waiting lists."

In 2008, Western Health had 800 patients waiting up to three years for the surgery. Since it began changing its focus, that number has fallen to about 300.

"From these people, some have gone and had the surgery done privately, some have gone to other public hospitals and others have simply chosen to try other ways to lose weight."

Patients are now referred to the clinic where they have access to dietitians, a psychologist and specialists such as physiotherapists and diabetes staff.

"We aim to promote that there are other options to lapband surgery," Ms Culley said. "Some patients are put on a weight-management plan and others who have no other options may go on the list for surgery. But now they are told about the risks and they must have a psychological assessment to determine if they are suitable."

Ms Culley said long waiting times were sometimes beneficial. "Sometimes, amazingly, the long wait has been the encouragement some patients needed to get on with it and start losing the weight themselves."

While the team is happy with results, she conceded there was still a 12-month waiting list for patients to access the service.

"At the moment, we are seeing 28 patients a day, but we do have a high, non-attendance rate so we may have to tighten up our policy."