Lisa Marie Presley's Friends Shocked by Secret Weight-Loss Surgery That Caused Her Untimely Death

People close to Lisa Marie Presley were stunned by her secret decision to go under the knife — which ultimately caused her death.

After the Los Angeles County medical examiner ruled that Elvis Presley's only daughter died of a bowel obstruction caused by weight-loss surgery, people in Presley's inner circle could not understand why she would need assistance dropping pounds.

"When did you ever see Lisa look as if she needed bariatric surgery?" a former pal said of the late actress, who passed away in January at the age of 54. "She was not big at all. I don't know what kind of doctor would perform this surgery on her."

While people close to Presley knew she received minor cosmetic tweaks here and there, the heavy press ramp-up for Baz Luhrmann's Elvis film put pressure on the singer to be as thin as possible. "She wanted to look her very best," a source spilled.

Former Scientologist and private investigator Jeffrey Augustine — whose wife Karen de la Carriere worked with Presley when her mother, Priscilla Presley, sent her daughter to church counseling at age 9 — agreed that the secret procedure was out of character for the star, who left the church in 2014 following an alleged rift with leader David Miscavige.

"She went on a crash diet to lose 40 pounds before showing up with Baz for the Elvis movie. She was having financial problems, and she hoped the publicity from the film would bump up Elvis sales," Augustine claimed.

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According to Augustine, her rift with the Presley matriarch and living in the shadow of a famous family played a part in her alleged body image issues. "It's well known that she and Priscilla didn't get along," he alleged. "In fact I think there was a real animosity there, and Lisa Marie resented living in her shadow as well as Elvis'. Lisa Marie always had issues with her weight."

Page Six spoke with Augustine and sources close to Presley.