Bariatric surgery5 min read
Obesity treatment options: when diets are not enough and surgery is needed
Obesity is a chronic condition, not a lack of willpower, and it usually needs more than a short diet. Treatment works in steps: nutrition, physical activity, psychological support, medication and, for some people, surgery. This article explains what each step can realistically achieve, why weight often returns after dieting, and which signs suggest that it is time to discuss bariatric surgery with a surgeon.
The main points in 30 seconds
- Obesity is a chronic condition; losing 5–10% of body weight already improves health.
- Nutrition, activity and psychological support are the base of any treatment.
- In studies, prescribed injections gave on average about 10–20% weight loss.
- Surgery is usually considered from a BMI of 40, or 35 with a serious condition.
- City Medical Centre performs sleeve, Roux-en-Y bypass, MGB and SADI-S.
Key facts about the procedure
- Back to work2–4 weeks
- Stay in clinic1–5 days
- Final result18–24 months
- Price
$4,800from $3,600
Why obesity is more than eating less
Weight is regulated by a complex system that includes genes, hormones, sleep, stress, medicines and the environment we live in. When a person loses weight by eating less, the body reacts: hunger hormones rise, fullness signals weaken and energy use falls. That is why many people regain weight after a diet, even when they try hard.
This does not mean that lifestyle changes are useless. Losing just 5 to 10 percent of body weight can already improve blood sugar, blood pressure and joint pain. It means that obesity is best treated as a long-term condition, with a plan that can be stepped up when needed.
Medical nutrition and energy balance
Nutrition is the foundation of every treatment, including surgery. The aim is a lasting way of eating, not a short strict diet. General recommendations include:
- eating slightly fewer calories than the body uses, aiming for a steady loss of about 0.5 to 1 kg a week;
- building meals around vegetables, protein and whole grains;
- cutting down on sugary drinks, sweets, fried food and alcohol;
- eating regularly and slowly, and noticing hunger and fullness.
A dietitian can adapt the plan to your health, culture and daily routine. Very strict diets rarely last, and quick losses are often followed by quick regain.
Physical activity and strength training
Exercise on its own rarely leads to large weight loss, but it is one of the best ways to keep weight off and protect health. It improves insulin sensitivity, blood pressure, mood and sleep.
- Aerobic activity: general guidance suggests at least 150 minutes a week of moderate activity, such as brisk walking, cycling or swimming.
- Strength training: two or more sessions a week help to preserve muscle while losing fat.
- Everyday movement: stairs, walking and fewer hours of sitting also count.
With joint pain or heart problems, it is sensible to start gently and agree the plan with a doctor.
Behavioural and psychological support
Eating habits are closely linked to emotions, stress and routine. Support from a psychologist or a structured programme helps people change these patterns for the long term. It can address:
- emotional eating and eating in response to stress or boredom;
- binge eating, which needs specific treatment;
- sleep problems, which increase appetite;
- motivation, setbacks and realistic goals.
This support matters at every stage, including before and after surgery.
Medication: who it suits
Modern weight-loss injections prescribed by a doctor, which act on appetite hormones such as GLP-1, have become an important option. According to general medical guidance, they are usually considered for adults with a BMI of 30 or more, or 27 or more with a weight-related condition. The product, dose and length of treatment are decided by the prescribing doctor.
In studies, people using them lost on average around 10 to 20 percent of their body weight, with wide differences between individuals. Side effects such as nausea are common at the start, and weight often returns after the medicine is stopped. City Medical Centre does not prescribe these injections; they are prescribed by your own doctor.
When conservative treatment is not enough
For some people, even a well-run programme of nutrition, activity, support and medication does not give a lasting result. These signs suggest that it is worth discussing surgery with a bariatric surgeon:
- BMI of 40 or more
- Surgery is usually considered
- BMI of 35 or more with a serious related condition
- Surgery is usually considered
- BMI of 30 to 35 with type 2 diabetes that is hard to control
- Surgery may be considered individually
- Weight returns again and again after several serious attempts
- Conservative treatment alone may not be enough
- Weight limits movement, sleep, work or fertility
- A reason for a specialist assessment
These figures are guidance, not an automatic decision. The final answer comes from the surgeon after examination. The criteria used by the clinic are described on the bariatric surgery page.
Surgery as the next step: assessment at City Medical Centre
Bariatric surgery does not replace healthy habits; it makes them easier to keep by changing appetite and the size of the stomach. City Medical Centre works with international patients and performs four operations: sleeve gastrectomy, Roux-en-Y gastric bypass, mini gastric bypass (MGB) and SADI-S. Diet programmes and weight-loss medication are arranged with your own doctor; the clinic’s service is surgery and the care around it.
The first consultation is free and can be held online: share your height, weight, weight history, conditions and the treatments you have tried. The surgeon assesses whether surgery is right for you, which method suits your case and what preparation is needed, and names the cost, which is fixed in the contract. A personal coordinator stays with you from the first message to the end of recovery, and documents can be sent by Telegram. Learn more on the bariatric surgery page.
How recovery usually goes
- First hoursYou may sit up, stand and drink fluids
- 1–5 daysObservation at the clinic, depending on the extent of surgery
- 2–4 weeksReturn to office work; physical work after about 1.5 months
- 1–2 monthsStaged diet from liquids to solids to let the stomach adapt
- Every monthOn average 10% of excess weight lost per month
- 1.5–2 yearsFinal result, stable eating habits prevent the weight from returning
Sources
Frequently asked questions
When should I consider weight-loss surgery?
Usually when your BMI is 40 or more, or 35 or more with a serious weight-related condition, and non-surgical treatment has not given a lasting result. With type 2 diabetes, surgery may be discussed from a BMI of 30. A surgeon makes the final decision after an examination.
Why do diets often fail long term?
When you lose weight, the body defends its previous weight: hunger hormones rise, fullness signals weaken and energy use falls. Strict diets are also hard to keep up. That is why steady changes and long-term support work better than short, severe diets.
Can exercise alone treat obesity?
Rarely. Exercise on its own usually leads to modest weight loss, but it is very important for keeping weight off, protecting muscle and improving blood sugar, blood pressure and mood. It works best combined with changes in eating habits.
Is medication an option before surgery?
It can be. Weight-loss injections prescribed by a doctor help some people avoid or delay surgery, and they are sometimes used before an operation. Your own doctor decides whether they suit you. City Medical Centre does not prescribe them.
What BMI makes surgery an option?
Surgery is usually considered from a BMI of 40, or from 35 with a serious related condition such as type 2 diabetes or sleep apnoea. Lower values are assessed individually, for example with diabetes that is hard to control. BMI is only one part of the decision.
Have a question about your case? Get a free consultation
Message a coordinator on Telegram: we reply right in the chat, and you can send photos and questions there too.
- The first consultation is free, online consultations are available
- The doctor names the cost after the assessment, and it is fixed in the contract
- A personal coordinator guides you from the first message to recovery
Message our coordinator on Telegram
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