To think excess skin removal should be available on the NHS?

[TheGoodEnoughWife]

I know being fat is seen as being self inflicted although I don't agree that it is and that people over eating should be taken as seriously as people under eating. But that isn't necessarily my point here..,

I am very overweight (about 6st overweight but am tall) and one of the things in the back of my mind is that if I lose weight my saggy skin will be awful. The reality is my 'strain' on the NHS being overweight has the potential to be great - surely encouragement to lose weight would cost the NHS less in the long run?
It would be helpful maybe to me and others who need to lose a lot of weight to know that treatment for excess skin would be available to them?

Now I may get flamed about self inflicted and so on but if I drive a car badly and crash I would be treated on the NHS, if I drink like a fish and cause myself illness I would be treated on the NHS, if I go about extreme sports and hurt myself I also would get treated on the NHS.
(I don't do any of those things!)

Any one see where I am coming from?

YY Helena I put on 2 stone in 3 months a year ago. Had never been overweight before. I ended up with a serious health condition which could have resulted in me losing my vision. The reason for the weight gain was a certain antidepressant had I researched it properly I would have known this. Have just lost the weight through sheer determination. Wish Id had the full facts though.

Hope you are feeling better now Maud.........both mentally and physically.

There was an item on the news this week about a woman who has resigned from an NHS position but has moved to another job in the organisation.

£180"000 a YEAR she gets paid!!!!!!!!!!!

I think maybe 1p on tax for higher rate tax payers in the answer. As a family with a higher rate tax payers I would prefer to pay abit more each month if it means the front line NHS gets the money.

Like another poster I have quite severe muscle separation and overhang. I developed a hernia purely caused by my obesity of course. Not multiple pregnancies C-section's and coughing of course. My hernia has been repaired but I worry it could come back.

Still no support with losing said weight or indeed losing more or keeping it off.

ipost there are a lot of disabilities that cause obesity

Yes. I know.

My late, bed bound great-grandmother put on enormous amounts of weight when she had to take steroids to try to slow down her cancer.

Late MIL had severe bipolar I that couldn't be effectively controlled with meds. The majority of times she was in a manic state we struggled (and spectacularly failed) to avoid her gaining large amounts of weight. Which was an issue becuase she had already lost most of the toes of one foot to diabetes and she had heart problms. Depressive episodes weren't often much better, it wasn't easy finding an anti-D that would work. Even harder to find one that worked AND wasn't contraindicated for other meds she was taking for one of the many physical issues she suffered from. By the time the field was thinned down that much, sometimes one associated with weight gain had to be risked because it was the lesser of many evils. Later on she was confined to a wheelchair. This made things harder still, weight wise.

Some people becoming obese due to their disabilities and illnesses, physical and mental, is not a new thing. It's been true all the years I have been alive. As a phenomenon it long pre-dates the notable upswing in obesity statistics. Not to mention the relatively new additional strain on the health services caused by a significant rise in weight related medical issues.

The fact that mentally ill and/or physically disabled people will suffer the most from a rolling back of the welfare state hasn't stopped them being among the first targeted for some of the sharpest cuts.

As a small sub group within a much larger group they are often employed as the more sympathetic face of -

-obesity
-crime
-people in receipt of benefits

Which IMO, rather than generating the intended protective effect for the whole group, has had the unintended consequence of mentally ill and physically disabled people becoming erroneously linked in people's minds with profound social problems and unsustainable economic costs.

I believe that is one of the reasons why it has been relatively easy for governments to scale back their public assistance hard, fast and first. With very little public outcry.

No, poverty is nothing new, but obesity is something new, and food is different to 30 years ago, society is different and our issues are different

30 years ago I, and most of the people I knew, lived with exactly the issues you mentioned as being relevant to a discussion about obesity today.

A lack of

-decent/reachable shops
-transportation
-money
-access to reasonably equipped cooking facilities
-knowledge of nutrition/cooking

How can they be the different issues of yesterday if they are the same issues you raised as being relevant today ?

How was my, and my peers', diet of mainly biscuits, chocolate and white sliced bread wildly different (in terms of sugar content/simple processed carbs content/calories per kilo/low nutritional value) to today's food ?

ipost i COMPLETELY understand where you are coming from. I do think though that with the prescribing of things like steroids for illnesses we as a society need to start looking at QUALITY of life rather than QUANTITY of life.

We would not even consider putting the animals we love through all that yet humans are expected to go through it.

