guarantee
Weight Loss Surgery in Sofia: Sleeve, Bypass, SADI-S
for good —
14,000 CMC patients already live in a new body. The result is fixed in an official contract, legally and not only verbally.
patients
experience
from excess weight
rating
Weight Loss Surgery in Sofia: Sleeve, Bypass, SADI-S
for good —
Everything for the result — included
Bariatric surgery —
is it right for me?
Tick the situations that sound familiar.
From 2 matches — a reason to talk to a surgeon.
Everything needed for the result —
already included
No hidden fees. No surprises. One package — the full journey.
Bariatric surgery —
is it right for me?
Tick the situations that sound familiar.
From 2 matches — a reason to talk to a surgeon.
Reasons to see a surgeon
You may need a surgical consultation because of related conditions, not only high BMI
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.
When is bariatric surgery justified?
Surgery is prescribed only when clear criteria are met
The role of body mass index (BMI)
The main way to assess the degree of obesity is BMI. It is body weight (kg) divided by height squared (m²). Generally, surgery is justified with BMI above 40, or above 35 combined with serious related conditions. Lower values may sometimes be considered for surgery too, when non-surgical measures have failed.
Key factors
- The patient's body mass index (BMI)
- Overall health and any related chronic conditions
- Previous efforts at weight loss through standard methods did not work
Why don't diets and exercise work for everyone?
Many try all kinds of diets and exercise for years, yet the body defends itself — metabolism drops, hunger grows and lost weight returns. Once it is obvious that medication and a changed diet alone cannot fundamentally fix the situation, bariatric surgery becomes the only effective path.
Key factors
- The patient's body mass index (BMI)
- Overall health and any related chronic conditions
- Previous efforts at weight loss through standard methods did not work
The role of body mass index (BMI)
The main way to assess the degree of obesity is BMI. It is body weight (kg) divided by height squared (m²). Generally, surgery is justified with BMI above 40, or above 35 combined with serious related conditions. Lower values may sometimes be considered for surgery too, when non-surgical measures have failed.
Why don't diets and exercise work for everyone?
Many try all kinds of diets and exercise for years, yet the body defends itself — metabolism drops, hunger grows and lost weight returns. Once it is obvious that medication and a changed diet alone cannot fundamentally fix the situation, bariatric surgery becomes the only effective path.
Medical indications
for bariatric surgery
If you have chronic conditions, please see a clinic doctor 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
Bariatric surgery methods at City Medical Centre
Sleeve gastrectomy
Most of the stomach is removed in the operation, leaving a narrow tube. Portion size falls dramatically and ghrelin, the hunger hormone, declines, meaning the patient gets full much sooner 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
The operation creates a small 50–70 ml stomach pouch at the top and connects it directly with the small intestine. Less food can be taken in, and fewer calories are absorbed because the path through the gut is shorter.
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 result lasts better than with other bariatric methods. Related conditions such as diabetes and hypertension often go into remission. Because the digestive anatomy changes, lifelong vitamin and mineral supplements are needed.
Mini gastric bypass (MGB)
An upgraded take on the classic bypass. In contrast to the standard method, only a single connection (anastomosis) is made between the small stomach and the small intestine. Being simpler, the technique is easier on the patient and shortens recovery.
Effectiveness: results comparable to classic Roux-en-Y bypass — up to 75–80% of excess weight lost.
Specifics: a faster operation and shorter recovery. The procedure can be undone technically, but there is a bile reflux risk from the single anastomosis.
Single anastomosis duodeno-ileal bypass (SADI-S)
SADI-S is a modern combined technique that unites the benefits of sleeve gastrectomy and intestinal bypass. It is done in two stages: first the stomach is turned into a narrow tube, then the small intestine is rerouted so that most of it is excluded from active digestion.
Effectiveness: a top-power bariatric operation — loss of excess weight reaches 80–90%, with a long-lasting result.
Specifics: a reduced stomach without its ghrelin-producing zone means less appetite, and diverting food past part of the intestine restricts calorie absorption. It is suited to super obesity (BMI over 50), severe type 2 diabetes, or 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
Preparing for bariatric surgery at City Medical Centre
A surgeon's consultation comes first — reviewing medical history, picking a method, planning recovery
Lab tests
Complete blood count and urinalysis, biochemistry, HbA1c, 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
Cardiologist, endocrinologist, psychiatrist, GP and gynecologist (for women).
Diet
Avoid fast carbs and fats during the 2–4 weeks before surgery; eat lightly the day before.
Lifestyle
Stop smoking a month in advance, reduce exercise and keep stress to a minimum.
The day before
Last light food in the evening, last liquids 3–4 hours prior to surgery.
Lab tests
Complete blood count and urinalysis, biochemistry, HbA1c, 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
Cardiologist, endocrinologist, psychiatrist, GP and gynecologist (for women).
Diet
Avoid fast carbs and fats during the 2–4 weeks before surgery; eat lightly the day before.
Lifestyle
Stop smoking a month in advance, reduce exercise and keep stress to a minimum.
The day before
Last light food in the evening, last liquids 3–4 hours prior to surgery.
