Morbid obesity after spinal cord injury: an ailment not to be treated?

A 28-year-old man with a T12 incomplete paraplegia after a spinal cord injury (SCI) was referred for weight management in October 2011. He reported a weight gain from about 120 to 180.3 kg since his SCI. He put on a further 11.4 kg in January 2012 despite intensive dietetic treatment, including very low-caloric diet, anti obesity medication and active physiotherapy programme. He had undergone an uncomplicated laparoscopic Roux-en-Y gastric bypass successfully in March 2012. For the first 7 months after surgery, his total weight loss was 32.4 kg. He has shown functional improvement (6 min walking distance and Berg balance score). There were important improvements in body mass index; waist circumference; mid-upper arm circumference; triceps-skinfold thickness; mid-arm muscle circumference; total cholesterol; high-density lipoprotein-cholesterol; and low-density lipoprotein-cholesterol and triglycerides. This report describes the first UK morbidly obese SCI patient who has undergone gastric bypass surgery and highlights the provision of bariatric surgery as an option to consider if all nonsurgical interventions have been tried.