14,000 CMC patients already live in a changed body. The outcome is recorded in an official agreement, with legal force behind it.
Weight Loss Surgery in Cologne
Tick the situations that sound familiar.
From 2 matches — a reason to talk to a surgeon.
No concealed charges or surprises. The whole journey, one package.
Tick the situations that sound familiar.
From 2 matches — a reason to talk to a surgeon.
It is not only a high BMI that justifies a surgical consult — related diseases do too
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 drugs, yet no durable result.
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 drugs, yet no durable result.
Surgery is prescribed only when clear criteria are met
BMI is the key measure used to assess how severe obesity is. You get it by dividing body weight (kg) by height squared (m²). Surgery is generally justified at a BMI above 40, or above 35 when serious related conditions are present. Sometimes it is also considered at lower values — when non-surgical methods have not worked.
Many people try various diets and exercise for years, but the body fights back: metabolism slows, appetite grows and the lost weight returns. When it becomes clear that diet changes and medication alone cannot fundamentally improve the situation, bariatric surgery becomes the only effective way out.
Key factors
The role of body mass index (BMI)
BMI is the key measure used to assess how severe obesity is. You get it by dividing body weight (kg) by height squared (m²). Surgery is generally justified at a BMI above 40, or above 35 when serious related conditions are present. Sometimes it is also considered at lower values — when non-surgical methods have not worked.
Why don't diets and exercise work for everyone?
Many people try various diets and exercise for years, but the body fights back: metabolism slows, appetite grows and the lost weight returns. When it becomes clear that diet changes and medication alone cannot fundamentally improve the situation, bariatric surgery becomes the only effective way out.
Chronic illness? Please talk to a doctor at the clinic first!
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
In the operation the surgeon removes most of the stomach, leaving a narrow tube. Portions become much smaller and levels of ghrelin, the hunger hormone, fall, so the patient feels full far sooner and eats less.
Effectiveness: the method is appropriate for a BMI of 35 to 45. Average loss of excess weight is 60–70%.
Specifics: bypass operations give a more durable result. Should the diet be ignored, especially with high-calorie drinks and liquid food, weight can return.

Roux-en-Y gastric bypass
A small pouch of 50–70 ml is created from the upper stomach and connected directly to the small intestine. Food intake is limited, and fewer calories are absorbed because food travels a shorter path through the gut.
Effectiveness: considered the “gold standard” when BMI exceeds 45–50 with type 2 diabetes. Patients lose 75–85% of excess weight.
Specifics: the result is more durable than with other bariatric techniques. Diabetes, hypertension and similar related conditions often enter remission. The changed digestive anatomy means lifelong vitamin and mineral supplements.

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: brief surgery and rapid recovery. While technically reversible, the procedure has a bile reflux risk linked to the single anastomosis.

Single anastomosis duodeno-ileal bypass (SADI-S)
A modern combined approach, SADI-S merges the benefits of sleeve gastrectomy with those of intestinal bypass. It takes two stages — turning the stomach into a narrow tube, then rerouting the small intestine so that the larger part is excluded from active digestion.
Effectiveness: one of the most powerful bariatric operations — excess weight loss reaches 80–90% with a long-lasting result.
Specifics: with the ghrelin-producing zone removed, the smaller stomach reduces appetite; redirecting food past part of the intestine limits calorie uptake. Used for super obesity (BMI over 50), severe type 2 diabetes, or as a second stage when a sleeve was ineffective.
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
It starts with a surgeon's consultation: medical history, choice of method and a recovery plan

Lab tests
Complete blood and urine tests, biochemistry, HbA1c, and a coagulation panel (clotting test).
Instrumental diagnostics
Chest X-ray, ECG, abdominal and kidney ultrasound, leg vein Doppler.
Endoscopy
Gastroscopy (required) and colonoscopy (if indicated).
Specialists
GP, endocrinologist, psychiatrist, cardiologist, plus gynecologist (women).

Diet
Starting 2–4 weeks pre-surgery, drop fast carbs and fats; on the eve, move to light meals.
Lifestyle
A month before, quit smoking, lower physical activity and shun stress.
The day before
Last light food in the evening, last liquids 3–4 hours prior to surgery.

Lab tests
Complete blood and urine tests, biochemistry, HbA1c, and a coagulation panel (clotting test).
Instrumental diagnostics
Chest X-ray, ECG, abdominal and kidney ultrasound, leg vein Doppler.
Endoscopy
Gastroscopy (required) and colonoscopy (if indicated).
Specialists
GP, endocrinologist, psychiatrist, cardiologist, plus gynecologist (women).

