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A 44-year-old woman died of malnutrition 10 years after undergoing bariatric surgery for weight loss, according to a new report from a local coroner.
After the surgery, the woman, who also may have had an eating disorder and other mental health conditions, could barely eat. Her weight went from 322 pounds to 70 pounds over the course of the decade.
Bariatric surgeries and eating disorders have a complicated relationship, with the procedures both attracting people with disordered eating patterns and leading to eating disorder symptoms.
Eating disorders and other life-threatening complications of gastric bypass surgery are rare. Most patients do well with extensive preparation and follow-up, including from dietitians and psychologists.
A 44-year-old mother of three in the UK died after a decade of malnutrition and severe weight loss following a gastric bypass operation, according to the Manchester Evening News, which reported she 'starved to death.'
The woman, named Kimberly Wall, originally underwent the surgery, despite concerns from her family, after trying many other weight-loss strategies, according to the Evening News. She was pleased with the initial weight loss but later said she regretted it, becoming more depressed and anxious over time, the woman's mother told the news outlet.
Over the course of the 10 years, Wall — who also may have had an eating disorder, according to a hospital that treated her — had such difficulty eating she lost 75% of her body weight, dropping to just 70 pounds. She was unable to walk and had to be hospitalized, which she had been before.
Wall died a week after her last hospitalization from heart failure as a result of malnutrition, ruled by the coroner to be related to the bariatric surgery. "Kimberly's problem with nutrition is a rare but recognized complication of the gastric bypass surgery," the coroner said.
Bariatric surgery is generally safe and side effects are typically temporary
Bariatric surgeries include several procedures designed to help patients lose weight through various methods by reducing the size of the stomach or re-routing the digestive system.
Its risks are similar to those of other common surgical procedures such as a hip replacement or a gallbladder removal according to Melissa Majumdar, a bariatric dietitian who works with patients on proper diet and nutrition before and after weight-loss surgery.
"There might be cases of death, but there are cases of death with any type of surgery," Majumdar told Insider. Less than 1% of bariatric surgery patients die from the procedure or related complications, she said.
While there can be digestive complications of surgery such as nausea, vomiting, and trouble eating, those usually clear up after the first week post-surgery, Majumdar said.
After surgery, patients undergo extensive follow-ups with their medical team to help mitigate any complications, including nutritional deficiencies, digestive problems, or psychological issues. Typically, check-ins occur within a few weeks, six months, and a year after surgery but continue well into the long-term.
"What's unique about bariatric surgeries is that patients should follow up with their care team for life," Majumdar said.
In rare cases, eating disorders can be a dangerous complication for bariatric surgery patients
Despite the relative safety of the procedures, bariatric surgery and eating disorders have a complicated relationship.
"People can go into bariatric surgery with disordered eating," Majumdar said. "In a culture of dieting and restriction, that's very common." On the other end, around 8% of eating disorder patients have had a bariatric surgery, according to the psychiatric department at Johns Hopkins Medicine.
Which came first — the disorder or the procedure — is difficult to asses. Either way, eating disorders can be life-threatening, since malnutrition can cause dangerous amounts of weight loss, heart problems, and eventually cardiac arrest.
But serious eating disorders related to bariatric surgeries are rare, Majumdar added, in part because patients should be going through a thorough preparation ahead of time. For example, many care providers, including insurance companies and surgeons, require patients to consult with a bariatric psychologist before the procedure, at least in the U.S.
Bariatric surgery should be a "whole program," not just one surgical procedure
Bariatric surgery is far more than a single operation, Majumdar emphasized, but a long-term process. For it to work, patients need a variety of resources, including dietitians to monitor nutritional intake. Many bariatric programs also offer support groups to patients both before and after surgery.
"When you embrace the whole program, it's not just surgery," Majumdar said. "It's an entire process that involves a lot of education, preparation, consultation, and follow-up."