The High Court has authorised urgent surgery to remove a gastric band from a woman in her thirties despite her clear opposition to the procedure.
The HSE sought orders under the High Court’s inherent jurisdiction after treating clinicians concluded that the band was dangerously obstructing the passage of food and fluid and had contributed to malnutrition and significant dilation of the woman’s oesophagus.
The woman, identified only as R.F., lives independently, is employed and was described by the court as intelligent and articulate. She strongly opposed the proposed treatment and expressed concern about weight gain, her employment, professional studies, rent and household bills.
The court heard unanimous psychiatric evidence that she has an eating disorder known as Other Specified Feeding or Eating Disorder. The experts concluded that while she could understand and communicate medical information, the condition prevented her from properly weighing that information when deciding whether to accept treatment.
Medical evidence showed that a barium swallow test carried out on July 6, 2026 recorded no contrast passing through the gastric band after 11 minutes. Her oesophagus measured 7.8cm in diameter, compared with a normal measurement of about 2cm.
Two bariatric surgeons agreed that simply loosening the band would not adequately address the risks. Those included worsening malnutrition, permanent damage to the oesophagus, gastric or oesophageal perforation and potentially fatal complications.
Mr Justice Barry O’Donnell found that R.F. lacked capacity to make the specific decisions concerning removal of the band and the proposed postoperative treatment. He also held that the intervention was necessary and proportionate despite its impact on her bodily integrity and autonomy.
The treatment plan includes laparoscopic removal of the band followed by approximately four to six weeks of inpatient care in a specialist eating-disorder unit.
The judge directed that the most intrusive measures, including restraint or compulsory removal to hospital, should be used only as a last resort. Every effort must first be made to secure R.F.’s cooperation, and the case will remain under court review.