Diet
Starting 2–4 weeks pre-surgery, drop fast carbs and fats; on the eve, move to light meals.
Lifestyle
A month before, quit smoking, lower physical activity and shun stress.
The day before
Last light food in the evening, last liquids 3–4 hours prior to surgery.
Bariatric surgeons with deep experience and real care for patients' health

Ruslan S. Menzulin
Bariatric surgeon · surgical oncologist
Completed training at Mercy clinic with Vadim Gushchin; presented at the World Congress of bariatric surgery (2025). Co-authored 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.
The approach to obesity at City Medical Centre is comprehensive. Following an initial examination, a personal diagnostic program — lab and instrumental — is drawn up for each patient to detect every disorder in the body.

A method matched to your goal
Our doctors select the surgical method for each patient individually. Before deciding, they assess your health, weight history and related conditions to suggest the most suitable surgical treatment.

Support that stays in touch
City Medical Centre's team remains with you after surgery. Over the first year specialists watch your weight loss, monitor test results and respond to all questions regarding diet and recovery.

Fast recovery
Bariatric operations at City Medical Centre use laparoscopy, which greatly cuts recovery time. Most patients move around on day one and get back to normal life within a week.

Full diagnostics on site
No need to travel between clinics. From our own lab to ultrasound and gastroscopy, the centre has all you need for your work-up. Preparation is fast, without queues, in one building.
The pace of recovery is largely personal, but minimally invasive laparoscopic techniques shorten rehabilitation as much as possible.

Duration
Observation at the clinic lasts 1 to 5 days, based on how extensive the surgery is and on related conditions.
Activity
You may sit, stand up and drink fluids within the first few hours after surgery.
Wound care
Absorbable sutures are used; they dissolve on their own.

Work
Depending on the physical demands of your job, you can return to work 7–14 days after surgery.
Restrictions
During the first weeks, stay away from bathhouses, saunas and intense exercise.
Diet
The prescribed staged diet runs 1–2 months, shifting from liquids to solids so the stomach adapts.

Pace
Patients sticking to the specialists' advice shed on average 10% of excess weight per month.
Stabilization
The final outcome arrives within 1.5–2 years. By this time the patient has lasting eating habits that stop the weight returning.
Important! City Medical Centre specialists supervise your recovery and support you psychologically and medically 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
You may sit, stand up and drink fluids within the first few hours after surgery.
Wound care
Absorbable sutures are used; they dissolve on their own.

Work
Depending on the physical demands of your job, you can return to work 7–14 days after surgery.
Restrictions
During the first weeks, stay away from bathhouses, saunas and intense exercise.
Diet
The prescribed staged diet runs 1–2 months, shifting from liquids to solids so the stomach adapts.

Pace
Patients sticking to the specialists' advice shed on average 10% of excess weight per month.
Stabilization
The final outcome arrives within 1.5–2 years. By this time the patient has lasting eating habits that stop the weight returning.
Important! City Medical Centre specialists supervise your recovery and support you psychologically and medically 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 them, but the goals are fundamentally different. Bariatric surgery is a medical way to treat obesity and related diseases. It changes how the digestive tract works, getting at the causes of excess weight and metabolism. Plastic surgery only 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?
Modern laparoscopic technique allows the operation through 4 small punctures of 5 to 15 mm. Cosmetic sutures make the marks almost invisible when fully healed.
What diet do I need to follow?
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.
What types of bariatric surgery are there?
Four main bariatric surgery types are available at City Medical Centre: sleeve gastrectomy, Roux-en-Y gastric bypass, mini gastric bypass (MGB) and SADI-S duodeno-ileal bypass. The method is picked individually, considering BMI, related conditions and the patient's goals.
Can I plan a pregnancy after surgery?
Getting pregnant after bariatric surgery is possible, but doctors advise waiting at least 12–18 months, so the body can stabilize, weight can reach target values and nutritional status can normalize.
Do I need to take vitamins after surgery?
Yes, after bariatric surgery vitamins cannot be skipped. As the digestive anatomy changes, some nutrients are absorbed less well, making regular vitamin and mineral supplements a permanent feature of the patient's life.
Can the weight come back?
Weight can be regained after bariatric surgery, but this is very unlikely with the doctor's advice followed. Proper nutrition, avoiding high-calorie drinks and regular follow-up with City Medical Centre specialists are crucial.
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Service
Discounted price
Roux-en-Y gastric bypass creates a small 50–70 ml pouch at the top of the stomach and connects it straight to the small intestine. It is considered the gold standard for a BMI over 45–50 with type 2 diabetes, bringing excess weight loss of 75–85%. Anyone researching bypass in Cologne should know that it requires lifelong vitamin and mineral supplements.
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 Cologne discuss these points with the surgeon well before the operation date.
Before spending on another diet, get a professional assessment. A short no-cost talk with the surgeon, about a quarter of an hour, shows whether your BMI and related conditions justify surgery. If they do, one package takes you through tests, the operation, care in the ward and follow-up, with the weight loss result set in a contract. Residents of Cologne can apply online.
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Apply before the end of the year and get a consultation at the clinic's expense!