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NHS denying surgery to obese patients/smokers
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By (user no longer on site) OP
over a year ago
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The Royal College of Surgeons have produced a report found a third of local NHS health bosses put restrictions on certain patients having surgery until they had lost weight or quit smoking.
They think it's being used to ration surgery in the current tough financial climate. And these patients are a soft target for savings.
Clinically they say there's often no difference in outcome . Some NHS groups disagree - saying for less urgent surgery it helps.
I have a feeling it may help targets to send someone off to lose Weight/ quit smoking.
It really is a postcode lottery!
What do you think ?
|
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"The Royal College of Surgeons have produced a report found a third of local NHS health bosses put restrictions on certain patients having surgery until they had lost weight or quit smoking.
They think it's being used to ration surgery in the current tough financial climate. And these patients are a soft target for savings.
Clinically they say there's often no difference in outcome . Some NHS groups disagree - saying for less urgent surgery it helps.
I have a feeling it may help targets to send someone off to lose Weight/ quit smoking.
It really is a postcode lottery!
What do you think ?
"
And a reduction in national insurance contributions because they cannot expect the same level of service maybe? |
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By (user no longer on site)
over a year ago
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"The Royal College of Surgeons have produced a report found a third of local NHS health bosses put restrictions on certain patients having surgery until they had lost weight or quit smoking.
They think it's being used to ration surgery in the current tough financial climate. And these patients are a soft target for savings.
Clinically they say there's often no difference in outcome . Some NHS groups disagree - saying for less urgent surgery it helps.
I have a feeling it may help targets to send someone off to lose Weight/ quit smoking.
It really is a postcode lottery!
What do you think ?
"
Surely it depends on the risks with each surgery and it's not a blanket ban on treatment for those patients.
I think if the risk is too high, then it's a good decision. Being dead is worse than some ailments. |
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Nothing has changed. For years now surgeons have put surgery off due to the weight of a patient.
Anesthesia is one factor. The amount of drug needed is decided by weight and can be dangerous in some cases. Another factor (especially where knees and hips are involved) is that if you weigh alot then your recovery will be slower due to mobility issues and the surgeon doesn't want his work to last half as long.(not if he /she can convince the patient to lose a bit of weight.... It worked for my father in-law who lost 3stone and got his knee op. He's now fitter than before and returned to theobromine he loved doing yrs ago.
This is just more media hype...over old issues. |
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By *mmabluTV/TS
over a year ago
upton wirral |
A couple of months ago I had to have an op and was told I was just ok for the op,if I had been a few pounds heavier would have had to wait longer.
This seems very silly to me and is just false economy as I would have become worse if I had had to wait. |
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By (user no longer on site)
over a year ago
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It is risk based. A good friend of mine recently had surgery. He smokes. He was asked/told to stop and give his lungs and himself the best chance of speedy recovery. This was only 5 days before surgery. Being on a bed, flat, not breathing in deeply with the addition of dis functional lungs is asking for pneumonia.
Good on the health care for asking people to lower risk factors and take some responsibility for themselves. |
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By (user no longer on site)
over a year ago
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"A couple of months ago I had to have an op and was told I was just ok for the op,if I had been a few pounds heavier would have had to wait longer.
This seems very silly to me and is just false economy as I would have become worse if I had had to wait."
Yeh let's prioritise the economics over it when it's a life or death matter. |
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"A couple of months ago I had to have an op and was told I was just ok for the op,if I had been a few pounds heavier would have had to wait longer.
This seems very silly to me and is just false economy as I would have become worse if I had had to wait.
Yeh let's prioritise the economics over it when it's a life or death matter. "
Where does it say that they are delaying surgery in a life and death situation??
Why wouldn't you want to give yourself the best chance to get through the operation and aid recovery? |
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By (user no longer on site)
over a year ago
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"A couple of months ago I had to have an op and was told I was just ok for the op,if I had been a few pounds heavier would have had to wait longer.
This seems very silly to me and is just false economy as I would have become worse if I had had to wait.
Yeh let's prioritise the economics over it when it's a life or death matter.
Where does it say that they are delaying surgery in a life and death situation??
Why wouldn't you want to give yourself the best chance to get through the operation and aid recovery? "
You've misunderstood. Anaesthetising a morbidly obese person can be deadly, and smoking after certain surgeries can cause deadly infections with necrosis. |
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Being overweight/smoker does carry additional risks, I don't think any reasonable person would argue with that.
