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AIBU to support gastric band surgery on the NHS?

(21 Posts)
absentgrana Mon 11-Jul-11 11:38:37

An obese man is taking his local health authority to court because they have refused to allow him gastric band surgery on the NHS. His condition falls within the NICE guidelines but these are not a legal obligation. He suffers from diabetes, presumably as a result of being so overweight, and is housebound, so his condition is having a profound effect on the rest of his family. It seems that the surgery would be cost effective so the grounds for refusal strike me as spurious and simply short-term saving. He has to become heavier, i.e. all his conditions must worsen, before he qualifies for surgery in his location.

Baggy Mon 11-Jul-11 11:46:23

I don't know much about Type 2 Diabetes (nor Type 1 for that matter). Would this man's condition improve if he lost weight?

harrigran Mon 11-Jul-11 12:56:59

The risks associated with this type of operation are high. I think that sometimes people see this procedure as a quick fix and everything will be fine after.
A diabetic patient should be watching their diet and help from someone in that field initially would be more sensible.

jangly Mon 11-Jul-11 13:40:55

I think he should get it. I know its the thing to blame obese people by saying they eat too much, but I think there must be a reason why they need to eat so much. Something to do with metabolism or something.

However, those of us who are just a few pounds overweight blush could definitely do something about it.

Why did I just stuff that sodding cake?!

jangly Mon 11-Jul-11 13:42:01

And its so unfair that celebs can get it so easily and ordinary people can't.

harrigran Mon 11-Jul-11 14:20:46

Celebrities get a gastric band by paying mega bucks for it, if you have the funds you can have anything you want.

absentgrana Mon 11-Jul-11 14:36:43

Baggy I think it depends on how soon weight is lost – by whatever means – after the diabetes has developed. In some cases, it disappears completely.

JessM Mon 11-Jul-11 14:56:05

It is a drastic thing to have done if you are not grossly obese. You can only eat a handful of food before your stomach is full. It can lead to vitamin deficiencies. So it should not be seen as a celebrity led fashion. Rich people can always get operations they fancy, even if they don't need them!

It is not easy, I understand, operating on huge people. Risks of anaesthetic high. Need to get them mobilised afterwards to prevent thrombosis - difficult and apparently it is physically difficult for the surgeon operating through a very thick layer of fat.

crimson Mon 11-Jul-11 15:08:03

I was thinking about this the other day [before this thread] and I do feel that people should be made more accountable for their own health. Either that or people who do everything possible to live a healthy [ish] life should get brownie points towards their new hip/knee etc. I understand that health is a bit like Russion Roullette and people have terrible health problems through no fault of their own and deserve everything that the NHS can provide, but others just abuse their bodies and then expect someone to pick up the pieces.

janthea Mon 11-Jul-11 15:46:15

You have to ask the question why he allowed himself to get this fat in the first place. Perhaps if he showed some resolve and actually lost a bit of weight, one might have more sympathy for him. I've just been reading about a woman who has a paralysed stomach and is starving to death, but the NHS won't pay for the operation. The NHS has only limited resources and there maybe more deserving cases than someone who over eats.

JessM Mon 11-Jul-11 16:05:46

I think the NHS sees it as an investment because the long term costs of looking after someone this obese much greater than if weight lost, by fair means or foul.
It is difficult to know whether to view people like this as just lacking in will. Is it an addiction? Is it psychiatric? Or is it caused by the incredible availability of cheap calories every where you go. "And would you like three doughnuts with your petrol sir? Those crisps are 2 for 1." (conversation at BP petrol station on Saturday)
I may be wrong but I think obesity like this was rare in the 50s or 60s. Or were they all hiding indoors? Looking at my school photo, 700 girls, no one was overweight. And not because we were sporty.

Baggy Mon 11-Jul-11 16:22:04

Maybe he should go on hunger strike to get what he wants.

crimson Mon 11-Jul-11 16:22:07

Living/working in such warm conditions probably doesn't help. When we were young we probably used a lot of calories just keeping warm. Another reason for British Gas to put their prices up......

