Ban on surgery for patients who are overweight or who smoke?

So all that is needed is a list of those suffering from self inflicted injuries / illnesses , millions of pounds saved , add those who do not pay NIC, NHS is safe

Not you grannypiper

Don't forget people who use naughty words on public forums.

I have calmed down, this was discussed on Today this morning, if the obese are to be denied health treatment should they not be given treatment to help them overcome their addiction to food ?

Each individual case would have to be judged on its merits with clear guidelines in place . Medicine is not a black and white subject- lots of grey areas. However if someone needed a new knee and weighed say 15 stone and was told they could have an op at say 13 and a half stone it would seem reasonable. Meet people half way perhaps.

Thanks Iam, now I am on the list

Apparently they have to lose 10% of their weight, and then they will be treated.

Doesn't a huge amount of fat make surgery more difficult?

I have just had a TKR. I am overweight but very fit. My weight was never mentioned at consultations either by my GP or the Consultant. I have been very inactive for many months because of my knee and virtually housebound for at least 6 months. This didn't help my weight.
Of the people on the two wards I was in only two of us were discharged on the day designated which was op &3. We were both 79.
I would have been very unhappy if my weight had gone against me as far as surgery went and now post op & 26 days Iam making a very good recovery (and I have lost 10lbs).

Well done Ann! Now your knee is done there will be no stopping you!

So,pleased for you Ann,

or drivers who crash when speeding/drink driving, sometimes people cannot lose weight until after the surgery - they could have mobility issues & instead of exercising sit & eat yet after surgery they could exercise instead

I feel having paid National Insurance from the age of 15 to 70 I should be treated whatever.

also I have a son with type one diabetes and I am having to pay £100 per month to supply him with a device that makes his life easier, if he was a drug addict he would get what he needed free
Yes I am bitter

some people are obese because they are unable to exercise.
i have arthritis in both knees - well had arthritis in both knees as i now have had a knee replacement op.
i was told by my doctor that i should lose weight by [a] following a diet sheet and [b] excercising.
i was unable to exercise because my arthritic knees meant that couldn't do a lot of the exercises which would have reduced my weight ............ i was unable to walk very far so that was out.
and, as i couldn't exercise, i didn't lose weight although i did cut down on my food.
it is unfair to say that obese people are addicted to food - some may well be but most aren't. and before they start spouting off about "you must lose weight before we can operate" doctors and other medical professionals should consider whether their patients are able to lose weight.
a friend of mine who has arthritis in both hips and both knees has been told to lose weight and she's in complete and utter despair - she can't exercise and although she's a fairly active lady she can't walk very far either.
so i don't think this ruling, if it's going to be brought in, is fair to those who may be overweight because of a medical condition such as arthritis.

Must admit to very mixed feelings about this. Addiction needs treatment but not sure obese people are addicts in the true sense. Think if people make an effort to lose weight prior to treatment 10% was mentioned then treatment should be given..As annsixty says it can be a vicious circle with inaction due to pain. There are so many factors I think each case should be decided on an individual basis. Don't agree with liver transplants for alcoholics who won't attempt rehabilitation.

Do you mean you have to pay for medication BPJ?

Annsixty I'm very glad that your op has gone well and I wish you a very speedy return to full health.

BPJ I would be bitter as well, in our working lives we had an expectation fron cradle to grave and that includes our children.

Anniebach A list for you, I don't think so, you're fast becoming a national treasure.

This can be a two-edged sword. My brother was grossly obese. Started with prostate treatment with female hormones, then once that weight piled on, his bad knees from an on-the-job RTA as a cop got worse. So he was put on Oxycontin. He'd been on that for years and was unable to lose any weight...the two conditions created a vicious cycle. And he developed kidney trouble.

Heart disease runs in our family, but my dad lived to a very old age with himself getting overweight in the end once confined to a wheelchair because an MRSA foot wound infection did not heal and he lost muscle tone to walk. He had kidney trouble, too.

