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

Maybe faecal transplants are the answer! Just google it. Tim Spectors book -the Diet Myth is worth a read.

So why don't you lose weight, janeayressister, before it becomes a problem? If it's difficult for you, imagine how much worse it is for somebody whose life seems hopeless.

When somebody is seriously depressed, they don't make choices. Their lives seem totally out of control. Unfortunately, very few GPs seem to understand depression. There is much which could be done.

AnnieBach, well in a way depressed obese people are choosing death over life.

What on earth can be a strategy to help them ? I wish someone could come up with something. The governments latest ruling on processed food didn't help.

Nothing helped George Best did it. He was such an amazing footballer. I felt really sad about they way his life ended. Not that he was fat.

I know it is very difficult to lose weight, boy don't I know! I have to work hard at it. But coming from a medical family I also hear the frustration when someone presents themselves at the Surgery, when the Doctor knows practically almost all that he can do for a patient is being done in vain, because they are appallingly overweight.

It is galling to know that when you write a prescription that it is going to be wasted. The real cause is probably psychological and there is not enough money or counselling to truly help.
If there is a need for blame, should we be looking to ourselves or always searching for external sources to excuse our own self destructive behaviour?

Blaming someone else nowadays seems to be a very popular option. My Father was abusive so.... I am fat because of......

It isn't a case of people 'deserving' healthcare. Doctors aren't judging patients. However, some operations are riskier and less successful if patients are obese.

In the UK, all medical treatment is assessed by an organisation called NICE and health benefits/value for money are calculated in QALYs (Quality adjusted life years). I've been looking up some of the research about obesity and hip/knee surgery and it would appear that the risks of the operation itself are greater and patients are less likely to benefit from replacement if they're obese.

I strongly believe that people should be encouraged to lose weight, but not by being shamed. There are health benefits from being a normal weight, but breaking the vicious circle of denial and lack of motivation is a challenge. Just telling or threatening somebody about weight isn't going to work.

Before it comes down to deciding who among us deserves to be more expendable, don't Doctors have a sworn duty to 'first do no harm'? Not sure about how healthcare policies are crafted in the UK, but it would appear to me that deliberately delaying/denying surgery to someone in need for financial reasons, crosses some serious ethical boundaries. Healthcare providers are bound to uphold the Hippocratic oath, no matter where they practice medicine, so I've been told.
Here in the US, insurance companies have tried to pull the same draconian argument unsuccessfully. What they have been encouraged to do instead is to provide incentives (in the way of lower premiums, deductibles or co-payments) to customers who pledge to enroll in weight loss programs, quit smoking or voluntarily go into rehab.

Crossed posts, daphne.

It seems there's been a partial U-turn...

www.bbc.co.uk/news/uk-england-york-north-yorkshire-37265752

www.theguardian.com/society/2016/sep/03/vale-of-york-nhs-obesity-smokers-deny-elective-surgery

Plans have been put on hold.

And if you were struggling with depression Jane you may not be in a position to think clearly, also if you had depression you may choose death to life

I am overweight because I eat too much. I would expect to be told to lose weight if it would not be effective to operate, both economically and medically, unless I did.
Imagine how depressing it is for a surgeon to know that what you are doing is useless.

If there were no alternatives given to me, I would have a choice.

Ana, I get compliments , I want to slap them and say - no I am not lucky to be so thin ,

By the way, 65% of trusts are in arrears, so it will not be long before others follow suit, according to the RCS.

Not on a case by case basis, as you would have realised if you had read the link.

'Hospital leaders in North Yorkshire said that patients with a body mass index (BMI) of 30 or above – as well as smokers – will be barred from most surgery for up to a year amid increasingly desperate measures to plug a funding black hole. The restrictions will apply to standard hip and knee operations.'

It's just to save money that NHSE is not giving them.
It would not be necessary if the £350 million a week was put into the NHS. It's making people with a BMI of over 30 stay in pain for another year.

Me too Annie, but sometimes get comments about my small appetite (not from people who really know me) implying that it's an affectation...

The NHS recognises that obesity isn't all about having no will-power...

www.nhs.uk/Livewell/loseweight/Pages/statistics-and-causes-of-the-obesity-epidemic-in-the-UK.aspx

Daphne, great post, I think people have to know despair to understand why some eat too much yet others cannot eat, I am in the latter group. I am no different to those who overeat yet I don't have to take the criticism , the jokes, the judgement so many obese people hive to take.