My beef is I required a hysterectomy and was told I had to lose five stones before they considered it as anaesthetic was given according to body weight and the amount needed to put me under could be fatal: fair enough. In the next breath I was offered bariatric surgery. When I said no thanks, but could I have the anaesthetist who would give me a gastric band on hand at my hysterectomy I was classed as difficult.  |
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"A couple of months ago I had to have an op and was told I was just ok for the op,if I had been a few pounds heavier would have had to wait longer.
This seems very silly to me and is just false economy as I would have become worse if I had had to wait.
Yeh let's prioritise the economics over it when it's a life or death matter.
Where does it say that they are delaying surgery in a life and death situation??
Why wouldn't you want to give yourself the best chance to get through the operation and aid recovery?
You've misunderstood. Anaesthetising a morbidly obese person can be deadly, and smoking after certain surgeries can cause deadly infections with necrosis. "
Not to mention this has been brought up just as the Dr's are about to strike.
Next the Government will will say that this wouldn't happen if they could only privatise the NHS |
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By (user no longer on site)
over a year ago
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"Being overweight/smoker does carry additional risks, I don't think any reasonable person would argue with that.
My beef is I required a hysterectomy and was told I had to lose five stones before they considered it as anaesthetic was given according to body weight and the amount needed to put me under could be fatal: fair enough. In the next breath I was offered bariatric surgery. When I said no thanks, but could I have the anaesthetist who would give me a gastric band on hand at my hysterectomy I was classed as difficult. "
What's your point exactly? That the surgeon thought that the hysterectomy was risky due to weight issues? Fuck me, what does the surgeon know?! |
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By (user no longer on site) OP
over a year ago
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East and North Hertfordshire CCG - requires a patient's BMI to be under 30 or for them to lose 10% of their bodyweight before surgery
North East Essex CCG - requires patients who smoke to stop and attend smoking cessation programmes before referral to surgery.
I do get it - but it's strange that it's not a blanket policy across all NHS Trusts.
One of the main surgeries they seem to be saying should not be postponed is knee and hip replacements. But I guess less weight is less pressure afterwards. And like others have said the risk of Anaesthesia.
Sarah
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By (user no longer on site)
over a year ago
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The problem lies with general anesthetic. Cam put a huge strain on the heart and lead to infections in smokers. Only just learned all this stuff myself. Having to quit smoking and sort my blood pressure out just to get a couple of wisdoms out. |
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"Being overweight/smoker does carry additional risks, I don't think any reasonable person would argue with that.
My beef is I required a hysterectomy and was told I had to lose five stones before they considered it as anaesthetic was given according to body weight and the amount needed to put me under could be fatal: fair enough. In the next breath I was offered bariatric surgery. When I said no thanks, but could I have the anaesthetist who would give me a gastric band on hand at my hysterectomy I was classed as difficult.
What's your point exactly? That the surgeon thought that the hysterectomy was risky due to weight issues? Fuck me, what does the surgeon know?!"
No!
My point is if surgery is risky ar my weight it is contradictory to offer me ANY kind of surgery, or did you miss that bit trying to be funny? |
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"A couple of months ago I had to have an op and was told I was just ok for the op,if I had been a few pounds heavier would have had to wait longer.
This seems very silly to me and is just false economy as I would have become worse if I had had to wait.
Yeh let's prioritise the economics over it when it's a life or death matter.
Where does it say that they are delaying surgery in a life and death situation??
Why wouldn't you want to give yourself the best chance to get through the operation and aid recovery?
You've misunderstood. Anaesthetising a morbidly obese person can be deadly, and smoking after certain surgeries can cause deadly infections with necrosis. "
I'm aware of the risks which is why I said why wouldn't people want to stop smoking or loose weight to give themselves and the surgery the best outcome |
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By (user no longer on site)
over a year ago
|
"A couple of months ago I had to have an op and was told I was just ok for the op,if I had been a few pounds heavier would have had to wait longer.
This seems very silly to me and is just false economy as I would have become worse if I had had to wait.
Yeh let's prioritise the economics over it when it's a life or death matter.
Where does it say that they are delaying surgery in a life and death situation??
Why wouldn't you want to give yourself the best chance to get through the operation and aid recovery?
You've misunderstood. Anaesthetising a morbidly obese person can be deadly, and smoking after certain surgeries can cause deadly infections with necrosis.
