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?

Well done on the loss though Sally

BMW6

People arent purposely going to become obese if skin removal surgery was available.

What a stupid thing to say.

Ive lost nearly 8 stone. I do have excess skin but it's not that bad when I have clothes on, I mentioned it to a friend and she said i didn't have an, i showed her and she said you can't tell which cheered me up at bit

YY Username I got the same reaction from a friend too.

Sir

If people were in control why would they be choosing to buy trolleys full of unhealthy foods?
Why don't they choose not to?

I have explained what I believe the problem is, environmental, physical (hormonal) and psychological.
It can also be cultural.
Obesity is also more prevalent in lower socioeconomic groups.

I don't know what the solution is, but blaming people who feel shitty enough is not it.

My heart goes out to everyone reading who is trying to tackle these issues.

It should definitely be available, I know someone who was in this situation. Not doing it isn't free to the NHS as she ended up on anti depressants and was at risk of developing infections in the excess skin.

Regarding the sausage debate, and bulking up quality meats with this or that, if you bulk with fresh ingredients they a) have a short shelf life, b) are more expensive, c) you have to transport them home and D) have the knowledge and equipment to turn them into healthy food. If you are buying tinned food, you still have to have time and money to go and get it and transport it, as well as the skills to prepare it.
This is something you won't comprehend if you are not reliant on public transport on a very tight schedule and very limited budget. People saying it is an excuse very obviously have not been in that position.

This was true 30+ years ago. When I was 16-21 and living mostly on biscuits, cheap chocolate and cardboard white loaves bought from the corner shop.

Squats and the cheapest (mouldy) bedsits offered no, or minimal kitchens.

Electricity was not a given, cos the meter ate 50p pieces like they were going out of fashion. Or it was off, cos they were trying to force us out of the squat.

I walked everywhere. Public transport was lousy, not that it made any difference cos I couldn't afford the fare. Which made a trips to a supermarket with family packs of biscuits pretty much impossible. We tried walking once. But there were no pavements and cars hurtled past us like we weren't there. I didn't fancy repeating the exercise. I wasn't prepared to risk death, or maiming for a better deal on imitation shortbread fingers.

There were so many of us living a cold, hungry existence on nutritionally valueless foods, chosen for the greatest hunger staving qualities possible, for as few coins as possible. The number of us down there in the poverty pit with moderate-severe mental health issues was staggering. I have never since seen such a concentration of abandoned people, in dire need of psychiatrist services, in a single community.

Few of us were overweight. Fewer still were obese. Most of us were on the scrawny side. Because when all you can afford/get to is an overpriced packet of biscuits, the conditions that dictate that set of circumstances also dictates that you have to eek them out.

Poverty is not a new invention. A lack of access to a kitchen was rife in the 80s, and earlier. People stuck with an exorbitantly priced local shop stocked in the main with shitty quality, packaged/processed food has been around at least since I was 16 and in that position, and I'm nearly 50.

It doesn't seem logical to look at the rise of obesity and point the finger at conditions that have been with us for decades.

The packet of crappy biscuits probably costs much less in real terms now. Cos the cost of food in the UK is now ridiculously cheap compared to the past, and other European countries. But the realities of my existence down in the poverty pit would not have translated into more biscuits. More that I would have been able to reduce the proportion I spent on food and been able to buy other things I needed, but went without. Like toothpaste, shampoo and washing powder (so I could wash my clothes in the bath more often). Cos a lack of those 3 things was a real impediment to finding and keeping a job.

I don't believe that excess skin is always just a cosmetic thing though.
If you lose a lot of weight then the excess skin can be a physical thing too.
Or so it seems from some of the US programmes I've seen re very obese people losing a lot.

So yes, I think it should be available on the NHS. Or at least considered, on a case-by-case basis.

For further information on the facts google your local CCG website for the list of "procedures of limited clinical value" and the the hoops you have to go through for "individual funding requests"
Both have long lists of things including a lot of pain procedures such as injections. It is getting to the point GPs can't refer anything without prior approval for the cost.
Very depressing reading as the list gets longer each year

As other posters have said, OP, you may not necessarily have loose skin. And if you lose the weight slowly and in combination with exercise, it's even more unlikely.

My sister lost 5st (she's short, too, so proportionally more of her body weight than you, I'd guess) and had no loose skin at all.
She was back in size 16 clothes and the fittest she'd ever been. She did it with gym sessions plus dancing and Zumba, and slimming world (12 weeks funded by the NHS and carried on paying afterwards).

Problem was though, she's lost and gained the weight ever since, getting heavier and heavier each time. Skin removal surgery (if she'd needed it) wouldn't have solved her underlying issues with overeating and emotional eating.

She's been through every NHS service available, including counselling, a personal trainer, funded gym sessions and funded Slimming World.
But she knows the real change has to come from her - and that will involve making a resolution to eat healthily for life, rather than months of dieting and then back to daily "treats."

So yes, I think it should be available on the NHS. Or at least considered, on a case-by-case basis

Whose health care would you deny in order to pay for it ?

One poster has pointed out that it isn't unheard of for people with gall stones to be left in such agony that they consider sucide, or die of a heart attack.

Mental health services are so stretched that people who are danger to themselves are left without the crisis help they need. All. The. Time.

Paediatricians are playing eenie meeny miny mo with very ill babies to see which one gets the cot that improves outcomes.

In a perfect world who of us wouldn't wave a magic wand and create a health service that helped everybody, regardless as to what they had wrong with them and why ? Almost nobody.

