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 believe some areas do 8 weeks ww or slimming world membership and presumably longer for some people but like a lot of bhs services now it's a postcode lottery and some areas don't offer it.

phoenix Some areas offer 12 weeks slimming world or weight watchers vouchers. I do agree that obesity services in the NHS are poor and that we need to be tackling things as a preventive measure as well as better addressing the issues.

People are still posting on this thread how discriminatory (!) it is to deny people NHS services if they are obese but they're not really engaging their logical brains, just expressing OUTRAGE!!!!!!The risks of general anaesthetic are much higher if you're obese. It's the same for smoking, hence why people are asked to stop smoking before elective operations too.

It is a bit baffling why some people on here are getting themselves all worked up because this isn't really news. This has been going on for a couple of decades, at least. It's common sense.

People expect too much of the NHS anyway. Personal responsibility has gone out the window. I work for a government organisation and a survey showed that the NHS can only actually treat or manage around 20% of things that come through their door because the rest of it is down to choice and lifestyle management. How many people don't bother to do physiotherapy exercises after operations? How many people miss follow ups? How many people miss dentist appointments when it's known that, for certain conditions, oral care is paramount? I am not saying that there aren't reasons. Money is a factor, as is ability to get to hospital appointments, social support and mental illness etc. My point is that the NHS cannot "fix" what people would like it to.

I don't think people have been reading things right. An obese person won't have to wait until they are not obese- if they lost 10% of their body weight they would get their elective surgery. And certain people would be excused- I'm guessing those that have little control over their weight due to medical issues.

Actually, some of us find it problematic exactly because of little details like that. The sort of thing that makes it sound punitive rather than clinically based.

If someone's BMI means a certain procedure or anaesthesia is dangerous, surely that's the case however they arrived at that size? If someone will be allowed an elective procedure within a year if they lose 10% of their body weight even if still obese, how can it possibly be clinically justified to deny it to a person with the same BMI or possibly even a lower one because they've not lost weight? You're basically using access to elective procedures as a reward and punishment scheme. Understand that some of us have funny ideas like these things should be based on clinical need.

It's quite obvious that some of you don't understand the risks to the patient of operating when they are obese. Yes, it saves money but also, it's unethical to undertake a fairly big operation like a hip replacement on someone who is obese.

This is a rather broad claim. I'm aware that there comes a certain point when it becomes pointless and the risks outweigh the benefits, but are you really saying that point is a BMI of 30? Evidence?

I disagree with this.

I had a member of my family struggle with mental illness for years. They went to see a GP twenty years ago and was told to pull themselves together and deal. I could never get them to go back. This family member knew that smoking/drinking/drugs are not the answer, so ended up self medicating with sugar. It wasn't until 2 years ago, when they hit rock bottom and almost lost their life, that I finally got them help. But by then, they were 8 stone over weight and the medication makes you put on weight.

Luckily, they're physically fit enough not to need this type of help from the NHS yet. But I wonder what the future holds, as hip or knee replacement for someone who needs it would increase mobility, fitness and lift your mood. I feel this is incredibly short sighted and is being utilised as fat hating is the only acceptable discrimination left.

Also isn't smoking/drinking/drugs/dangerous behaviour/sex ...or any vice, a self medicating behaviour to deal with a larger problem? Isn't this the thin end of the wedge? Will skin cancer end up not be treated if you have a tan? What happens if/when they come for your particular peccadillo?

I truly feel that we are being trained to fall out of love with the NHS, so it can be dismantled.

My understanding of the reasons for this is to save money. NHS england are saying should be on a case by case basis rather than a blanket rule and if the trust persists with this they may step in to prevent it.

Whilst I think these decisions should be done on clinical grounds and so this plan should be rethought, it is a reflection of the strain the NHS is under. If politicians would actually do what they are elected to do, they would have the guts to face up to this- perhaps have a cross party committee or similar- to look into where we are going. We have choices here- if we want the NHS to do everything, for everybody and in a timely fashion (and especially if we want routine work done 7 days a week) then we need to look into what that will actually cost. If we can't afford that or don't want to pay for that level of service then as a country we need to decide what level of funding we want or can afford and shape services accordingly. I wish politicians would stop misleading the public that they can have everything for the same or less funding.

I'd also say the trust do have a point regarding the finances- statistically speaking those who are obese do have a higher likelihood of intra-operative or post-op complications and so requiring a longer recovery time, often requiring a longer in-patient stay and more post-op rehabilitation. That means, statistically, that for the same procedure patients who are obese are more likely to cost the NHS more than a patient with a normal BMI. It just doesn't seem fair to restrict on anything other than clinical grounds.

Was watching the BBC report on this. They had the usual filming of anonymous people from the chest down. Most of them were very overweight but one was much smaller with a belly overhang.

In other words someone who has lost weight. ITV NEWS pulled this shit a few months ago.

If they are going to film people anonymously at least learn to tell the fucking difference between weight and loose skin you fuckers.

No the person in the film wasnt me but i know loose skin when i see it.

That's fine, but give me my significant taxes back (£20k last year alone) so that I can spend it on private medicine!

I feel.uncomfortable that somebody who has paid into the system all their life could not access certain health care if they were obese.

Yet somebody who contributes nothing, but takes and takes who, say has been in a self inflicted fight in a club, in which others are also harmed, can access treatment.

It's a slippery slope

I hate this idea and agree with the slippery slope argument.