I'm aware of the risks which is why I said why wouldn't people want to stop smoking or loose weight to give themselves and the surgery the best outcome "
I'm not sure why you're asking me this? |
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By (user no longer on site)
over a year ago
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"Being overweight/smoker does carry additional risks, I don't think any reasonable person would argue with that.
My beef is I required a hysterectomy and was told I had to lose five stones before they considered it as anaesthetic was given according to body weight and the amount needed to put me under could be fatal: fair enough. In the next breath I was offered bariatric surgery. When I said no thanks, but could I have the anaesthetist who would give me a gastric band on hand at my hysterectomy I was classed as difficult.
What's your point exactly? That the surgeon thought that the hysterectomy was risky due to weight issues? Fuck me, what does the surgeon know?!
No!
My point is if surgery is risky ar my weight it is contradictory to offer me ANY kind of surgery, or did you miss that bit trying to be funny? "
No attempt ar humour on my behalf. Sarcasm, yes.
All surgery is different. All carry risks. Some are more intrusive and put the body under more stresses. |
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By (user no longer on site)
over a year ago
|
"Being overweight/smoker does carry additional risks, I don't think any reasonable person would argue with that.
My beef is I required a hysterectomy and was told I had to lose five stones before they considered it as anaesthetic was given according to body weight and the amount needed to put me under could be fatal: fair enough. In the next breath I was offered bariatric surgery. When I said no thanks, but could I have the anaesthetist who would give me a gastric band on hand at my hysterectomy I was classed as difficult.
What's your point exactly? That the surgeon thought that the hysterectomy was risky due to weight issues? Fuck me, what does the surgeon know?!
No!
My point is if surgery is risky ar my weight it is contradictory to offer me ANY kind of surgery, or did you miss that bit trying to be funny?
No attempt ar humour on my behalf. Sarcasm, yes.
All surgery is different. All carry risks. Some are more intrusive and put the body under more stresses. "
Tbf, one may have been able to offer an epidural instead of general. Some aren't okay with that for major surgery. |
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"Being overweight/smoker does carry additional risks, I don't think any reasonable person would argue with that.
My beef is I required a hysterectomy and was told I had to lose five stones before they considered it as anaesthetic was given according to body weight and the amount needed to put me under could be fatal: fair enough. In the next breath I was offered bariatric surgery. When I said no thanks, but could I have the anaesthetist who would give me a gastric band on hand at my hysterectomy I was classed as difficult. "
Did you not ask them ? I take it they'd be looking at the risk vs the benifits from each procedure. Plus if different time under anesthesia and if key hole or not plus numerous other factors .
I know when I had hysterectomy the difference keyhole surgery to open surgery was huge . |
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"Being overweight/smoker does carry additional risks, I don't think any reasonable person would argue with that.
My beef is I required a hysterectomy and was told I had to lose five stones before they considered it as anaesthetic was given according to body weight and the amount needed to put me under could be fatal: fair enough. In the next breath I was offered bariatric surgery. When I said no thanks, but could I have the anaesthetist who would give me a gastric band on hand at my hysterectomy I was classed as difficult.
What's your point exactly? That the surgeon thought that the hysterectomy was risky due to weight issues? Fuck me, what does the surgeon know?!
No!
My point is if surgery is risky ar my weight it is contradictory to offer me ANY kind of surgery, or did you miss that bit trying to be funny?
No attempt ar humour on my behalf. Sarcasm, yes.
All surgery is different. All carry risks. Some are more intrusive and put the body under more stresses. "
Hysterectomy and a gastric bypass are both invasive surgery. Surgery at my weight at the time would have been risky: no ifs, buts or maybe. Both would require general anaesthetic, therefore to my simple mind saying you're too fat for invasive surgery a but we'll do invasive surgery b didn’t make sense.
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"Being overweight/smoker does carry additional risks, I don't think any reasonable person would argue with that.
My beef is I required a hysterectomy and was told I had to lose five stones before they considered it as anaesthetic was given according to body weight and the amount needed to put me under could be fatal: fair enough. In the next breath I was offered bariatric surgery. When I said no thanks, but could I have the anaesthetist who would give me a gastric band on hand at my hysterectomy I was classed as difficult.
What's your point exactly? That the surgeon thought that the hysterectomy was risky due to weight issues? Fuck me, what does the surgeon know?!
No!
My point is if surgery is risky ar my weight it is contradictory to offer me ANY kind of surgery, or did you miss that bit trying to be funny?