My brother had open heart surgery after a MILD heart attack just last spring. It was to be a quad bypass with an aorta valve replacement.

He came out of surgery and was on machines for almost two weeks. The trauma of the surgery was too much for his 74 year old body. They turned the life support off.

This is in America... land of 'you can get whatever health care you can pay for as long as your insurance company agrees with the consultant.'

He should not have had that surgery in that obese condition. He was over 24 stone! He had a MILD heart attack and probably would have had another eventually, but could have lived with his blockages and lost weight, and responded to kidney medication, before having the bypass.

Before they turned off the machines, his daughter was there and he opened his eyes. He could not talk with the intubation, but he heard her and knew what was going to happen. He cried... he knew he should have taken better care of himself. There is no second chance.

So there are huge risks to surgery for very overweight people, especially cardiac surgery.

sad]

My kidney removal tool 9 hours instead of the predicted 2-3 hours due to adipose around the kidney. I was overweight. I am losing it gradually. The instruments my surgeon kindly told me before op were only slightly longer than the fat on my tummy. Being fat does compromise surgery.

When I had my hip replaced,11 years ago, I was certainly overweight though not clinically obese, but I was never weighed until the pre-op which, due to an oversight on their part, was done in a hurry the day before the op. I have read that weight is more likely to be a factor in wear and tear on the knees than on the hips. So far, my knees have borne up well!

....if the obese are to be denied health treatment should they not be given treatment to help them overcome their addiction to food ?

That strikes me as a reasonable idea, ab. It fits with supporting people overcome other addictions in addition to the necessary self-help/determination that's also required.

I find myself conflicted: my heart is in the "it should be for all" camp, but my head is very aware that no national health service is ever going to have an infinite budget, and when medical procedures (plus post-op outcomes) have financial ramifications, hard and unpalatable choices have to be - and are - made every day in our hospitals. It is horrible to think of it this way, but a 'pecking order of worthiness' is established, and my use of the loaded term 'worthiness' was deliberate: those making the decisions will of course bring their own personal opinions on worthiness to the table. Even if someone designed an algorithm to make the decisions in every case, so that there were no local variations, the bias of the designer/programmer would automatically be built into the algorithm. It isn't fair, it isnt giving everyone an equal chance, but until we live in some utopia where budget is no longer an issue, it will be increasingly the case that certain groups will have less access to certain surgeries and treatments, and this will be based on the decision-makers' opinions, however biased they may (or may not) be. I wish I could think that there was a way to resolve it so that none are penalised, but i cannot.

I meant to say that I do not approve of rationing surgery bu weight. Imagine being in unbearable pain which could be alleviated by removal of kidney stones or gallstones, and being told to go away and lose weight. No doubt a bonus for the private sector for those who can afford their care.

I have mixed feelings about this. I'm a teetotal, underweight ex smoker and I never forget that the tax on cigarettes adds up to around 9 billion a year. Don't know what the tax on alcohol is but people who have these addictions have paid for their treatment many times over, except that these taxes probably never reach the NHS.
Having said that, if giving up cigarettes and alcohol and losing weight helps your chance of recovery you'd be stupid not to at least try.

Well that's me well and truly out then! I would be classed as overweight and I smoke.
I think before long the decision will be made for us since I do not see how the NHS can continue in it's present form. I do feel that some sort of charging will have to be introduced. Online consultations with a GP was something I was reading about the other day. Charging to see a GP in person perhaps? An age limit on some procedures? Some procedures withdrawn from the NHS completely?
I do feel something will have to give before long. What do others think?

I think these decisions should be evidence based rather than simplistic decisions based on worrying about budgets.
If there was clear evidence to back decisions e.g. if there was research to demonstrate that knee operations had very low success rate if patients are obese.
or if death rates after such surgery were high in overweight smokers, there would be a justification for saying that surgery will be delayed until weight lower/ smoking stopped.
But if they are talking about cost-effectiveness wouldn't it save the NHS money if more resources were put into helping patients lose weight or stop smoking.