Weight Loss Surgery in Bloemfontein: Sleeve, Bypass, SADI-S

Bariatric surgery at the clinic is performed by experienced bariatric surgeons:

• Ruslan S. Menzulin — bariatric surgeon and surgical oncologist, 9 years of experience. Trained at Mercy clinic (USA) under Vadim Gushchin, spoke at the World Congress of bariatric surgery in Santiago (2025). Co-author of an international study published in The Lancet.
• Andrey G. Ugay — lead bariatric surgeon, 27 years of experience. Has performed the largest number of SASJ operations in the country. Expert council member of the national Society of Bariatric Surgeons.

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Surgery is prescribed only when clear criteria are met

• The patient's body mass index (BMI)
• Overall health and any related chronic conditions
• Failure of previous attempts to lose weight by conventional means

BMI serves as the chief indicator of obesity severity. Divide body weight (kg) by height squared (m²) to calculate it. Surgery is normally justified at BMI above 40, or above 35 with serious accompanying conditions. In selected cases it is considered at lower values as well — if non-surgical methods did not help.

These two are frequently confused, although their goals differ at the core. Bariatric surgery is a medical treatment of obesity and related diseases that changes the workings of the digestive tract, targeting the causes of excess weight and metabolism. Plastic surgery corrects outer body contours; it does not treat obesity or change metabolism.

At City Medical Centre there are four main types of bariatric surgery — sleeve gastrectomy, Roux-en-Y gastric bypass, mini gastric bypass (MGB) and SADI-S duodeno-ileal bypass. Every method is chosen individually from BMI, related conditions and the patient's goals.

Our approach is modern laparoscopic technique: 4 small punctures of 5 to 15 mm. We use cosmetic sutures, so the marks turn almost invisible after healing.

Recovery depends on what you plan to do. Office work: after 2–4 weeks. Physical work: after 1.5 months. Sport and activity: swimming after 30 days, other exercise phased in as weight drops. Travel and holidays: preferably not earlier than one month after surgery.

Your diet changes in stages: from liquid food to soft, then to solid. The focus is on protein and on limiting high-calorie, fatty food.

You can become pregnant after bariatric surgery, but doctors advise a wait of at least 12–18 months. Over this period the body stabilizes, weight hits target values and nutritional status normalizes.

Yes, vitamins are essential after bariatric surgery. As digestive anatomy changes, the body absorbs certain nutrients less well, so regular vitamin and mineral supplements become a lasting part of the patient's life.

After bariatric surgery weight regain can happen, but it is very unlikely if the doctor's advice is followed. What matters is proper nutrition, avoiding high-calorie drinks and regular follow-up with City Medical Centre specialists.