No attempt ar humour on my behalf. Sarcasm, yes.
All surgery is different. All carry risks. Some are more intrusive and put the body under more stresses.
Tbf, one may have been able to offer an epidural instead of general. Some aren't okay with that for major surgery. "
No, both general. |
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By (user no longer on site)
over a year ago
|
"Being overweight/smoker does carry additional risks, I don't think any reasonable person would argue with that.
My beef is I required a hysterectomy and was told I had to lose five stones before they considered it as anaesthetic was given according to body weight and the amount needed to put me under could be fatal: fair enough. In the next breath I was offered bariatric surgery. When I said no thanks, but could I have the anaesthetist who would give me a gastric band on hand at my hysterectomy I was classed as difficult.
What's your point exactly? That the surgeon thought that the hysterectomy was risky due to weight issues? Fuck me, what does the surgeon know?!
No!
My point is if surgery is risky ar my weight it is contradictory to offer me ANY kind of surgery, or did you miss that bit trying to be funny?
No attempt ar humour on my behalf. Sarcasm, yes.
All surgery is different. All carry risks. Some are more intrusive and put the body under more stresses.
Tbf, one may have been able to offer an epidural instead of general. Some aren't okay with that for major surgery.
No, both general."
In that case, perhaps the bariatric team had way more experience with overweight patients and the risk was lowered due to expert knowledge. A gynaecologist may not have that knowledge. |
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"Being overweight/smoker does carry additional risks, I don't think any reasonable person would argue with that.
My beef is I required a hysterectomy and was told I had to lose five stones before they considered it as anaesthetic was given according to body weight and the amount needed to put me under could be fatal: fair enough. In the next breath I was offered bariatric surgery. When I said no thanks, but could I have the anaesthetist who would give me a gastric band on hand at my hysterectomy I was classed as difficult.
Did you not ask them ? I take it they'd be looking at the risk vs the benifits from each procedure. Plus if different time under anesthesia and if key hole or not plus numerous other factors .
I know when I had hysterectomy the difference keyhole surgery to open surgery was huge . "
Both would have been keyhole under general. |
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By (user no longer on site)
over a year ago
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"Being overweight/smoker does carry additional risks, I don't think any reasonable person would argue with that.
My beef is I required a hysterectomy and was told I had to lose five stones before they considered it as anaesthetic was given according to body weight and the amount needed to put me under could be fatal: fair enough. In the next breath I was offered bariatric surgery. When I said no thanks, but could I have the anaesthetist who would give me a gastric band on hand at my hysterectomy I was classed as difficult.
What's your point exactly? That the surgeon thought that the hysterectomy was risky due to weight issues? Fuck me, what does the surgeon know?!
No!
My point is if surgery is risky ar my weight it is contradictory to offer me ANY kind of surgery, or did you miss that bit trying to be funny?
No attempt ar humour on my behalf. Sarcasm, yes.
All surgery is different. All carry risks. Some are more intrusive and put the body under more stresses.
Hysterectomy and a gastric bypass are both invasive surgery. Surgery at my weight at the time would have been risky: no ifs, buts or maybe. Both would require general anaesthetic, therefore to my simple mind saying you're too fat for invasive surgery a but we'll do invasive surgery b didn’t make sense.
"
I don't know the facts and I'm neither a surgeon or an anaesthetist. I Am not qualified to question there decisions nor their risk factors.
I make judgement calls in my job. I avoid risks which are unnecessary to be faced for obvious reasons. I am the expert in my job, I make decisions which can be life or death, either myself, other engineers or users of the plant on which I am working. I make the call not the customer.
I wish you good health 
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"It is risk based. A good friend of mine recently had surgery. He smokes. He was asked/told to stop and give his lungs and himself the best chance of speedy recovery. This was only 5 days before surgery. Being on a bed, flat, not breathing in deeply with the addition of dis functional lungs is asking for pneumonia.
Good on the health care for asking people to lower risk factors and take some responsibility for themselves."
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Keyhole is OK but not as clean cut as people think.
Take a simple appendectomy
Open surgery.. Small scar done in 30- 40 mins.
Keyhole.. 3 x small scars takes 1h 10 - 30mins if the surgeon is is good.
All that time under general anesthesia.
Sometimes keyhole is not the way.
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"East and North Hertfordshire CCG - requires a patient's BMI to be under 30 or for them to lose 10% of their bodyweight before surgery
North East Essex CCG - requires patients who smoke to stop and attend smoking cessation programmes before referral to surgery.
