14,000 CMC patients already live in a different body. The result is stated in an official contract — in law, not just in talk.
Gastric Sleeve and Bypass in Bremen
Tick the situations that sound familiar.
From 2 matches — a reason to talk to a surgeon.
No hidden extras. Nothing unexpected. One package, start to end.
Tick the situations that sound familiar.
From 2 matches — a reason to talk to a surgeon.
Not just high BMI: associated health conditions also warrant a surgical consultation
Medical history
Excess weight since childhood or a genetic predisposition
Metabolic disorders
Type 2 diabetes and hypertension associated with obesity
Resistance to conservative treatment
Several years of diets and medication, and nothing that lasted.
Medical history
Excess weight since childhood or a genetic predisposition
Metabolic disorders
Type 2 diabetes and hypertension associated with obesity
Resistance to conservative treatment
Several years of diets and medication, and nothing that lasted.
Surgery is prescribed only when clear criteria are met
The degree of obesity is mainly assessed with BMI: body weight (kg) divided by height squared (m²). As a rule, surgery is justified when BMI exceeds 40, or exceeds 35 alongside serious related conditions. In some cases lower values may also qualify for surgery if non-surgical approaches have failed.
Plenty of people diet and exercise for years, only for the body to resist: a slower metabolism, a bigger appetite and the weight coming back. When diet changes and medication clearly cannot fundamentally improve matters on their own, the only effective option left is bariatric surgery.
Key factors
The role of body mass index (BMI)
The degree of obesity is mainly assessed with BMI: body weight (kg) divided by height squared (m²). As a rule, surgery is justified when BMI exceeds 40, or exceeds 35 alongside serious related conditions. In some cases lower values may also qualify for surgery if non-surgical approaches have failed.
Why don't diets and exercise work for everyone?
Plenty of people diet and exercise for years, only for the body to resist: a slower metabolism, a bigger appetite and the weight coming back. When diet changes and medication clearly cannot fundamentally improve matters on their own, the only effective option left is bariatric surgery.
If chronic conditions apply to you, please consult a clinic doctor!
Indications

Excess weight

Type 2 diabetes

Hypertension

Sleep apnea

Joint disease

Varicose veins

Fatty liver disease

Reproductive health problems
Contraindications

Age under 18

Malignant tumors

Less than six months since breastfeeding ended

Acute illness or flare-ups of chronic disease

Severe chronic and mental illness

Blood clotting disorders

Pregnancy

Sleeve gastrectomy
The surgeon removes the larger part of the stomach so it becomes a narrow tube. This strongly reduces how much fits in a portion and lowers ghrelin, the hunger hormone; the patient feels full faster and eats less.
Effectiveness: the method suits a BMI of 35 to 45. On average patients lose 60–70% of their excess weight.
Specifics: the result is not as long-lasting as with bypass surgery. Breaking the diet, particularly through high-calorie drinks and liquid food, can bring weight back.

Roux-en-Y gastric bypass
The surgeon forms a small 50–70 ml pouch at the top of the stomach and joins it straight to the small intestine. This restricts food intake and cuts calorie absorption by shortening the route food takes through the gut.
Effectiveness: the operation is considered the “gold standard” for a BMI over 45–50 with type 2 diabetes. Excess weight loss reaches 75–85%.
Specifics: the effect lasts longer than with other bariatric methods. Related diseases, including diabetes and hypertension, often reach remission. As digestive anatomy changes, supplements of vitamins and minerals are needed for life.

Mini gastric bypass (MGB)
It is an improved variant of the classic bypass. Unlike the standard method, here the surgeon forms only one connection (anastomosis) linking the small stomach to the small intestine. The simpler technique is less demanding and needs less recovery time.
Effectiveness: comparable with the classic Roux-en-Y bypass: patients drop up to 75–80% of excess weight.
Specifics: shorter operating time and faster recovery. Though technically reversible, it carries a risk of bile reflux due to the single anastomosis.