But it isn't perfect world. IMO there isn't any real chance of most health services in Europe going anywhere other than down for at least a decade, if not an awful lot longer. IMO Europe is likely going to move/stick to centre right or lurch a bit further right for the foreseeable future. Which doesn't bode well for expanded availability of procedures/care in anybody's health service. Or any other branch of a welfare state. Especially since I believe we are entering a period of sharp shock and extended economic/political uncertainty as the EU wobbles mightily, and either struggles to regroup, or falls apart at the seams. Which is something that I don't think the UK will be utterly immune from.

Those are the real circumstances under which choices as to who and what gets treated must be made today and tomorrow. Case by case is an incredibly expensive process because it involves consultations, admin and appeal. If anything I reckon wholesale blanket bans whereby GPs can't refer at all for certain procedures will become ever more prevelant.

People who end up with acute conditions (septicaemia, dire infections) caused by loose skin will have those symptoms treated as emergency cases. Some may end up with a skin removal procedure as a result. But likely only on the area that is causing the current trouble. With the aesthetics of the result being the least of any considerations.

I also think obesity and addictions (drugs/alcohol) are going to be the waggled conditions that are used to soften up the general public to ever more swathing cuts into disability support, both economic and services. So the chances of it costing more to leave a person untreated will shrink. Possibly dramatically. They won't cost as much untreated if their condition no longer qualifies for disability support, or their unemployment benefits become time limited, or mainly contribution based. If NHS moves towards "not entirely free at point of treatment" and they have to co-pay for their meds and services due to the medical fall out of loose skin, they become cheaper still left untreated. Especially if they can't afford their cut so the NHS doesn't pay the balance, cos no treatment happens.

If wishes were fishes everybody would get the healthcare they needed, mental and physical. That would include people stuck in a cycle of over eating. Who would have a personalised plan with extensive support and evidence based care tweaked to their individual circumstances. For as long as they needed it. Plus any procedures required to put right any conditions that resulted from the sought and supported weight loss.

If the above happens, look down. And see the snowstorm in hell.

Because that is not the direction the world is going in. In my lifetime I expect to see a very clear beginning of the end of the welfare state.

It might come back one day, when I'm long dead and gone. But I believe it will probably cycle out and only return once people's expectations have been completely reset and the thorny issues of the day are about leaving people to die for entirely treatable conditions due to inability to pay, rather than leaving them with loose skin after weight loss.

Excellent post, iPost!

The NHS need to stop giving out mixed messages on this issue.

a. They need to stop peddling the low fat myth when its sugar thats the problem.
b. they need to stop prescribing certain drugs that affect weight just because those drugs are cheaper.
c. more help needs to be available for carers like my cousin who has been neglecting his own health for selfless reasons. Instead of waiting until my aunt and uncle arent around anymore and THEN moaning at him about his weight when its very handy for them to have him in the position hes in at the moment.
d. there needs to be a big publicity drive against fast fix diets And slimming clubs and VLCDS who encourage and push for fast results.

It is not a healthy way of losing weight and a big risk factor for gallstones and other health problems.

I suspect there would be as much reluctance to tackle the diet industry as there is the food industry..............money.

But you cant have it both ways!!!

Helena Those drugs that cause weight gain are not new. In fact, they used to be prescribed far more often than they are now as there are newer treatments.

An MNer posted on a previous thread how she was gaslighted by a consultant.

That consultant had a go at her about her weight while writing out yet another prescription for steroids.

It was because the MNer "lost it" with the consultant that the next time she got the alternative which had a lot less chance of weight gain but was more expensive.........the £12"000 a year injections.

Like i said they cant have it both ways!

ipost there are a lot of disabilities that cause obesity.

My sister has lost 5 stone up to now and has about three to go but has no excess skin. Do it slowly.

Ive lost 10 stone and i will take no risk that would fuck that up. If i ever get ill (touches wooden coffee table) and im prescribed anything like steroids or anything that im suspicious about.........the prescription wont even get filled..........it would go in our shredder.

No way im taking any risks or taking anything like this only to be blamed and gaslighted for it afterwards.

Ive worked fucking hard to get this weight off and its staying off NO MATTER WHAT I HAVE TO DO.

I lost 7 st last year through running and calorie counting. Not sure this is relevant but I have carried and given birth naturally to two children. Youngest being 5. I panicked that I would need excess skin removal but I didn't and I get into a 6/8 now with no overhang. I am nearly 40.

Don't be afraid. May not happen.

That doesn't really address the point that steroids have always been around. In fact, they were prescribed much more freely and for longer periods than they are now. I do think the NHS needs to provide targeted and good quality dietician support for people with weight issues and the mental health support is shocking. However, I don't think blaming them for various other issue is the answer. People need to stop making excuses...and I say this as a fat person who has been on high doses of steroids!

Im simply saying they need to stop giving out mixed messages with regards to weight.

If they did the same with smoking and drinking the press would have a field day.

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.

Pointing the finger at people does not help.

Stretched skin is stretched skin, it stretches on the way out not on the way back, losing weight slowly will not help stretched skin.

Interestingly the woman who criticises my weight POST weight loss in RL is five stone heavier than me..............

YY Friend of Bill. there are a lot of ignorant uneducated comments made about loose skin.

I was actually told by 2 people that i could excersise it off.

My doctor had the good grace to laugh when i told him and he said "theyve got no idea what they are talking about"

It should absolutly Be allowed on NHS.

Maybe if the government wasn't purposely fucking the NHS up to have a excuse to privatise it or stop paying fucking fat cats ridiculous amounts who 'manage' hospitals there would be money in the kitty.