The twats who bully overweight ppl in the street cant possibly know if its through overeating or for medical reasons. If i had to go through the abuse i used to get just for the sake of hanging on to life??? NO that is not QUALITY of life . That is QUANTITY and i would choose the FORMER EVERY time!!!!

According to NHS, half of the UK will be obese by 2030.
Things are certainly different from 30 years ago.

I was in McDonalds yesterday having found myself in a social situation where I had to be there. I did not eat as I do not like their food. I spent 20 minutes watching the world go by instead. These were my observations.

1. There were a lot of obese parents and children in there, able bodied, eating their food really fast. It was a bit sad watching them, but they were there because that's a treat their parents could afford. Conversations between parents and children about menu choice were about cost rather than nutritional content.
2. If McDonalds put better stuff on the menu they could change lives. I mean putting their marketing heft and wholesale buying power behind fruit and veg, more dietary fibre, new forms of food production that involve simpler unprocessed foods, using their psychological marketing tools to make kids hanker after the good stuff more, that kind of thing. Applause to them for calories printed on boxes, children's milk, sports toys in happy meals, vouchers for reading books, carrot stick bags and fruit bags but they need to make the healthy ranges much more central and extensive and, over time, let the crap fade away (over a generation). They have a responsibility here having eased out local street food in many areas in favour of their products through aggressive business expansion.
3. The NHS is there to serve people, not the other way around, so we need to help obese people more rather than condemn them.

We live in an obesogenic environment. These problems are bigger than just individuals.

I went on an intensive NHS state of the art pain management course, three weeks, full-time, state of the art, highly effective and I mean highly effective.

They need to develop similar processes for obesity, especially relating to childbirth. If you tackle mums really effectively you stand a chance of breaking particular cycles, and they can lobby for societal change in due course.

I've had barbaric surgery so I see it from both sides
I have awful bingo wings and a hideous hanging tummy
I just don't wave bare armed and don't wear a bikini, do wear bucket knickers etc

However there's a lady in my group who has lost 40 stone

40 STONE!!!!!!! She needs, medically needs skin removal. She's constantly ill with ulcers and infection and cellulitis, and I worry that one day, sepsis will get her
She was so huge that she couldn't exercise for the first 25 plus stone, she could barely move
Ido think there should be exceptions, her surgeon and GP are super supportive and have re applied several
Times for funding so far

Barbaric 🙄
Bariatric

Gotta love iPhones

iPhone Freudian slip!!

Boffin I do think we live in an obesegenic environment to a certain extent but I think your suggestion of McDonalds radically changing their menu to be quite unrealistic.

Ultimately the power and control lies within each individual.

Food doesn't seem to be used as fuel but rather for pleasure, comfort and many other things. I think some people have lost those signals such as true hunger. Some people have little self discipline.

Practices such as fasting can build this. Helps to reset and realise what true hunger is. It is useful within a spiritual aspect and without.

We also get confusing messages about how our diet should be. That we should eat three meals a day. Maybe we don't all actually need this. Are we eating because we are truly hungry or because they clock says it is time?

Eating more fuels more hunger. Eating a lot less when fasting radically decreases hunger. My personal experience

You are absolutely right but George Orwell wrote about this and explained why certain groups fall into the chips rather than crispbread trap. He nailed it.

I have to add that I get pissed off with folk in my support group who do the following

1. post about their amazing upcoming holiday that they'd enjoy much more without their apron - priorities folks!!

2. slag off restaurants etc who won't charge child prices for an adult meal made smaller
   The restaurant overheads are the same. I either have a starter or ask for a ruddy doggy bag OR drumroll realise now, that it's ok to eat until you are full and then leave leftovers!
   That was half my problem

Anyway. To summarise, cosmetic, tough. Making you ill so that you still can't work and still have carers and still claim benefits - consider that along with the physical side

The 'Why should alcoholics be able to get a transplant on the NHS' isn't a valid argument here. You can't pay privately for a transplant. There's no secret stash of livers on ice somewhere on Harley Street, for those with money. All donor organs are on the same register, and if you're 999th on the list to receive an organ, that's where you stay, whether you're a billionaire or homeless.

You CAN pay privately for bariatric surgery. A single liver transplant costs the NHS around £50k, so considerably more than a gastric bypass, yes. But the NHS is the only option for someone ill enough to warrant a transplant. If you want excess skin removed, you CAN pay for it.

