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Obese patients "denied surgery"

Obese patients are having to put on weight to become eligible for weight loss surgery due to "inconsistent and unethical" funding constraints in some parts of the country, leading doctors have said.

Some patients eligible for operations have to wait until they develop a serious illness such as diabetes or get even heavier before they receive much-needed treatment, the Royal College of Surgeons (RSC) said.

NHS rules state patients with a Body Mass Index (BMI) of more than 40 are morbidly obese and have the right to be assessed for surgery; yet the RSC said some health trusts were not adhering to the national guidelines.

It estimated only 2% (4,300) of 240,0000 obese people who qualified underwent the procedure last year because of budgetary reasons.

About two thirds of surgeons said they saw eligible patients refused surgery because some trusts would only refer the most extremely ill patients, according to the RSC.

Rather than just having a BMI over 40, these patients had to have an obesity-related illness and BMIs above 50 or 60 to be considered for an operation.

Professor Mike Larvin, RCS education director, said: "In many regions the threshold criteria are being raised to save money in the short term, meaning patients are being denied life-saving and cost effective treatments and effectively encouraged to eat more in order to gain a more risky operation further down the line."

A Department of Health spokesman said independent guidance on obesity from the NICE recommended that "drugs and surgery should always be a last resort".

Copyright © Press Association 2010

Royal College of Surgeons in England

Your comments (terms and conditions apply):

"Virginia Tyler it seems that now you have gained control of your eating/exercise regime, you find it fit to slander those who are not able to do the same?  What a clever person you must be! May God Bless You!" - Nikki, Suffolk

"There are many different reasons, both physical and mental, as to why people become obese. I think the NHS would do well to tackle more the 'comfort eating'/psychological issues surrounding obesity in some patients prior to considering surgery since unless the underlying cause is tackled this may continue to be the individuals lifelong health issue" - Frances Harris, Sussex

"In my experience as a practice nurse, most people who are obese are acutely aware of it, and do not want to be like that.  In most cases, the cause has usually been mental/emotional causes, ie boredom, depression, etc. They are people who have health needs, and where possible, we should try everything we can to help them on the understanding that they have to take responsibility themselves for a joint solution" - Sara Finnegan, Cheshire

"Not all obese patients or people should go under surgery but only those who really need to prevent more harm to their health. I suppose the surgery will take longer time, and there would be some cases that may not be advisable to go under surgical correction. Only their own GP could say" - Naheeda Philip, Glasgow

"Yes! And while we're at it, lets stop wasting time and money on alcoholics. They should just stop drinking!! And why spend so much helping people to stop smoking?! Come to think of it why help any of them?! We help because we can, because people need our help, because it is right to do so. I hope those who think it is too much to help people improve their health never in need for themselves" - Name and address supplied

"Whatever you feel about the cause of obesity, and experts agree it is not simply a matter of gluttony, the fact is the problem is there. If we do nothing they consume vast NHS resources eg, diabetic treatment. Surgery saves that money whether you like these patients or not. So do the maths - and stop wasting money when we have a fix" - Mike Larvin, London

"I believe that there is enough in the way of education and support etc to avoid becoming obese and the MAJORITY of these patients could do more to help themselves. For that number that have syndromes, metabolic disorders, medical problems or factors beyond their control that cause obesity, other than gluttony or sloth, surgery should be available. People should take responsibility for their own health and not expect the all-giving NHS to sort out problems caused by lifestyle. I would hazard that a lot of people in this country have factors they would like to have sorted out by surgery but would never expect the NHS to pick up the tab; why is self-inflicted obesity any different from that? The NHS, and the public sector in general, is in a parlous state. Just because an operation is possible does not mean that it should be given as an absolute right" - Timothy Dodd, Hull

"I think this idea is ridiculous - to encourage folk to PUT ON WEIGHT - so they can be eligible for surgery for obesity! What in the world are we coming to?" - Mabel Farr, N Ireland

"What utter nonsense. Stop mucking about - people choose their lifestyle including what they eat. If they choose to eat too much and exercise not enough, then they have to live with the consequence of that choice. I know - I was morbidly obese and now am not due to taking responsibility for my lifestyle and my health. Stop wasting time and money debating this type of nonsense" - Virginia Tyler, West Midlands