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Obese people to be refused surgery

458 replies

ReallyReallyNearly · 03/09/2016 09:02

Isn't this just another form of discrimination, www.bbc.co.uk/news/uk-england-york-north-yorkshire-37265752
Argument seems to be on financial reason rather than health, do we stop nhs services for people who smoke, or those who drink too much etc. Where does one draw a line?!

OP posts:
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8
Runningupthathill82 · 04/09/2016 16:18

As others have said, this isn't new. My grandmother was told in the 80s that she needed to lose weight for a hip replacement. She never did it, and died in her 60s from a heart attack.

Right up until she died, she'd been in massive denial about the extent of her weight problem. She said she was "only" a size 16; she could walk for hours so wasn't unfit; she wasn't anywhere near the biggest person she knew; she didn't eat "bad" foods. And she didn't, really. She just ate huge portions and convinced herself they were normal.

But the fact was, she was clinically obese, spent her whole life obese, and died obese, from an obesity-related heart attack. And there are far more people like her now than there were 15 years ago, when she died.
You can see them on this thread, saying their BMI might put them in the obese category but they're not that big, not really.

Which is why it's so hard to do anything from a public health perspective. When you've got 65% of adults in the UK now being overweight or obese, how can you possibly tackle that when a large proportion of those people seem not to think there's a problem?

FWIW, I used to be big. I told myself for years it was just my build, I was naturally that size (big feet etc) and I was fit at the size I was (I was fit - I ran marathons). It took losing the weight and seeing my "new" body to make me realise I wasn't naturally big at all.

What was worrying though, was when I lost weight, getting to an ideal BMI, people were queuing up to tell me I was "gaunt." Being overweight is the norm now. It's positively encouraged, with the whole "treat yourself, here have a cupcake" culture.

Encouraging obese patients to lose weight before operations is a good idea in theory, but in practise is little more than pissing in the wind. The problem is so much greater than this and needs tackling on individual, community and national levels - but nothing can escape the fact that the obesity crisis is primarily down to individuals and what they choose to eat.

bakeoffcake · 04/09/2016 16:39

Running I agree with most of what you just posted. I do however believe that govt has a responsibility to make it easier for people to stay healthy. That should bring in revolutionary (for this country) laws, such as all new housing and roads must incorporate cycle paths, all supermarkets must have an equal amount of offers on fruit and veg that they have on crisps, cake, coke etc. All products must have the number of teaspoons of sugar clearly on the front of the packet.
Anyone wanting to lose weight should be given free advice and help(like they do with smoking) they're are lots of other things too but I think it's very important that an individual trying to lose weight and/or eat healthily, is allowed to get on with it with support of society, shops, infrastructure etc.

HazelBite · 04/09/2016 16:43

I had both knees replaced last year. the surgeon told me that as I was still working ie active, only slightly overweight he would recommend me for the procedure.
1lb of extra weight puts 3lb of extra pressure through your knees! if you were hugely overweight you wouldn't easily be able to do the exercises that you have to do during recovery.

I think it is acceptable for doctors to insist for weight loss before hip and knee replacements are offered.

Shiningexample · 04/09/2016 16:56

I wonder if it would make any difference to people behaviour?

Pretty sure that obesity rates in the USA are even worse than ours and I think it's hard to get medical treatment there unless you have insurance

insurance which would surely be more expensive if have risk factors such as obesity or smoking?

I know it isn't always useful to extrapolate from one culture/country to another but even so...food for thought?

Catsrus · 04/09/2016 16:58

What was worrying though, was when I lost weight, getting to an ideal BMI, people were queuing up to tell me I was "gaunt." Being overweight is the norm now. It's positively encouraged, with the whole "treat yourself, here have a cupcake" culture

^ this. And vanity sizing doesn't help. I've been thrilled to get down to a size 10 skirt / jeans from a size 16 in the last few years. I was offered some lovely summer skirts by a friend having a clear out - they were from the 1980's and so very "Laura Ashley" - quite on trend now. They were size 16 so I was sure they would be too big, but they fit perfectly Shock. A lovely smart size 10 skirt from the charity shop, likewise, far too small. Every high street shop I go in I'm a standard size 10.

I'm getting lots of "don't lose any more weight will you?" Comments now - while my BMI is fine (19ish) my waist is still thick, 33inches - according to all the literature I need to lose more weight around my waist, so I'm aiming to do that.

We don't have limitless resources on the NHS - decisions have to be made where to use them. Some people are effectively killing themselves with things like food, alcohol, drugs, tobacco - their prognosis for recovery from surgery is often not good, the care they need during surgery is hugely more than for patients without those issues .... I think hard decisions do have to be made. I've got family members waiting for elective surgery - one is in her 70's, obese with sleep apnoea, the other in their 20's, fit and otherwise healthy. Of course I want both to have the surgery they need - but I recognise that one will be hugely more expensive and complicated than the other. That's a simple fact. Somewhere, someone has to decide where the resources go.

Personally I'd scrap trident and fund the NHS fully - but that's not going to happen in the next 12 months is it!

HelenaDove · 04/09/2016 17:14

I have an old FITTED size 12 skirt i can now get into. My waist is quite small. Im an hourglass and cant change my natural body shape.

Richard Carpenter was talking about his sister Karen on a TV show last night and said Karen was a natural hourglass which is what most women used to aspire too. Now its all thin thin thin.

