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

@Lewlew

I'm not sure what point you're making.

The reason is that food high in saturated fat and calorie laden, as well as being relatively easy to prepare is generally cheaper.

Poor nutrition/food education is also a key.
Culture also plays a part.
Obesity comes with a myriad of reasons. Scapegoating is unpleasant and ill-informed.
In fact our relationship with food has gone askew. As well as obesity we also have a relatively large percentage whose relationship results in anorexia etc.

After I had stents put into a partially blocked artery (in France) about 10 of us patients had some talks on healthy living. Nearly all were still smokers, and you know how nicotine clogs the arteries. I had stopped about 15 years ago TG.
A nurse told the smokers that if they were in UK they wouldn't be operated on until they had given up smoking. I was doubtful about this, but that's what she said. 2006.

"In fact our relationship with food has gone askew." I couldn't agree more! I read somewhere that it's our brains rather than our stomachs which dictate how much we eat.

I'm pretty sure I know the answers too, whitewave, but I didn't want to make assumptions. The challenge now is to change culture and lifestyles, which isn't easy without getting people's backs up.

That's not true, Tricia. My brother-in-law recently had a mild heart attack and had stents within a couple of days. He was a heavy smoker, who's cut down a bit (allegedly), but still smokes.

I put on a lot of weight prior to having both hips replaced, following the op I am finally beginning to shed some of it. I was overweight not because I am fat and lazy but because it was too painful to walk at all and I had a long wait for surgery. I also had several other health issues contributing to weight gain. How quick the media is to jump on band wagons without looking properly into why things happen.If the government looked at other ways, and there are many they could save money instead of constantly picking on those that can least help themselves then maybe the health service would not be forced into such ridiculous decisions. The vast salary the chief executive of the health authority in the south was on prior to being fired and her subsequent grossly over the top severance pay would go a long way to helping pay for operations. May be the health service should look at the salary's they pay their top line management. Sorry to rant but this has really made me cross.

I doubt if her pay would fund many operations. I read the report and one of the issues was that there weren't enough managers to oversee what was going on.

Cultural attitude change is long term - not something that can be achieved very quickly.

It raises the question whether the NHS should be responsible for prevention as well as cure. Given that this government is hell bent in screwing the NHS it is highly unlikely that there will sufficient resources for a comprehensive health service - we can forget education and health

NICE claims that preventative medicine is good value for money, so it does make sense to invest in prevention. In any case, the NHS is no longer responsible for most public health - local authorities are, but there's little incentive for them to spend, because they don't have to pick up the pieces.

I agree that changing cultural attitudes are long-term and very difficult to achieve without seeming like a patronising 'nanny state'.

What a person actually weighs isn't necessarily an indicator of whether or not they're over weight, nor is their BMI.

I'm in my mid 50's, have been on HRT since my early 30's which increases bone density hence it's positive effect on osteoporosis. I attend a gym 3 to 4 times a week and have done so for several years, regularly lifting weights which increases my muscle mass; muscle weighs more than fat.

People are often surprised when they know how much I weigh, expecting it to be less because I don't look over weight yet, if I were to do my BMI I would most certainly come out as weighing more than I should.

I smoke on average 10 to 12 cigarettes a day, haven't been to the doctors for years (apart from getting sleeping pills due to Mr. S.'s snoring) and enjoy more than the occasional glass of wine.

I received a 'phone call from our doctor's surgery several months ago, was told they were updating their records and asked if I smoked. Before answering, I asked if they'd be asking me any other questions and when I was told 'no', I told them it was none of their business as it isn't, unless of course I develop health problems directly linked to smoking.

I see no reason why anyone should be judged and then denied medical treatment. As so many other posters have pointed out, where would it end? Would someone who is no longer overweight, no longer smokes or no longer drinks alcohol be denied treatment because they have a medical condition bought about by the fact that they used to do all, or one of those things?

A couple of months ago I took my brother to hospital for tests and wasat how many members of the medical profession were not just overweight but how many could have been judged as morbidly obese.

Once again...