Our specialists
Bariatric surgeons with deep experience and real care for patients' health
Ruslan S. Menzulin
Bariatric surgeon · surgical oncologist
Trained under Vadim Gushchin at Mercy clinic and spoke at the 2025 World Congress of bariatric surgery. Co-author of an international study published in The Lancet.
Andrey G. Ugay
Lead bariatric surgeon · surgeon
Has carried out the largest number of SASJ operations in the country. Serves on the expert council of the national Society of Bariatric Surgeons and presents regularly at national and international congresses.
City Medical Centre bariatric surgery centre
— your path
to confidence and harmony
Obesity care at City Medical Centre is comprehensive. After the first check-up, every patient receives a personalized lab and instrumental diagnostic program to uncover each disorder in the body.
A method matched to your goal
Our doctors tailor the choice of surgical method to each patient. Ahead of the decision they study your health, weight history and related conditions to offer the best-suited surgical treatment.
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 surgery at City Medical Centre is done laparoscopically, greatly shortening recovery. Most patients stand and walk on the first day and are back to normal life within a week.
Full diagnostics on site
No shuttling between clinics. Your full work-up happens at our centre, from our own lab to ultrasound and gastroscopy. Preparation is quick, there are no queues, and it is all in one building.
Recovery after bariatric surgery
Each patient recovers differently, but minimally invasive laparoscopic techniques keep rehabilitation as brief as possible.
Duration
The patient is kept under clinic observation for 1 to 5 days, depending on the scale of surgery and related conditions.
Activity
Within the first hours after surgery you may sit up, stand and drink fluids.
Wound care
Absorbable sutures are used; they dissolve on their own.
Work
Back to work in 7–14 days after surgery, depending on how physical your job happens to be.
Restrictions
The first weeks exclude bathhouse, sauna and intense physical exercise.
Diet
A staged diet is prescribed for 1–2 months, moving from liquids to solids so the stomach can adapt.
Pace
Keeping to the specialists' advice, patients lose 10% of their excess weight monthly on average.
Stabilization
The final result is seen after 1.5–2 years. In that time the patient builds stable eating habits that keep the weight from returning.
Important! City Medical Centre specialists supervise your recovery and support you psychologically and medically at every stage of weight loss.
Duration
The patient is kept under clinic observation for 1 to 5 days, depending on the scale of surgery and related conditions.
Activity
Within the first hours after surgery you may sit up, stand and drink fluids.
Wound care
Absorbable sutures are used; they dissolve on their own.
Work
Back to work in 7–14 days after surgery, depending on how physical your job happens to be.
Restrictions
The first weeks exclude bathhouse, sauna and intense physical exercise.
Diet
A staged diet is prescribed for 1–2 months, moving from liquids to solids so the stomach can adapt.
Pace
Keeping to the specialists' advice, patients lose 10% of their excess weight monthly on average.
Stabilization
The final result is seen after 1.5–2 years. In that time the patient builds stable eating habits that keep the weight from 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
Frequently asked questions
about bariatric surgery at CMC
Bariatric vs plastic surgery: what's the difference?
It is common to confuse them, but their goals are fundamentally different. Bariatric surgery treats obesity and related diseases medically. By changing how the digestive tract works, it addresses the causes of excess weight and metabolism. Plastic surgery shapes the body's outer contours; it does not treat obesity and has no effect on metabolism.
How soon can I return to work and normal life?
Will there be visible scars?
Using modern laparoscopic technique, we perform the operation via 4 small punctures of 5 to 15 mm. Cosmetic sutures are placed, leaving marks that are nearly invisible after healing.
What diet do I need to follow?
Eating changes gradually: liquid food first, then soft, then solid. The focus is protein, with high-calorie, fatty food kept to a minimum.
What types of bariatric surgery are there?
City Medical Centre carries out four main types of bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass, mini gastric bypass (MGB) and SADI-S duodeno-ileal bypass. The choice of method is individual, based on BMI, related conditions and the patient's goals.
Can I plan a pregnancy after surgery?
Pregnancy is an option after bariatric surgery, but doctors advise waiting at least 12–18 months. By then the body has stabilized, weight has reached target values and nutritional status has normalized.
Do I need to take vitamins after surgery?
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.
Can the weight come back?
Weight can come back after bariatric surgery, but this is very unlikely if you follow your doctor's advice. Proper nutrition, skipping high-calorie drinks and regular follow-up with City Medical Centre specialists are key.
Prices
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Service
Discounted price
City Medical Centre licences
Other services at our clinic
Choosing a bariatric method in Sofia
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 Sofia should know that it requires lifelong vitamin and mineral supplements.
It begins with a surgeon's consultation: medical history, choice of method and a recovery plan. Patients from Sofia then complete a work-up — blood and urine tests, biochemistry, HbA1c, coagulation, chest X-ray, ECG, abdominal and kidney ultrasound, leg vein Doppler and a required gastroscopy — plus consultations with a GP, endocrinologist, psychiatrist, cardiologist and, for women, a gynecologist.
Weight loss is written into the contract, and the package includes every stage: consultation, diagnostics, the operation, inpatient care with meals and a year of support. A personal coordinator guides you from day one. To begin, patients from Sofia leave a request on the page or message the clinic, then receive a free consultation with a bariatric surgeon.
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