I do get it - but it's strange that it's not a blanket policy across all NHS Trusts.
One of the main surgeries they seem to be saying should not be postponed is knee and hip replacements. But I guess less weight is less pressure afterwards. And like others have said the risk of Anaesthesia.
Sarah
"
The problem with BMi though is that it isn't always accurate.
When I was went through my anorexic stage and was SICKLY thin, my BMI still measured at 31/32 (I know they probably wouldn't consider one or two points over to be a massive problem, bit still).
- Amy. x |
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I'm against this on so many levels. It's clear that the wider adoption of private health insurance is what would be preferred by many of those in charge -especially if they or their mates can make a nice sum from hiving off NHS work, as it's starved and decommissioned piecemeal.
Risk assessments for individual patients are fine but blanket exclusions are inappropriate. |
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By (user no longer on site)
over a year ago
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"I'm against this on so many levels. It's clear that the wider adoption of private health insurance is what would be preferred by many of those in charge -especially if they or their mates can make a nice sum from hiving off NHS work, as it's starved and decommissioned piecemeal.
Risk assessments for individual patients are fine but blanket exclusions are inappropriate. "
There isn't blanket exclusions, there is just a duty of care for all and exclusions where the risk is deemed too great.
The story would read:
"Surgeon has been struck off as a patient dies post surgery. Dismissal and court appearance are due to negligence after failing to carry out his duty of care, for an obese smoker who was clearly at great risk of major surgery".
All because somebody couldn't put any effort in to laying off the ciggies and losing some weight. |
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To be honest if their surgery needed is because of theses things then I agree. Why give a smoker nee lungs just to have the same thing happen to them. I for one wouldn't want my lungs to go to a person who would just kill of mine as they did their own.
Hip replacement because of being larger seems pointless to me if they don't make themselves less likely to need the other done.
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By *B9 QueenWoman
over a year ago
Over the rainbow, under the bridge |
"The Royal College of Surgeons have produced a report found a third of local NHS health bosses put restrictions on certain patients having surgery until they had lost weight or quit smoking.
They think it's being used to ration surgery in the current tough financial climate. And these patients are a soft target for savings.
Clinically they say there's often no difference in outcome . Some NHS groups disagree - saying for less urgent surgery it helps.
I have a feeling it may help targets to send someone off to lose Weight/ quit smoking.
It really is a postcode lottery!
What do you think ?
And a reduction in national insurance contributions because they cannot expect the same level of service maybe?"
|
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By (user no longer on site)
over a year ago
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"Being overweight/smoker does carry additional risks, I don't think any reasonable person would argue with that.
My beef is I required a hysterectomy and was told I had to lose five stones before they considered it as anaesthetic was given according to body weight and the amount needed to put me under could be fatal: fair enough. In the next breath I was offered bariatric surgery. When I said no thanks, but could I have the anaesthetist who would give me a gastric band on hand at my hysterectomy I was classed as difficult.
What's your point exactly? That the surgeon thought that the hysterectomy was risky due to weight issues? Fuck me, what does the surgeon know?!
No!
My point is if surgery is risky ar my weight it is contradictory to offer me ANY kind of surgery, or did you miss that bit trying to be funny? "
Did you ask them WHY?
Did you do a quick Google to see the operation times?
Or did you just get sarcastic like you have here hence being labelled "difficult ".
30mins to do a lap band roughly.
60mins upwards for any of the hysterectomies.
Think about that for a while... |
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By (user no longer on site) OP
over a year ago
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"To be honest if their surgery needed is because of theses things then I agree. Why give a smoker nee lungs just to have the same thing happen to them. I for one wouldn't want my lungs to go to a person who would just kill of mine as they did their own.
Hip replacement because of being larger seems pointless to me if they don't make themselves less likely to need the other done.
"
I understand where you're coming from, but if your hip pain prevents you from exercising its a catch 22. And yes I get that you don't have to stuff your face. But exercise helps lose weight. |
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By (user no longer on site)
over a year ago
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"A couple of months ago I had to have an op and was told I was just ok for the op,if I had been a few pounds heavier would have had to wait longer.
This seems very silly to me and is just false economy as I would have become worse if I had had to wait."
Or you could have died during surgery. Or your post operative recovery could have been more complicated. |
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By (user no longer on site)
over a year ago
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"A couple of months ago I had to have an op and was told I was just ok for the op,if I had been a few pounds heavier would have had to wait longer.
