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AIBU?

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Original poster

Too fat for health treatment

96 replies

Megthehen · 12/10/2019 07:25

Shocked by colleagues agreeing with this today. They have both had very significant (life saving) medical treatment and surgery on their not obese bodies which they think should be denied to me and others of higher BMI. They did say that they didn't consider me to be part of this group but I am and would be if clinical rationing continues or expands so that I and others are deemed undeserving of medical help.

OP posts:
Orangecake123 · 12/10/2019 08:15

At my teaching hospital we were told that for that department they couldn't operate on anyone over 130kg mainly because they table they have wasn't reinforced and that it was harder for the surgeons.

Bariatric surgeons have more training, but it does add much more risks too.

Orangecake123 · 12/10/2019 08:17

(I've been anything from a size 12 to a 22. At my heaviest I was deeply unhappy and comfort eating did help. )

NotStayingIn · 12/10/2019 08:17

Why do you think it’s about being deserving/undeserving?

Anyone with a bit of common sense should be able to work out that it’s about the increased risk of an operation and it’s rate of success.

DisneyMadeMeDoIt · 12/10/2019 08:17

I think if it’s fair to withhold free surgery/treatment from smokers then it’s fair to withhold it from the (morbidly) obese! Both are addictions to substances which the over consumption of leads to poor health!

I say this as somebody who has been morbidly obese and who is highly prone to weight gain due to glandular issues. I get very frustrated when morbidly obese people try to justify their size as ‘unavoidable’ due to some medical issues which in reality just make it ‘a bit harder’ than it is for everyone else!

That attitude is akin to somebody in a wheel chair not having a career or ambition because facilitating it is harder for them 🤔 there is no excuse for not managing your weight (even with glandular issues...etc) I do it every day and have had a BMI of

Fuckenstein · 12/10/2019 08:19

I think your colleagues were a little tactless but their point isn't wrong.

If having surgery would be a great risk, greater than the benefits and you can reduce that risk by losing weight, then you absolutely should.

AJPTaylor · 12/10/2019 08:20

Not if it's life saving but otherwise it's always risks vs benefits

For example, I had to have a hysterectomy. Only had 4 weeks notice because it was serious. I had a bmi of 29 And doc told me to do everything I could to lose weight in that month. I managed about 12lbs.
After the op he told me that he had a whole list of patients that were candidates for surgery but it was about quality of life rather than life or death. But he could not in clear conscience put them under the knife when they had a bmi of 35/smoked etc as the risk was just too high.

DisneyMadeMeDoIt · 12/10/2019 08:20

^also from a medical point of view your chance of dying is significantly higher, it’s the anaesthesia that’s the problem. Unfortunately anaesthesia cannot be accused of fat shaming, it is what it is!

MoonlightDancer · 12/10/2019 08:23

I would rather somebody large get the help they need than the person who sits outside of a hospital puffing away on a cigarette and then puffing away on oxygen tanks every 5 seconds! I am large, classed as clinically obese due to sea combination things...poor diet, stress but mainly due to severe depression over the years!

My weight is slowly and surely going down but I will always be curvy as I was when I was as a child! People/Doctors really need to look at cases individually not just the bloody size of someone!!

LemonTT · 12/10/2019 08:26

The issue isn’t that they are denied medical treatment, it’s that some medical treatments are not appropriate because of their preexisting conditions. Essentially their weight will either have caused disease or conditions that mean certain interventions don’t or won’t have a positive outcome.

The medical team have to treat the whole person not just a symptom and sometimes that means tackling the weight issue first, or smoking or drinking and so on.

NotStayingIn · 12/10/2019 08:27

But OP yes I do agree that their conversation was most likely tactless and it seems like they didn’t really explain their reasons for holding that believe very well.

Interestedwoman · 12/10/2019 08:36

People with a very high BMI are not turned down due to discrimation. It's for reasons of the evidence showing the results for a particular treatment. Either the results are less effective, are there are more risks involved. Or, losing weight might even reverse the condition so no other intervention is needed at all.

Hope this helps.

HicDraconis · 12/10/2019 08:37

Your chance of dying is not significantly higher if you’re obese. At least not from the anaesthetic - I have looked after patients with bmi of 60+.

Your problems with complications, infections, wound healing, post op respiratory issues, the surgery not being successful - those are higher.

