Obese people to be refused surgery

[ReallyReallyNearly]

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?!

I was reading can't remember where that the rise in running for ordinary people has seen a rise in ligament and joint damage that's self inflicted

No you ate not going to turn away sport injuries as self inflicted because they are accidents after taking safety precautions (helmets, gum shields, shin pads etc)

As much as there will be people out there who are obese through injury or illness many simply eat shit food and too much of it. There are people out there who are to blame for their own predicament. Going round with a softly softly approach won't always work

Before I had an opperation I had to loose 10% of my weight so it wouldn't be such a strain on my heart ect. I struggled but managed it. However it took me the best part of 9 months to do so. My concern is what if an obese person needed emergency surgery? Do we let them die?
I hate fatty bashing just as much as racism and prejudiced against all who are not sigh normal.
Maybe all the nhs services should carry a fee. Make it fair for all.
After all this is just what the government wants.
I hate the fact the government punishes obese people yet still won't put out a blanket ban on junk food advertising. Sugar tax and tax on convenience foods which are the route cause of obesity.
Anyway rant over.

The link between MH issues and addiction (food, alcohol, drugs, nicotine) is widely researched.
I would never advocate cutting services for addiction.
Treating a person who has an addiction can be frustrating, often seem futile and can seem like a complete waste of money to some but, having never been in that person's shoes, I don't want to see services cut.
I could rant about the motorcyclist who ends up needing thousands of £ of medical treatment / physio after coming of their bike at 100 MPH ...
Where does it begin and end?

My concern is what if an obese person needed emergency surgery? Do we let them die?

The policy will only apply to elective surgery for non life-threatening conditions.

A person who is injured while exercising has had an unlucky accident whilst doing something difficult which improves health

A person who is obese or who smokes has deliberately chosen to do things which are in every way detrimental to health

The two scenarios are not parallel

I think there needs to be some incentive to avoid things which are inherently harmful to health

Some surgeries are less successful in obese patients so I have no problem with them not being offered - it already happens. There is a weight cut off for heart transplants. I've got 2 patients who have said 'I'm never going to lose it' and accepted the consequences - basically early death, and another who got on with it, lost the weight and has now had her transplant and has a new lease of life.

Frankly if someone who can't exercise at all due to heart disease can lose weight with no dietetic input or other help, then it can be done but it is hard hard work. I've got other patients who've lost weight against the odds including bedbound ones - some people do it when the stakes are high enough but others do not.

People make their choices in different ways. Some people carry on smoking/doing extreme sports/eating unheathily - there are consequences for these actions.

In all honesty, yes I would like smokers suffering from a condition exacerbated by smoking to pay for treatment for that condition. -They do, through taxes.

People who smoke and/or are obese may actually be less of a burden long term due to the fact they are more likely to die younger, thus saving the NHS money that would be used to treat other health conditions more associated with more elderly people www.telegraph.co.uk/news/health/news/9359212/Obese-and-smokers-less-of-a-burden-on-the-NHS-than-the-healthy-who-live-longer-report.html

I think weight issues can be caused by many things. For many people it's a psychological issue. Get them some therapy and you could fix the problem that's causing them to comfort eat etc. For many many, it's due to medication (myself included, as I am on 3 different medications, all listing weight gain as a side effect). I don't think it's fair that due to my mental health problems - none of which have anything to do with weight - should mean that I have to pay if my weight is an issue. I think this is a very complex problem, and they shouldn't just draw the line on "BMI over 30: pay for your problems". It's simply unfair, and makes obese people even more of a target for discrimination and shaming. I am very much against this, and I don't even need any medical help for my weight.

This is really a hard one.

I don't necessarily disagree, though. They aren't refusing emergency or life saving operations, just routine procedures which evidence show are less effective and/or ineffective on people who are obese anyway.

This reminds me of my MIL. She is obese. I would say a size 18-20? Doesn't exercise and refuses to change her diet. Has been offered a free gym membership and referral to CBT. All refused.