This seems very silly to me and is just false economy as I would have become worse if I had had to wait.
Or you could have died during surgery. Or your post operative recovery could have been more complicated."
|
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By (user no longer on site)
over a year ago
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Excellent thread.
Amazing reading the extreme _iews. Obviously the surgeon who spends two decades training just to become a first year consultant - what does he know. |
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By (user no longer on site)
over a year ago
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"A couple of months ago I had to have an op and was told I was just ok for the op,if I had been a few pounds heavier would have had to wait longer.
This seems very silly to me and is just false economy as I would have become worse if I had had to wait.
Or you could have died during surgery. Or your post operative recovery could have been more complicated."
|
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By (user no longer on site)
over a year ago
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It's got to depend on the health implications.
I'm obese (nearly just overweight, finally!) If I needed surgery for something that was unrelated to my weight, where my weight wasn't going to affect the health outcome of the surgery, I'd be pretty fucking pissed off to be refused because I don't fall one side of a certain line. I'm not going to magically be healthier when I get to a BMI of 29.9 instead of 30.1.
But if I had a BMI of 40 and would be more likely to suffer serious complications during surgery as a result then that would seem a good reason to delay treatment until I'd lost weight. |
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By (user no longer on site)
over a year ago
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"It's got to depend on the health implications.
I'm obese (nearly just overweight, finally!) If I needed surgery for something that was unrelated to my weight, where my weight wasn't going to affect the health outcome of the surgery, I'd be pretty fucking pissed off to be refused because I don't fall one side of a certain line. I'm not going to magically be healthier when I get to a BMI of 29.9 instead of 30.1.
But if I had a BMI of 40 and would be more likely to suffer serious complications during surgery as a result then that would seem a good reason to delay treatment until I'd lost weight."
Firstly emergency surgery is different from elective surgery.
The BMI chosen is based on research. Doctors constantly get taken to task by patients who blame them for everything so they have to be able to defend their decision. This decision is based on extensive research looking at outcomes and complication profiles. For most surgeries it's been shown that complication profile is higher for those with a BMI higher than 30.
People also forget that these complications are not just the patients but doctors get performance assessment and league tables. Their also judged (including by those who acuse them of 'denying' them surgery) and have to undergo distressing investigations if their rates are higher. |
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By (user no longer on site)
over a year ago
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"It's got to depend on the health implications.
I'm obese (nearly just overweight, finally!) If I needed surgery for something that was unrelated to my weight, where my weight wasn't going to affect the health outcome of the surgery, I'd be pretty fucking pissed off to be refused because I don't fall one side of a certain line. I'm not going to magically be healthier when I get to a BMI of 29.9 instead of 30.1.
But if I had a BMI of 40 and would be more likely to suffer serious complications during surgery as a result then that would seem a good reason to delay treatment until I'd lost weight."
I watched a programme about BMI,they worked it out that just about every England rugby player would be classed as obese according to their BMI.
What hope have we got. |
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By (user no longer on site)
over a year ago
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"It's got to depend on the health implications.
I'm obese (nearly just overweight, finally!) If I needed surgery for something that was unrelated to my weight, where my weight wasn't going to affect the health outcome of the surgery, I'd be pretty fucking pissed off to be refused because I don't fall one side of a certain line. I'm not going to magically be healthier when I get to a BMI of 29.9 instead of 30.1.
But if I had a BMI of 40 and would be more likely to suffer serious complications during surgery as a result then that would seem a good reason to delay treatment until I'd lost weight.
Firstly emergency surgery is different from elective surgery.
The BMI chosen is based on research. Doctors constantly get taken to task by patients who blame them for everything so they have to be able to defend their decision. This decision is based on extensive research looking at outcomes and complication profiles. For most surgeries it's been shown that complication profile is higher for those with a BMI higher than 30.
People also forget that these complications are not just the patients but doctors get performance assessment and league tables. Their also judged (including by those who acuse them of 'denying' them surgery) and have to undergo distressing investigations if their rates are higher."
I get that. But as an individual, nothing is magically going to happen to me when I get from BMI 30.1 and therefore too fat for whatever to 29.9 when I'm deemed acceptable. I won't suddenly be much healthier than I was before, I will just weigh a couple of pounds less. So I can understand people being pissed off with what can feel like arbitrary lines being drawn which exclude them. |
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By (user no longer on site)
over a year ago
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"It's got to depend on the health implications.