I assume the Health Trust concerned will decide on a case by case basis.

Obese in this case is a BMI of 30+, which apparently is 35% of adults. Yikes. That is a lot of people affected.

x posts dapnedill

Annie, of course anyone's heart would go out to someone who feels so unloved and unwanted that they overeat to compensate or make themselves feel better.

But not every obese person can give that reason - sometimes a loving couple can both be overweight and not care. It often takes a major health issue to make some people aware of what they're actually doing to themselves.

@ab

You're right.

About two thirds of over 60s are overweight and between a quarter and a third of 60-70 year olds are obese, so the chances are that many GNers fall into one of those categories.

I've mentioned before that I've suffered from chronic depression most of my adult life, although it's relatively well controlled. I'm one of the third of over 60s who isn't overweight - at the moment. However, every so often I have an acute depressive episode, when nothing matters and I don't see that I have a future. When I feel like that, I sometimes don't have the energy to eat anything at all and at others, I could eat everything in the house. I have to be very careful about what I eat and usually I am, but if I have a very black depression, I just don't care.

It is a fact that obesity is correlated with deprivation and depression. It's not unreasonable to assume that people who live in bleak surroundings with little hope of climbing out of them will 'comfort eat' with little regard to health warnings. Unfortunately, it's a 'chicken and egg' situation. People are less likely to think positively of themselves if they are obese, especially when people call them weak-willed gluttons. Less positive people are likely to become depressed, so will do something which gives them pleasure...and so it goes on.

I wish people wouldn't concentrate on the 'moral' (or lack of) aspects of obesity. It's a health issue and people very often need a helping hand, not a slap in the face.

Hattiehelga My tone matches your tone. You said "all the Health Tourists and those who have not paid a penny into the system but get preferential treatment for free". Who are the people who don't pay a penny but get preferential free treatment, other than "health tourists" and what has voting to Leave got to do with it?

It hadn't occurred to me but, as daphnedill said, just about everybody pays some sort of tax. VAT is 20% on everything but the most essential things.

Re - why should the food industry be reined in?
There are several examples of products that are known to harm human health. They are dealt with very differently under the law
1. drugs such as cannabis, heroin etc are classified as illegal. The effect of this is that no tax is collected and the trade is not in the hands of registered companies.
2. cigarettes and tobacco are heavily regulated and heavily taxed. They are controlled by law - not allowed to advertise, not even indirectly via sports sponsorship, not allowed to be sold to young people , sold by licensed shops
3. alcohol - heavily regulated and heavily taxed and controlled by law re sales to young people and only sold by licensed companies
4. sugary foods - taxed the same as other foods, (paltry sugary drinks tax levy on it's way) advertised freely and can be sold to children by any shop. Can be added to almost any prepared food without making it clear. (beans, tinned soup, pulled pork, sweet cure bacon etc)
When governments in the past realised how harmful tobacco was they moved to control its consumption and publicised the dangers. The result was a steep fall in smoking and consequently a steep drop in smoking related illness. This despite extremely heavy lobbying from the tobacco industry. So now that we have realised the damage being done by heavy consumption of sweet drinks, confectionery, cakes, biscuits etc why not do something about it? A few pence on a sugary drink is just a token gesture.

At the end of the day we in the west have to much of everything, a free health service, education etc. and an easy life compared to so many in the world. Enough said, will bite my tongue before I upset. A whole load of people

Can we remember that this news story results from the NHS running out of money so they have to delay or refuse some operations. Cataracts, knees, hips even for the thin and non smoking will be deferred. So refusing the obese smoker is just part of that process, on the basis that they are the authors of their own misfortune. Why stop there? Here are some categories on which we could save money. All cosmetic surgery other than repairing damage caused by other people. All fertility treatment. All regendering treatment. All contraceptive prescriptions unless the mother's health would be endangered by pregnancy. All sports injuries. All injuries to a driver of a car at fault in an accident. All burns caused by putting petrol on a barbecue. Etc etc. Please be clear that I am NOT in favour of cutting treatment to these categories of people, but honing in on smokers and the obese [whch today means mildly overweight] is thoroughly unfair and a nasty way of dressing up a financial policy as though it is based on medical necessity.