Surprise surprise, she now has problems with her hip. She refused to go the doctor for about a year because "he will just tell me to lose weight".

Finally got to the point she couldn't walk up stairs. Went to doctor, who told her she needed to see an osteopath as well as lose weight. She refused to see the osteopath because he was make so went to see a female chiropractor instead. She was recommended six sessions and offered support to maintain hip and exercise it in safe, recuperative ways.

She will only go for three sessions because that's all she will get for free, and "why should she have to pay". She won't exercise because "they all just blame her weight".

The reality is a lack of exercise and refusing to address the issue, as well as carrying extra weight, is the problem!! No point in replacing the hip!!!

I agree that it's a bit of a slippery slope into refusing treatment of any kind of 'self-inflicted' illness and injury. Also presumably obese people will continue to pay their taxes and NI; all of which contribute to the NHS but receive no treatment?

I hate the fact the government punishes obese people yet still won't put out a blanket ban on junk food advertising. Sugar tax and tax on convenience foods which are the route cause of obesity.

Junk food advertising does not cause obesity.

But as a pp mentioned, if someone is refused surgery based on obesity grounds and is then forced to give up work, surely this will have more of a financial impact? My surgery was for an accident-horse related, I chose to be around horses. Should I have been told no (they couldn't refuse, it was a big serious thing!)? Plus I'm obese, maybe they should have turned me down.

Ah, I see Maud - So only 'category 3 ' patients? Makes sense then.

I agree with this policy because people need to be encouraged to take responsibility for their own health. However, people with long-term problems with maintaining a healthy weight need help and support, not vilification.

Obviously anyone who needs emergency surgery should get it regardless of their BMI/ lifestyle choices.

It's not a judgement on anybody, it's risk vs benefit.

Agree, it's a cost/benefit analysis

It depends. If they're depriving people whose bmi is over thirty, that's most athletic men, nearly all male athletes, certain racial groups who's natural build and muscle mass is larger.... That's the problem with one size fits all, it doesn't. People are different.

You cannot define obesity unless you're taking into account build, muscle mass and fat percentage.

Rejecting people who don't move, eat far to much and are genuinely fat in some instances can make sense because they're more likely to die or develop problems as a result of surgery. Often very fat people have hip/knee/other problems as a direct result of their excess weight and losing it could alleviate or even solve the issue.

If they're going to blanket ban everyone over a certain bmi which the article suggests then that is stupid and morally wrong.

So where does the line stop? Drug addicts? Alcoholics? Extreme sport enthusiasts? Cosmetic surgery addicts?. What about people on benefits - they don't contribute to the NHS so let's cross them off the list too.

the bmi rating is a load of nonsense

some people are above thuirty but still fit so do they automatically get refused?

I'm overweight, why because I'm in a wheelchair and my meds cause as the list of side effects say "rapid weight gain". I think this is unfair.

I agree with it. Obesity has become so 'normalised' in society that people don't believe they have to take any responsibility for their health. The NHS does not have infinite resources. It has to put limits somewhere.

It is discriminatory, clearly, but the North Yorkshire NHS are basically saying they're being forced into it due to extreme financial constraints. I wonder if decisions could be challenged legally?

I think refusing surgery without offering support to lose weight is unfair and wrong. It could be condemning some people to long term pain and reduced mobility (not going to help weight loss!), until their knee/hip problems become so bad it's no longer considered elective surgery.

I too am on the fence. Yes, some people need to told strictly that something needs to be done before a medical procedure can be performed. But, think it's a slippery slope to denying others medical attention.

The cosmetic surgery point is interesting. Surely nearly all cosmetic surgery is elective, apart from things like reconstruction after accidents, mastectomies etc? So should all NHS cosmetic surgery, bar reconstructive surgery or similar, be stopped due to lack of funds? Also what about fertility treatment? That is elective and non-life threatening too.