Case report

Dercum's disease as a cause of weight loss failure after gastric bypass surgery

Case report

A 45-year-old woman with a history of obesity since adolescence presented for consideration for bariatric surgery. Her body mass index at presentation was 42.5 kg/m². Her co-morbidities included dyslipidemia, osteoarthritis, bilateral lower extremity lymphedema, irregular menses, migraine headaches, and joint and low back pain. She described a history of multiple failed attempts at weight loss through supervised diets and medications. The patient underwent the multidisciplinary evaluation,

Dercum's disease

Dercum's disease is a rare condition characterized by the development of multiple, painful subcutaneous lipomas on the trunk and extremities. Also known as lipomatosis dolorosa or adiposis dolorosa, it was first described by neurologist Francis Dercum in 1892[3].

Dercum's disease often occurs in association with obesity, allodynia, joint stiffness, fatigue, and a range of neuropsychological disturbances, including headaches, depression, dementia, and epilepsy. Patients typically complain of

Discussion

Obesity is likely to remain a continuing challenge in the developed world, and RYGB is a recognized treatment of this condition. The place of gastric bypass surgery in the management of obesity secondary to other medical conditions remains unclear. Promising results have been reported such as for hypothalamic obesity after resection of a craniopharyngioma[14]. Bariatric surgery has never previously been described for the treatment of Dercum's disease. This is the first published case report

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.