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Obesity Surgery in Fresno: Bariatric Methods
Tick the situations that sound familiar.
From 2 matches — a reason to talk to a surgeon.
No fees hidden away. No shocks. One package for the whole path.
Tick the situations that sound familiar.
From 2 matches — a reason to talk to a surgeon.
Both a high BMI and associated conditions can make a surgical consultation worthwhile
Medical history
Excess weight since childhood or a genetic predisposition
Metabolic disorders
Type 2 diabetes and hypertension associated with obesity
Resistance to conservative treatment
Diets and medicines have failed to give a lasting result for years.
Medical history
Excess weight since childhood or a genetic predisposition
Metabolic disorders
Type 2 diabetes and hypertension associated with obesity
Resistance to conservative treatment
Diets and medicines have failed to give a lasting result for years.
Surgery is prescribed only when clear criteria are met
BMI is the principal gauge of how advanced obesity is, found by dividing body weight (kg) by height squared (m²). Typically, a BMI above 40 — or above 35 with serious related conditions — justifies surgery. Some patients with lower values are considered for surgery too, if non-surgical options have failed.
People often spend years on diets and physical activity, but the body counters: metabolism slows, appetite increases, lost weight creeps back. When it is plain that changing the diet and taking medication cannot fundamentally improve things alone, bariatric surgery is the only effective exit.
Key factors
The role of body mass index (BMI)
BMI is the principal gauge of how advanced obesity is, found by dividing body weight (kg) by height squared (m²). Typically, a BMI above 40 — or above 35 with serious related conditions — justifies surgery. Some patients with lower values are considered for surgery too, if non-surgical options have failed.
Why don't diets and exercise work for everyone?
People often spend years on diets and physical activity, but the body counters: metabolism slows, appetite increases, lost weight creeps back. When it is plain that changing the diet and taking medication cannot fundamentally improve things alone, bariatric surgery is the only effective exit.
With chronic diseases, please get advice from 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
During surgery the surgeon removes most of the stomach, turning it into a narrow tube. This greatly reduces portion size and lowers ghrelin, the hunger hormone, so the patient feels full much faster and eats less.
Effectiveness: the method is used for a BMI of 35 to 45; average loss is 60–70% of excess weight.
Specifics: less durable results than bypass operations. Without sticking to the diet, especially avoiding high-calorie drinks and liquid food, the weight may return.

Roux-en-Y gastric bypass
At the top of the stomach the surgeon makes a small 50–70 ml pouch, linking it directly to the small intestine. Intake of food is restricted and calorie absorption falls, since food passes through less of the gut.
Effectiveness: known as the “gold standard” for a BMI over 45–50 combined with type 2 diabetes. Excess weight loss hits 75–85%.
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)
An advanced version of the classic bypass. Differing from the standard method, it involves only one connection (anastomosis) from the small stomach to the small intestine. The simpler technique is gentler on patients and needs a shorter recovery period.
Effectiveness: results comparable to classic Roux-en-Y bypass — up to 75–80% of excess weight lost.
Specifics: shorter surgery and faster recovery. The procedure is technically reversible, but there is a risk of bile reflux due to the single anastomosis.

Single anastomosis duodeno-ileal bypass (SADI-S)
SADI-S, a modern combined technique, pairs the benefits of sleeve gastrectomy and intestinal bypass. It is carried out in two stages: the stomach is reshaped into a narrow tube, after which the small intestine is rerouted so most of it is bypassed in active digestion.
Effectiveness: one of the most powerful options in bariatric surgery: excess weight loss of 80–90%, lasting a long time.
Specifics: the smaller stomach, minus its ghrelin-producing zone, dampens appetite, and bypassing a portion of the intestine limits calorie absorption. It is an option in 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
First comes a consultation with the surgeon — your medical history, the method and a recovery plan

Lab tests
Blood and urine analysis, biochemistry, HbA1c, coagulation panel to check clotting.
Instrumental diagnostics
Chest X-ray, ECG, abdominal and kidney ultrasound, leg vein Doppler.
Endoscopy
Gastroscopy (required) and colonoscopy (if indicated).
Specialists
GP, endocrinologist, cardiologist, psychiatrist and gynecologist (women only).

Diet
In the 2–4 weeks leading up to surgery, reduce fast carbs and fats; light meals the day before.
Lifestyle
A month before, quit smoking, lower physical activity and shun stress.
The day before
Final light meal in the evening; last drinks 3–4 hours before surgery.

Lab tests
Blood and urine analysis, biochemistry, HbA1c, coagulation panel to check clotting.
Instrumental diagnostics
Chest X-ray, ECG, abdominal and kidney ultrasound, leg vein Doppler.
Endoscopy
Gastroscopy (required) and colonoscopy (if indicated).
Specialists
GP, endocrinologist, cardiologist, psychiatrist and gynecologist (women only).