Liver transplant assessment - whether you can be put on the waiting list, basically - is HUGELY strict. The stringent criteria came in after George Best destroyed his donated liver, and rightly so. If the need for transplant arose due to alcohol/intravenous drug abuse, candidates have to prove AT LEAST 6 months' documented sobriety before they're even considered for listing. They also have to sign a lifetime agreement to remain sober, and are expected to engage with addiction services unfunded by the NHS.

It also bears pointing out that liver cirrhosis is just as likely to be caused by being morbidly obese as it is by abusing alcohol. So who should take priority there? Addiction is addiction.

There are overlaps, it seems. No pun intended.
Just think it's sad that the NHS is having to deal with why is essentially a self-inflicted condition.

...with what...

But if we look at what are self inflicted conditions where do we stop? Smoking related illness, accidents through own negligence, pregnancy!

Smoking counts as an addiction, so we can add it to that particular pile.

As for accidents caused by negligence, fuck me, the NHS is there to treat that kind of thing. Pregnancy? What do you mean by that exactly? I had a botched EMCS that destroyed my abdominal wall and left me with ugly skin flaps, but the NHS did their job and delivered my baby alive. I don't expect them to do anything more.

It sounds like you're trying to compare things the NHS is ACTUALLY for, with things it has no obligation to provide, such as cosmetic issues cause by weight lost. Yes, those things DO cause self esteem issues, and in some of the more extreme cases mentioned on this thread, occasionally result in horrible infections. In the case of infection that endangers life, steps should be taken. But just being unhappy with your appearance? No. The facility is there to pay for it privately. If you can't afford it, save up. But at least private treatment IS there.

I'm not going to get into an argument about an individual's personal ability to pay for weight loss/cosmetic surgery. That isn't my point. My point is, it's THERE. Privately funded transplants are not.

I do think though that with the prescribing of things like steroids for illnesses we as a society need to start looking at QUALITY of life rather than QUANTITY of life

I agree, in a context of informed consent. I have a Dignitas exit plan laid out that I am actively saving for, because apparently I have no legal right to a DNR or a living will over here. Having witnessed rage, rage against the dying of the light in action, for myself I am rather more attracted to going out with a speedy, painless whimper. I'd rather die several months too early than a day too late. In theory at least. Will have to see how I feel about it in practice when the "something sinister, poor prognosis" shit hits the fan.

When a focus of quality of life comes combined with increased costs it has to weighed against the realities of finite, and ever shrinking, resources. When a more expensive drug is OKed for one condition it automatically shrinks the pot, meaning another condition can't be prescribed the newer, more expensive drug with less horrible side effects. Or they have their wait times for treatment extended. Or they get lumbered with the staff cuts leading to less access to services. Or the new piece of equipment that will enhance their quality of life can't be purchased in adequate volume to make a notable difference to the group as a whole.

So we are back to "whose more expensive+better meds/equipment/staffing levels/reduced wait time for treatment do you deny? In order to free up funds for non-weight gain inducing medication for X group, in the entirely justified belief that quality of life matters"

The twats who bully overweight ppl in the street cant possibly know if its through overeating or for medical reasons

I long ago came to the conclusion that Twats on the street generally don't care about the reasons behind the characteristic that they are currently target for abuse.

They only care that there is a handy target available. For example, it's no state secret that a significant number of homeless teenagers over the years have ended up where they are due to issues like sexual/physical abuse in the home and being discharged abruptly from care. That hasn't stopped twats hurling vicious abuse, spitting, chucking liquids and rubbish, aiming a stream of urine at them and terrorising for fun. Abusive Twats are also a decent chunk of the reason why the mentally ill are in far more danger from the general public than the other way around.

So, you have my every sympathy and solidarity on the twats front. 20 years of attracting them in droves, due to the high visibility and clear vulnerability of the evidently unwell woman I was trying to persuade to come home, did much to erode what little faith I had left in humanity after spending a chunk of my formative years in the poverty pit.

I long ago came to the conclusion that Twats on the street generally don't care about the reasons behind the characteristic that they are currently target for abuse.

This. I've personally known several people to die from cirrhosis of the liver. A couple were alcoholics. A couple contracted hepatitis B from blood transfusions in the past. One had haemochromatosis, which is an excessive buildup of iron in the liver. One, tragically, was a 4 year old who had cryptogenic cirrhosis, which was through no known cause.

All of those people, bar the child, were assumed to be drunks.

Organs are transplanted on location and suitability.

If an alcoholic is 90% match, and a non alcoholic is 40% the alcoholic would get it.
Better not to throw the liver away completely.