Yes, if it's only for elective surgery that has a reduced chance of success due to weight or is dangerous to the person due to their weight then I think that is fine. But that can be case by case, it doesn't need a policy. All the policy does is allow the number of people refused surgery to grow grow and the reasons for it to become more and more about cost and not health.

It also massively increases discrimination against fat people because it allows people official justification for their prejudiced opinions.

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

Sure - but a few years ago I was eating 'shit food and too much of it'. The difference between me and an obese person was that I threw every single bit back up again and weighed less than 6 stone. The NHS covered my 4 week long hospital stay - rather more expensive than the knee replacement I might have needed had I kept the food down, I think.

For many years before that I was eating shit food and almost nothing of it. When I was a teenager the NHS covered my 4 month long hospital stay. Serious money. Now I eat very healthy food but still not enough of it. I don't need much medical intervention but it happens. And is still expensive and still self inflicted.

But I have encountered little if any judgement for my food abuse and cost to the NHS - because I am skinny not fat. That's the only difference. And it isn't fair. Should eating disorders be treated but obesity not? And if you think that then do you draw the line at all mental health? Self harmers do it to themselves, depressives take the overdose with their own hands, that anxious or stressed person should just pull themselves together and go to work. And what if their mental health has affected their physical health? Tough? Then, once you've ruled all mental health sufferers out of free treatment the process would start again with grading the worthiness of those with physical conditions. It would never end.

The NHS only has a certain amount of money. It has to draw lines somewhere.

This ruling will only be for people who need non urgent surgery. It will save money because people with a BMI over 30, take much longer to recover from surgery and the results aren't as good. I don't see the problem in asking obese people to lose some weight.

They must be provided with support and help though.

Gallstones is classed as non emergency surgery but is excrutiatingly painful. I had to wait nearly a year AFTER my weight loss.

Leaving anyone in that amount of pain when something can/should be done is inhumane.

Does this mean that obese people will get a refund on some of their tax/ national insurance? If they aren't able to access services they should be refunded so they can pay privately.

www.dailymail.co.uk/news/article-2365464/Man-41-died-gallstones-begging-999-operator-GP-ambulance-told-bath.html

They need a better system than BMI then, they can fuck off with that one
They seem to have a thing that anyone over a BMI of 30 needs larger beds, ambulances, special care etc etc
I've just had an op. Came round and was discharged about 90 mins later, no problem. My weight wasn't even mentioned
I exercise, walk, pole fitness, ride my horse, eat well etc etc
Both pics I'm over 30 on BMI
Yes, before someone starts pointing out my chubby thighs, I'm not slim but I build muscle v easily and I'm not built like a "female" as such - broad shoulders, big feet, tall

So if the NHS only has limited funds then don't target the obese, target those that don't pay in, like poor people!

I am being asked to pay taxes and NI contributions and then I am refused treatment when someone who hasn't and probably will never contribute gets all the treatment that they need!

If this were a company and people had the option of not paying if they didn't get the service then it would go bust!

It should be purely based on medical reasons ie. if being overweight is going to adversely affect the surgery then by all means, refuse it. If it is just to save money then it is very unfair.

If we are going to restrict access to medical services based on lifestyle choices then where could that lead? Maybe I shouldn't have been operated on after my skiing accident?

First they came for the Jobless and you said

'That's ok I have a job'

Then they came for the disabled and you said

'That's ok I'm not disabled'

Then they came for the obese........so on and so forth, the tories will keep giving you thise 'deserving' and 'undeserving' rhetoric and still some of you swallow it, good luck with that

Good. I'm glad about this and I'm overweigjt

I think they are trying to create some obvious consequences of obesity faced with growing levels of obesity in both children and adults. The obvious consequence should be your health will suffer, but then the obvious answer to that is "the NHS will sort it out". That's the bit they are trying to break the link with.

My parents have both been obese and have had various health issues (knee joint replacements, mini strokes, heart issues, borderline diabetes, high cholesterol, high blood pressure) that are likely linked to their obesity but they DO NOT connect their weight AT ALL with these health issues. It's just "something that happens" to people.

It has been very frustrating sitting in hospitals over the years knowing that their obesity (and not taking care of their health i.e. excersise, drinking etc) has contributed at least if not caused their health issues.

My mum has been 6 stone overweight but still thinks she's "not that bad" compared to some people and when she's got flattering draped clothes on and her hair and makeup done. She judges it purely on looks though, again, she DOES NOT think about the health issue at all. The current "fat and fabulous" movement makes it easier to ignore the health angle too.]

I am relieved to say that they have both been on a healthy eating plan and have since lost weight, taking them into the overweight category instead of obese.

So back to the point, I think something that draws attention to the consequences of obesity and directs people back to taking responsibility for their weight... it's not perfect, but I think it has to help in some way.

alegretto don't you have holiday insurance when you go skiing?

Totally understand the logic to be fair - if a medical issue is linked to lifestyle choices you have made and you are required to show a willingness to change them then by all means.

However bmi is a ridiculous measure of health so shouldn't be based on bmi. There's much more accurate ways of measuring whether someone carries muscle or fat, or indeed carries their weight dangerously.

MylaMimi - I didn't unfortunately! I wasn't intending on skiing but DH suggested I give it a go so I blame him!

To be fair, I wasn't actually skiing at the time, more like just falling over with skis attached.

Can you define much longer bakeoffcake, and provide evidence that someone with eg a BMI of 31 would be so affected? I've heard a lot of assertions like that on this thread and I'm aware the risks get higher the more overweight you are, broadly speaking, but nobody seems to be quantifying.