The operation and recovery were uncomplicated and we looked forward to further weight loss and a return to a normal life. This did not occur. There were frequent admissions for shortness of breath and massive weight gain, due to fluid retention. Despite help by our cardiologists, she died within six months of chronic heart failure. She had been too obese for too long.
Malignant obesity is an appropriate metaphor.
Another patient was found on the floor of her house on a mattress, from which she was unable to rise because of her extreme weight. She was admitted with a large inflamed area on a swollen buttock from pressure. We strapped two beds together and provided the best of nursingcare and a reasonable diet, anticipating that it would take months to prepare this woman for an operation. She died within a few weeks of pneumonia. Some patients seemed to respond to our training program and then when about ready for an operation they would insist upon returning home for a little rest and recuperation, only to regain the weight they had lost or to not return at all.