Single anastomosis duodeno-ileal bypass (SADI-S)
As a modern combined technique, SADI-S brings together the benefits of sleeve gastrectomy and intestinal bypass. Its two stages: making the stomach into a narrow tube, then rerouting the small intestine so the majority of it is excluded from active digestion.
Effectiveness: among the most powerful bariatric operations — excess weight loss reaches 80–90% with a lasting result.
Specifics: appetite falls as the smaller stomach loses the zone that produces ghrelin, while food rerouted around part of the intestine yields fewer absorbed calories. Right for super obesity (BMI over 50), severe type 2 diabetes, or as a second stage after an ineffective sleeve.
Book a consultation
Call or message us -
our coordinator will contact you shortly
and book your consultation
Book a consultation
Call or message us -
our coordinator will contact you shortly
and book your consultation
Step one is a consultation with the surgeon: your history, the right method and a recovery plan

Lab tests
Biochemistry, HbA1c, complete blood count, urinalysis and a coagulation panel (clotting test).
Instrumental diagnostics
Leg vein Doppler, chest X-ray, ECG, and abdominal and kidney ultrasound.
Endoscopy
Gastroscopy (required) and colonoscopy (if indicated).
Specialists
GP, endocrinologist, cardiologist, psychiatrist and gynecologist (women only).

Diet
Avoid fast carbs and fats during the 2–4 weeks before surgery; eat lightly the day before.
Lifestyle
From a month before: no smoking, less physical activity, no stress.
The day before
Light last meal in the evening; final fluids 3–4 hours before surgery.

Lab tests
Biochemistry, HbA1c, complete blood count, urinalysis and a coagulation panel (clotting test).
Instrumental diagnostics
Leg vein Doppler, chest X-ray, ECG, and abdominal and kidney ultrasound.
Endoscopy
Gastroscopy (required) and colonoscopy (if indicated).
Specialists
GP, endocrinologist, cardiologist, psychiatrist and gynecologist (women only).

Diet
Avoid fast carbs and fats during the 2–4 weeks before surgery; eat lightly the day before.
Lifestyle
From a month before: no smoking, less physical activity, no stress.
The day before
Light last meal in the evening; final fluids 3–4 hours before surgery.
Experienced bariatric specialists who are committed to patients' health

Ruslan S. Menzulin
Bariatric surgeon · surgical oncologist
Trained at Mercy clinic, mentored by Vadim Gushchin, and spoke at the World Congress of bariatric surgery in 2025. A co-author of an international study in The Lancet.

Andrey G. Ugay
Lead bariatric surgeon · surgeon
Holds the country's record for the number of SASJ operations performed. Member of the expert council of the national Society of Bariatric Surgeons; a regular speaker at national and international congresses.
City Medical Centre treats obesity comprehensively. Following the first examination, every patient receives a personal diagnostic program (lab and instrumental) to detect every disorder in the body.

A method matched to your goal
The surgical method is chosen by our doctors on an individual basis. They first review your health, your weight history and related conditions, then offer the surgical treatment that suits you best.

Support that stays in touch
City Medical Centre's team stays with you once surgery is over. During the first year, specialists monitor your weight loss and test results and answer any questions on diet and recovery.

Fast recovery
Bariatric operations at City Medical Centre are laparoscopic, which greatly shortens recovery. Most patients are up and moving on day one and return to normal life within a week.

Full diagnostics on site
You don't have to go clinic to clinic. Our centre has everything needed for your work-up — own lab, ultrasound, gastroscopy. Fast preparation, no queues, one building.
While recovery is largely individual, minimally invasive laparoscopic techniques keep rehab time as short as possible.

Duration
Observation at the clinic lasts 1 to 5 days, based on how extensive the surgery is and on related conditions.
Activity
In the early hours after surgery you can already sit up, stand and have fluids.
Wound care
Absorbable sutures are used; they dissolve on their own.