JessM Mon 11-Jul-11 16:34:05

naughty Baggy !
There is a factor Crimson - when the temp goes up, appetite goes down. In the arctic you need loads more calories.
But i think it was diet. We ate plainer food without all these calorie rich treats and fast food options.
My husband bought himself a "salad" from Marks yesterday for lunch. 800 calories. i reckon labelling it "salad" is a blooming cheek. Cold pasta thingy with mayo, bacon chicken and a few nibs of sweet corn more like.

maxgran Tue 12-Jul-11 12:25:44

There are lots of psychological reasons for people having a weight problem but I also think its too easy to become obese thinking that a miracle will happen or someone else will sort it for you.
I don't think doctors concentrate enough on nutrician and diet - they just treat symptoms and problems with drugs.,.. probably because people do not really want to listen or change the way they live until its almost too late.

I have heard its more cost effective to provide these band ops, but I would worry that it would just become common practise because people may see it as the answer to a problem they are not willing to take responsibility for themselves ?

frida Tue 12-Jul-11 16:21:11

Is this the same man who's diabetic medication contributed to his weight gain ? I believe some medication can do that.

nainnainnain Tue 12-Jul-11 20:03:16

The gastric band just restricts the amount you can eat; therefore it's only going to work if the problem was over-eating. If he is housebound, where has he been getting all the food from? Shopping on-line, or is his family feeding him? Maybe the operation would be cheaper than getting him enough help and supervision to sort that out?

jaskie Wed 13-Jul-11 14:47:20

WE all live in an environment where the food choices can be full of sugar, fats and high carbohydrates......common sense, a strong will and some very basic
information re food choices to start a slimming diet ,,,, could easily result in the
guy losing masses of weight without a dangerous operation.
NON of these fat people woke up overnight as huge monsters .... my guess is that most of them love all the fattening types of food and lack the willpower to start portion /fats/calorie/low carbo etc diet and stick with it for perhaps a year or so to get slim again!!

absentgrana Wed 13-Jul-11 15:43:36

jaskie You are, of course, right that becoming obese is a gradual process and some self-discipline when the weight first starts going on could save much heartache (literally as well as figuratively) and expense later. However, there comes a point when the metabolism changes in such a way that dieting doesn't work, according to medics who specialise in this field. Sometimes, too, as someone else pointed out on this thread, weight gain may be exacerbated by diabtetes medication. My reason for supporting this surgery, which costs the NHS around £6,000 a pop, is that in the long run it saves the much higher costs of long-term medical care. Diabetes treatment can cost the NHS around £3,000 per year, for example. I think once someone has a gastric band it is nigh on impossible for him/her to become obese again.

maxgran Wed 13-Jul-11 15:55:50

Whether the metabolism changes or not, your body will burn fat if you use up more energy than you take in - Its impossibe for it not to !
Obese people often have a much higher metabolic rate than slim people,.. and they also burn off more calories just having to move about normally because of their weight !
Of course there are cases where medication makes it difficult to lose weight or cause a weight gain - but I think th emajority of overweight people prefer to find any cause rather than take responsibility for their own actions.

Synonymous Sun 24-Jul-11 15:22:43

Unless you have diabetes you really do not know how it works at all. If you do have diabetes you realise that it is not that simple! We are all unique individuals and what we eat can affect each of us very differently.

Diabetes is an indication that the body's system has broken down - the reasons can be very varied.

My friend was diagnosed with diabetes after a stroke had made her immobile for some time and it was only after the stroke that she put on weight. She had diabetes for years before she was diagnosed and that caused high blood pressure and ultimately her stroke. There should be far more tests for diabetes particularly when high blood pressure occurs.

After diagnosis you often have medication which can cause a multitude of other problems. Sometimes the medication causes more problems than the disease and this man's medication has caused many of his problems.

We can be very judgemental over diabetes encouraged by the ignorance of adverts like those for a large chain of chemists who give much misinformation about diabetes.

If you want to know how to help someone with diabetes then encourage them to go on to the forum at which gives lots of info but the introduction page of the forum is here: where they will find much help and encouragement from people who actually understand diabetes because they are living with it daily.