Too fat?

Don't operate on smokers and the obese says Patricia Hewitt, Britain's Health Secretary.

Unbelievably she then went on to say that it was right refuse care to those whose lifestyle choices could make treatment ineffective.

Miss Hewitt insisted the Government wanted to see people taking greater personal responsibility for their health. Oh I love it when the wordy ones use patronizing language, don't you?

It is the first time a minister has explicitly endorsed the controversial policy, which has already been adopted by some health trusts and we all know it's to do with finding ways of cutting costs as so many health authorities are in the red.

Health trusts in Suffolk were among the first to announce that obese people would be denied hip and knee replacements on the NHS and I bet they loved this announcement of Ms Hewitt's!

Personally I hate this whole business as I think it should be up to the surgeon to decide as he/she knows the patient and they are in a better position to call it than an accountant who probably smokes and is clinically obese! I'm not trying to be 'thinnest' here but could it be that there is a situation of a surgery between two people one is underweight but has blood pressure issues and food issues and and the other is obese but otherwise in perfect health? So who gets chosen?

The truth is though that in general the risks of operating on obese patients are higher and the treatment may be less effective, with replacement joints wearing out sooner. But consider the fact that the reason obesity is because of inactivity by the prospective patient who has arthritis. I have spinal condition and I'm unable to exercise, I also have an under active thyroid gland which meant I started to put on weight. I didn't have clue why I was putting on weight until the diagnosis a week ago and now that I am having treatment I I hope it will stop. Others in my position with back injuries and/or who suffer with other painful disabling conditions may not be as lucky. They cannot exercise pre operatively to loose weight but are desperate for the surgery so that they can exercise post operatively. They are in a catch 22 situation.

I've been looking for the evidence on which the Government based their reasoning's on and all I have come up is that some health trusts are already denying surgery to those with a body mass index of 30+. This figure accounts for one in five adults. I cannot find any evidence to show why people should be refused treatment if they have a body mass index of 40 or below. (Based on BMI figures.)
A British Medical Association spokesman said: "We would not want to see blanket rules. What about people who diet down from a body mass index of 40 to a BMI of 30 - would they still be denied surgery?"
Recent studies have highlighted shortcomings of the BMI measure, with experts increasingly agreeing that being heavy may not necessarily raise the risk of dying prematurely if the weight is muscle, not fat. Some doctors now suggest waist circumference, or waist-to-hip ratio, which indicates levels of abdominal fat, should be adopted as a more accurate guide. Additional fat around the abdomen releases more of the acids that raise heart disease risk.

I suspect that people will be denied treatment because of their 'lifestyles' as the health secretary puts it. It will be that simple and it is because of money and money alone. I don't care how money government authorities, voices etc come out in support of this it comes down to that one factor. But it is a case of shutting the gate once the horse has bolted.

The Government's drug rationing body, the National Institute for Clinical Excellence (NICE), has said lifestyle choices - and even age - can be taken into account if they directly affect the effectiveness of a drug or procedure.
It said in a recent report: "If... self-inflicted causes of the condition influence the clinical or cost effectiveness of the use of an intervention, it may be appropriate to take this into account."

Nice one NICE!

We all know that NICE have been called into question many times in recent months because they will not sanction a medication because of cost.

If the government is going to state one rule then it should support a structure than helps those people lose weight. The giving up smoking campaign is good one and as a non smoker I find it hard to identify with smokers. I've lost both my parents to smoking related diseases and this is a total turn off. Losing weight however is something I can identify with strongly and it is hard. I've never had surgery cancelled because of my weight and I live in a authority that is 30 million pounds in the red........I suspect that now they will be using this rule though.

I'd like to know when I was struggling to find help to shed those pounds, where was my help? I keep seeing that it is available but it is sporadic and most of it based on EXERCISE - No good for those who are disabled with arthritic hips and knees waiting for transplants but who can't go on those lists now because they are obese smokers!