(CNN) -- Gymnast Simone Biles has won the all-around title at the world championships for the fourth time, the most ever in women's artistic gymnastics.
Biles uncharacteristically struggled in the competition Thursday in Doha, Qatar, just days after tweeting she'd put off having a kidney stone removed until after the competition.
But despite a fall on the vault, a fall on the balance beam and stepping out of bounds during her floor exercise routine, Biles still won by 1.693 points -- the largest margin of victory of her four titles.
Fellow American Morgan Hurd took bronze, while Mai Murakami of Japan won silver.
In addition to the all-around, Biles, who returned to the sport this summer, led the US this week to team gold. She still can add to her medal haul in the individual vault, uneven bars, beam and floor events.
Hurd, last year's world all-around champion, will also compete in bars and floor.
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