Work
7–14 days after surgery you can return to work, depending on how physical the job is.
Restrictions
No bathhouse, sauna or intense physical exercise during the first weeks.
Diet
You follow a staged diet for 1–2 months, going from liquid to solid food as the stomach adapts.

Pace
When they follow specialist advice, patients lose an average of 10% of excess weight each month.
Stabilization
The end result is achieved in 1.5–2 years, when the patient already has stable eating habits that prevent weight regain.
Important! Recovery is supervised by City Medical Centre specialists, who provide psychological and medical support at every stage of weight loss.

Duration
Observation at the clinic lasts 1 to 5 days, based on how extensive the surgery is and on related conditions.
Activity
In the early hours after surgery you can already sit up, stand and have fluids.
Wound care
Absorbable sutures are used; they dissolve on their own.

Work
7–14 days after surgery you can return to work, depending on how physical the job is.
Restrictions
No bathhouse, sauna or intense physical exercise during the first weeks.
Diet
You follow a staged diet for 1–2 months, going from liquid to solid food as the stomach adapts.

Pace
When they follow specialist advice, patients lose an average of 10% of excess weight each month.
Stabilization
The end result is achieved in 1.5–2 years, when the patient already has stable eating habits that prevent weight regain.
Important! Recovery is supervised by City Medical Centre specialists, who provide psychological and medical support at every stage of weight loss.
Book a consultation
Call or message us -
our coordinator will contact you shortly
and book your consultation
Book a consultation
Call or message us -
our coordinator will contact you shortly
and book your consultation
Bariatric vs plastic surgery: what's the difference?
Many people confuse the two, but their goals are fundamentally different. Bariatric surgery is a medical treatment for obesity and related diseases. It changes how the digestive tract works, addressing the causes of excess weight and metabolism. Plastic surgery reshapes the body's outer contours; it does not treat obesity or affect metabolism.
How soon can I return to work and normal life?
Will there be visible scars?
We rely on modern laparoscopic technique. The operation is performed through 4 small punctures of 5 to 15 mm. Cosmetic sutures are used, so after healing the marks are barely visible.
What diet do I need to follow?
Your diet changes step by step: from liquid food to soft and then to solid. The emphasis is on protein and on cutting high-calorie, fatty food.
What types of bariatric surgery are there?
The four main types of bariatric surgery at City Medical Centre are sleeve gastrectomy, Roux-en-Y gastric bypass, mini gastric bypass (MGB) and SADI-S duodeno-ileal bypass. Each method is matched individually to BMI, related conditions and the patient's goals.
Can I plan a pregnancy after surgery?
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.
Do I need to take vitamins after surgery?
Yes — vitamins are required after bariatric surgery. With the digestive anatomy changed, some nutrients are absorbed less well, and regular vitamin and mineral supplements become a permanent part of life.
Can the weight come back?
Although weight regain after bariatric surgery is possible, it is very unlikely if you follow the doctor's advice. Proper eating, avoiding high-calorie drinks and regular follow-up with City Medical Centre specialists are key.
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Service
Discounted price
The decision rests on clear criteria: body mass index, overall health with related chronic conditions, and failed previous attempts at weight loss. BMI is weight in kilograms divided by height in metres squared. Contraindications include acute illness, severe chronic or mental illness, and less than six months since breastfeeding ended. Bremen patients receive a personal assessment against these points.
Several things are worth planning ahead. Pregnancy is advised no earlier than 12–18 months after surgery, once weight and nutritional status stabilise. Vitamins become a permanent part of life because the body absorbs some nutrients less well. Swimming waits 30 days, strength work longer. Patients from Bremen discuss these points with the surgeon well before the operation date.
One package covers the full journey, from consultation to final result. There are no separate charges added later: ward, meals, nursing care and coordinator support are included. To find out whether surgery suits you, patients in Bremen can book a free surgeon consultation; the doctor reviews BMI, health and weight history and recommends a method.
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Apply before the end of the year and get a consultation at the clinic's expense!