This isn't about 'judging'. It's about getting people to live healthier lifestyles. Why wouldn't people want to do that and be so rude to people whose jobs it is to support them?

That's what I meant about trying to change lifestyles without appearing like a patronising nanny state. Meanwhile, some sections of the media (and GNers) will be outraged at the obesity epidemic and blame single mums force feeding their children sausage rolls. Maybe mirrors should be prescribed.

It is about judging, were it to have been enforced it would have judged who could or could not have surgery based on whether or not someone's a smoker or overweight.

Refusing medical treatment isn't being supportive, it's being judge mental.

That's not judging. Refusing medical treatment which is unlikely to have a successful outcome is denying funding to people who could benefit more.

Of course it's judging. Denying medical treatment to one section of society because it's believed it would be more beneficial to another section of society is at best being judge mental, at worse discriminating.

I had cataract surgery on both my eyes a few years ago apparently it runs on my family as my 2 sisters needed surgery ..Luckily I had a very good optician who referred me quickly for it as Somerset Health Authority were making it harder for people to have the operation before you were nearly blind .How much would it cost the NHS if you had a fall or accident because you could not see .The reason I got it done was I was still working and driving What rationing is going to be next?

Rationing only for the poor. If you can pay? No problem.

Next the middle class will get annoyed because they are paying their NH contributions, but having to pay for some treatment. Just as well go with private insurance.

They will do just that whitewave

People who smoke pay a lot of tax on their cigarettes. I agree it is unhealthy and they should be given every encouragement to stop - prevention being better than the cure or worse!

But they are more than paying their way so if they need more treatment they should get it.

@Smilesless

It would be judgemental if the doctor said the the patient, "You big porker, it's your own fault your fat, because you're a greedy guts, and I'm punishing you by banning you from an operation." That's not what's happening.

The issue of not operating on overweight patients applies mainly to orthopaedic patients. It has been shown that knee/hip replacement surgery carried out on obese patients has a high risk of failure . This is the reason for the guide lines which have in fact been going on for some time now. In regards to smokers, once more it has been proven than the risk of complications following surgery on smokers is extremely high. Anaesthetists are reluctant to deal with smokers for this very reason and that is why epidurals have made a big come back.

@Mistyfluff

Both my parents have had cataract ops. My father was in his late 70s, when he already had heart and other problems. My mother had one cataract removed six weeks ago. She's 85, has survived cancer twice and it's returned, can hardly walk and is partially deaf.

No, that wouldn't simply be judge mental daphnedil that would be extremely rude and un professional. It doesn't matter how politely some one who is over weight or smokes is told that they can't have medical treatment, they are still being judged and discriminated against.

Exactly, lionpops. As for discriminating against patients when there's a low rate of success and/or greater risks, this has also been going on for ages. That's why we have NICE guidelines. There's only a limited amount of money (and I'll support anybody who says it's not enough), but I'd rather money were spent as effectively as possible. I'd rather money were spent on 100 cataract ops than one person, whose op would be risky and/or unlikely to succeed in improving health.

Remember that TV programme, 'Can't cook-Won't cook' whitewave? You've hit (one of) the nail on the head there. I practise calorie restriction i.e. 5:2 fasting. I'm not trying to convert anyone. It works for me. My son makes one of our fast day meals using two tins of butter beans @50p each. The whole recipe comes in around £3.25 and feeds two people a substantial meal. (We don't eat all of it on the fasting day. He makes a delicious hummus from what's left and we eat it for lunch next day.) It is also delicious, filling, low in fat and high in protein and both soluble and insoluble fibre. If you buy dried beans and soak them yourself, it would be considerably cheaper again. It's time schools raised the profile of cookery teachers and made cookery a compulsory subject in the core curriculum instead of GCSE food technology which covers large scale manufacture, product design and the psychology and design of packaging as well as a bit of cooking (at least it did when my daughter studied it). My son's are excellent cooks. They learned and were enthused by watching young TV chefs. My daughter's husband does most of their cooking. A* at GCSE hasn't given her any kind of expertise or interest in the kitchen.