I was thrilled to get down to a size 12/14 from a 28. Its only women who seem to want to piss on my chips though. Havent had one negative comment from a man.

Sunshineonacloudyday · 04/09/2016 17:26

Helena Karen Carpenter had an eating disorder thats what killed her in the end. Her brother is a cretin.

Sounbelievablydull · 04/09/2016 17:35

Really it's just the demise of the nhs
We will miss it when it's gone

SoupDragon · 04/09/2016 17:38

Sunshineonacloudyday I think you've misunderstood the point about Karen Carpenter. She was an hourglass trying to be thin.

HelenaDove · 04/09/2016 17:47

YY Soup Thats what i meant.

Topseyt · 04/09/2016 17:52

I was rendered overweight by a thyroid condition (now under control by medication).

It has been nearly impossible to lose the weight despite eating sensibly and usually healthily, exercising regularly (usually daily with two dogs to walk) etc.

I hardly drink and have never been a smoker.

I always feel threatened by this sort of article, even though it also makes some fair points.

It is unfair on people who do take responsibility for their health but who are still overweight or obese. People judge us. They think that we are all lazy-arse couch potatoes and if we would just move around more and eat less then all of our problems would magically disappear.

If only!

HelenaDove · 04/09/2016 17:56

bakeofcake i walked down to my parents last night in the rain. What was usually a forty min walk took nearly an hour...........because the pavements are in such a bad state there were deep puddles everywhere which to avoid i had to walk closer to the road which then heightened the risk of being splashed by cars. It was more like a prolonged game of hopscotch than a walk.

If we want more people to walk (which i do do regularly) letting pavements get into such a shitty state isnt going to help.

Sunshineonacloudyday · 04/09/2016 17:56

You can reach an ideal weight through eating sensibly and working out. You don't need a doctor to tell you that. The person needs to be motivated to lose weight or it won't happen. Back in the 90's I never saw many fat people I can count on one hand how many I saw. I lived in London back then and you had to be active to get around. Now I live in a town you don't see much activity going on.

Sunshineonacloudyday · 04/09/2016 17:57

Helena I misread what you posted. Blush

BoneyBackJefferson · 04/09/2016 17:58

Sunshineonacloudyday
You can reach an ideal weight through eating sensibly and working out

You missed out "in most cases"

fakenamefornow · 04/09/2016 17:58

A friend of mine had IVF, this wasn't funded on the NHS in her area even though she was early thirties, trying for five years, she had to pay privately. Ok, fine, she didn't have much of a problem with this, after all, in her words, she wasn't sick. What did really piss her off though was that she was told she also had to buy insurance to cover any emergencies or complications that might arise as a result of the treatment because the NHS could well seek to recover any costs of treatment from her because it would have been the result of private treatment going wrong. I think this was the case with the breast implants that proved problematic.

Groovee · 04/09/2016 18:00

The consultant at one of my appointments says I have to be below at least 40 BMI before she will consider surgery. This is because of the risks to me under anaesthetic. I'm trying hard.

HelenaDove · 04/09/2016 18:01

An ideal weight shouldnt include loose skin being calculated as part of your weight though.

SallyVating on the other thread has been told to get her weight down by another 4 stone which coincidentally Hmm is exactly what her loose skin weighs Hmm

If it was her husband classing loose skin as weight people would be saying it was abusive Why is it any different when the medical profession does it.

fakenamefornow · 04/09/2016 18:01

Sorry I meant to add that I think making my friend pay for private medical insurance because the NHS wouldn't treat her for free much more of an issue than requiring overweight patients to loose weight before surgery.

HelenaDove · 04/09/2016 18:03

No probs Sunshine.

whattheseithakasmean · 04/09/2016 18:06

Karen Carpenter was a very troubled and unwell woman whose problems went well beyond trying to be thin. I can see how that narrative would suit her family, but I think it is over simplistic and unhelpful.

Decisions should be made on clinical need and effectiveness. A knee replacement will be wasted on someone so fat they will just fuck their new knees. On a slim elderly person (such as my mum) it can be life enhancing, leading to many more useful, fit and healthy years.

Doctors must get so fed up with fat people complaining about being unwell, when the one thing that would really help is the one thing the doctor cannot do for them. Lose weight first - many clinical interventions may be prevented to begin with if you have a healthy BMI.

AnnabelC · 04/09/2016 18:12

But overweight people who work pay into the system. End of!

HelenaDove · 04/09/2016 18:12

Fine. But you dont tell someone to lose 4 stone when that is loose skin. Its abusive.

Helenefischer · 04/09/2016 18:14

I think the problem is with all addictions drinking, smoking and eating is acdenial thing and they hold no belief they can help themselves if anything rather than paying expensive surgeries they should be admitted to an eating rehab for a certain period of time to control food intake and regular exercise if they want surgeries they then need to pay. A rehab is a good enough NHS responsibility as opposed to paying surgeries as that is a quick fix and not necessarily a long term solution. Getting control and believing in your success is achievable

prettylegsgr8bigknockers · 04/09/2016 18:23

AAAARGH. Such a vexed question. Each case must be taken on its merits, people are individuals and taking a blanket view is difficult. (Ps have glass of rose in hand looking forward to cheese and biscuits later....)