Diet
In the 2–4 weeks leading up to surgery, reduce fast carbs and fats; light meals the day before.
Lifestyle
A month before, quit smoking, lower physical activity and shun stress.
The day before
Final light meal in the evening; last drinks 3–4 hours before surgery.
Our experienced bariatric surgeons care about every patient's health

Ruslan S. Menzulin
Bariatric surgeon · surgical oncologist
Mercy clinic training under Vadim Gushchin; speaker at the World Congress of bariatric surgery (2025). Among the co-authors of an international study in The Lancet.

Andrey G. Ugay
Lead bariatric surgeon · surgeon
Has performed the largest number of SASJ operations in the country. Expert council member of the national Society of Bariatric Surgeons; speaks regularly at national and international congresses.
City Medical Centre approaches obesity in a comprehensive way. Each patient, after the first examination, is assigned a personal diagnostic program (lab and instrumental) to identify all disorders in the body.

A method matched to your goal
Choosing the surgical method is individual for each patient at our clinic. Doctors first review your health, history of weight and related conditions and then propose the most suitable surgical option.

Support that stays in touch
Once the operation is done, the City Medical Centre team stays alongside you. Throughout the first year specialists follow your weight loss, review tests and answer all questions on diet and recovery.

Fast recovery
At City Medical Centre, bariatric operations are laparoscopic, which significantly shortens recovery. Most patients are up and active on day one and return to normal life within a week.

Full diagnostics on site
No need to run between clinics. Our centre has everything for your work-up, from our own lab to ultrasound and gastroscopy. Preparation is quick, with no queues, all in one building.
Much of recovery depends on the individual, but minimally invasive laparoscopic techniques keep the rehab stage as short as possible.

Duration
A clinic stay of 1 to 5 days under observation follows, depending on surgical extent and 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
A return to work is possible 7–14 days after surgery, based on how physical your job is.
Restrictions
In the first weeks, avoid the bathhouse, sauna and intense physical exercise.
Diet
A step-by-step diet lasts 1–2 months, from liquids to solids, giving the stomach time to adapt.

Pace
With the specialists' advice followed, average loss is 10% of excess weight per 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! Specialists at City Medical Centre supervise recovery, providing medical and psychological support across every stage of weight loss.

Duration
A clinic stay of 1 to 5 days under observation follows, depending on surgical extent and 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
A return to work is possible 7–14 days after surgery, based on how physical your job is.
Restrictions
In the first weeks, avoid the bathhouse, sauna and intense physical exercise.
Diet
A step-by-step diet lasts 1–2 months, from liquids to solids, giving the stomach time to adapt.

Pace
With the specialists' advice followed, average loss is 10% of excess weight per 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! Specialists at City Medical Centre supervise recovery, providing medical and psychological support across 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 confuse the two, yet their purposes are fundamentally different. Bariatric surgery is medicine's treatment for obesity and related diseases: it changes how the digestive tract operates and addresses the causes of excess weight and metabolism. Plastic surgery reshapes outer contours of the body without treating obesity or affecting metabolism.
How soon can I return to work and normal life?
Will there be visible scars?
We work with modern laparoscopic technique. The operation needs only 4 small punctures, 5 to 15 mm each. Cosmetic sutures are applied, so healed marks are almost invisible.
What diet do I need to follow?
In stages, your diet goes from liquid to soft to solid food. The main focus is protein and restricting high-calorie, fatty food.
What types of bariatric surgery are there?
City Medical Centre performs four main types of bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass, mini gastric bypass (MGB) and SADI-S duodeno-ileal bypass. Each method is chosen individually based on 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 — 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?
Regaining weight after bariatric surgery is possible, yet very unlikely when you stick to the doctor's advice. The keys are proper nutrition, no high-calorie drinks and regular check-ups with City Medical Centre specialists.
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Why do diets fail? The body fights back: metabolism slows, appetite grows, and lost kilos return. When diet changes and medication cannot fundamentally improve the situation, surgery becomes the effective way out. Fresno residents who have tried diets, fasting and pills for years without a lasting result are exactly the patients for whom bariatric operations are intended.
Preparation is practical. Two to four weeks before surgery, cut fast carbohydrates and fats; a month before, quit smoking, reduce physical activity and avoid stress. The day before, switch to light meals, with the last light meal in the evening and last fluids 3–4 hours before the operation. The same plan applies to everyone preparing for bariatric surgery in Fresno.
There are no hidden fees: one package covers everything required for the result. It brings together experienced surgeons, round-the-clock care, meals, nursing, a coordinator and a legal result guarantee. Tick the situations that apply to you and request a free check of your case; a coordinator will contact patients from Fresno to arrange the next steps.
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