BillHadersNewWife · 12/10/2019 08:42

I would rather somebody large get the help they need than the person who sits outside of a hospital puffing away on a cigarette and then puffing away on oxygen tanks every 5 seconds

Oh well that's that settled then! Your preferences count! Hmm

Lockheart · 12/10/2019 08:43

Obesity, with the likely corresponding issues of poor diet and lack of exercise, can cause or exacerbate a host of medical problems.

In this case, the treatment should be help to lose weight, not surgery. If the underlying cause isn't properly addressed then all you're doing is shunting the problem further down the line. Additionally surgery is riskier for overweight patients, and of course more expensive.

It's not about deserving or undeserving, it's about the practical realities of the situation.

Similarly if someone has respiratory or pulmonary problems but is a 20-a-day smoker, I would hope the advice in the first instance is to stop smoking!

StormcloakNord · 12/10/2019 08:44

Is it true you won't get IVF if you're obese? Sad

My BMI is technically obese but you wouldn't think it to look at me. I'm a size 14 and whilst I'm not skinny I'm definitely not fat either.

If they go off your BMI that's sad, it's looking like I'll need IVF but if they won't do it I'll need to lose a heap of weight to get my BMI down!

DtPeabodysLoosePants · 12/10/2019 08:49

What's the treatment OP? We need more details.

SimonJT · 12/10/2019 08:51

@StormcloakNord IVF isn’t as successful in those who are obese, but obesity can also cause fertility problems in men and women, obesity can also increase the risk of complications during pregnancy and birth.

PrayingandHoping · 12/10/2019 08:53

@StormcloakNord in my area the female partner had bmi has to be under 30 for ivf funding on nhs

General nhs care.... it's not just overweight people excluded. If your bmi is underweight you also can't have needed ops. I have a family member who struggles being underweight (she is receiving a lot of help with this) and has been told no to certain procedures she needs for other reasons. It is dangerous if you aren't a healthy weight.

So it's not just a "fatist" thing

DisneyMadeMeDoIt · 12/10/2019 08:54

@StormcloakNord

It’s important to understand that ‘overweight’, ‘obese’ and ‘morbidly obese’ are not the same thing. I know lots of people in the ‘overweight’ category who are healthy to look at.

The BMI system was created at a time where food/society were very different to today, so it’s far from a fool proof tool to determine health! Those with high muscle tone...etc will show up as over weight so doctors with apply common sense. I don’t think those in the ‘overweight’ category will be penalised but if you fall into the obese or morbidly obese category you would likely be asked to lose weight before being offered IVF (that’s how it works here anyway).

SafetyAdvice0FeedWhenAgitated · 12/10/2019 08:54

I wonder what life saving treatment and surgery was it. Bypass? Tumour removal?... I have a feeling you were not talking about "life saving" treatment and surgery, were you.

Not only obese patients carry significantly higher risk of surgical complications during surgery itself, the risk of post op complications also lasts longer. So while healthy size person is out of the risk of x in a week, obese person is risk even 2 weeks after surgery.

Lougle · 12/10/2019 08:56

Many of our patients who are post-surgery in ITU have their obesity listed as part of the reason that they are admitted. For some of them, it's the only reason.

Obesity means that anaesthetic times are longer, because the surgeon has to cut down through all the fat to get to the organ. There will be fat around the organs. When they try to get access, they will have to pull much harder to reach down through the fat layers.

When the patient is recovering, laying down puts pressure on the lungs. They will be less able to adjust their position in bed. When they are sat up, there will be more pressure on the wound. They will find it more difficult to mobilise, especially if that surgery cut through/separated muscles.

PurpleDaisies · 12/10/2019 08:56

but alcoholics ARE denied quite a few procedures!

Like what?

myself2020 · 12/10/2019 08:58

Being obese comes with significant health risks, and will lead to early, painful death.
some procedures are too risky on obese patients. some are just not worth it, as the long term effects of obesity just mean they are pointless .

myself2020 · 12/10/2019 09:03

@PurpleDaisies like liver transplants. pointless if someone is still drinking, so not done until they are abstinent

multiplemum3 · 12/10/2019 09:03

I worked on the wards for a few years. My back is still a mess from all the obese patients that needed help moving. Its more about the risks involved for the patient than discrimination for fucks sake lol.