I'm obese (nearly just overweight, finally!) If I needed surgery for something that was unrelated to my weight, where my weight wasn't going to affect the health outcome of the surgery, I'd be pretty fucking pissed off to be refused because I don't fall one side of a certain line. I'm not going to magically be healthier when I get to a BMI of 29.9 instead of 30.1.
But if I had a BMI of 40 and would be more likely to suffer serious complications during surgery as a result then that would seem a good reason to delay treatment until I'd lost weight.
Firstly emergency surgery is different from elective surgery.
The BMI chosen is based on research. Doctors constantly get taken to task by patients who blame them for everything so they have to be able to defend their decision. This decision is based on extensive research looking at outcomes and complication profiles. For most surgeries it's been shown that complication profile is higher for those with a BMI higher than 30.
People also forget that these complications are not just the patients but doctors get performance assessment and league tables. Their also judged (including by those who acuse them of 'denying' them surgery) and have to undergo distressing investigations if their rates are higher.
I get that. But as an individual, nothing is magically going to happen to me when I get from BMI 30.1 and therefore too fat for whatever to 29.9 when I'm deemed acceptable. I won't suddenly be much healthier than I was before, I will just weigh a couple of pounds less. So I can understand people being pissed off with what can feel like arbitrary lines being drawn which exclude them. "
Why not just lose the weight of it's just a couple of pounds? Claiming it's the principle of the BMI being "arbitrary" is ridiculous over one's health. In the end, not being so obese is better. Everyone wins. |
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By (user no longer on site)
over a year ago
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As I just said it's not an arbitrary line.
Secondly, no one gets refused because their BMI is 30.1 as we all accept a margin of error.
Furthermore, bmi is not absolute as mentioned and surgeons look at other measures such as fat depth seen on scans.
Bottom line is their decision is not arbitrary but due to the complexity of it, many don't understand.
As note, remember patients underweight may not be allowed to have certain surgery too. |
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By (user no longer on site)
over a year ago
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"As I just said it's not an arbitrary line.
Secondly, no one gets refused because their BMI is 30.1 as we all accept a margin of error.
Furthermore, bmi is not absolute as mentioned and surgeons look at other measures such as fat depth seen on scans.
Bottom line is their decision is not arbitrary but due to the complexity of it, many don't understand.
As note, remember patients underweight may not be allowed to have certain surgery too."
Of course, and the same applies to the person refused at 17.9. BMI trends apply to populations. It doesn't make that refusal of treatment feel any better to you as an individual.
And yes, people do get refused treatment for not reaching that magic weight line. Even wheb by all the other recognised measures they're deemed acceptable. |
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By (user no longer on site)
over a year ago
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"I reckon the real reason people are upset is cos they don't like being called fat, and having it pointed out as their own fault. "
You may be right..but some people think that because they are slim and not over weight,that they are healthier. |
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"As I just said it's not an arbitrary line.
Secondly, no one gets refused because their BMI is 30.1 as we all accept a margin of error.
Furthermore, bmi is not absolute as mentioned and surgeons look at other measures such as fat depth seen on scans.
Bottom line is their decision is not arbitrary but due to the complexity of it, many don't understand.
As note, remember patients underweight may not be allowed to have certain surgery too.
Of course, and the same applies to the person refused at 17.9. BMI trends apply to populations. It doesn't make that refusal of treatment feel any better to you as an individual.
And yes, people do get refused treatment for not reaching that magic weight line. Even wheb by all the other recognised measures they're deemed acceptable. "
It's more about showing a willingness to change your weight. If you don't quite make the finish line then it could still go ahead as you've made a significant change to your lifestyle. Bmi after all is only good for drug calculations most prop forward are clinically obese by the Bmi......
I'm not going to be the one to tell them!  |
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Health is very important. I agree the decisions may be economically 'influenced' but there are also health issues associated with recovery from surgery if someone smokes or is overweight, so it makes sense to follow the health experts health advice. |
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By (user no longer on site)
over a year ago
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"As I just said it's not an arbitrary line.
Secondly, no one gets refused because their BMI is 30.1 as we all accept a margin of error.
Furthermore, bmi is not absolute as mentioned and surgeons look at other measures such as fat depth seen on scans.
Bottom line is their decision is not arbitrary but due to the complexity of it, many don't understand.
As note, remember patients underweight may not be allowed to have certain surgery too.
Of course, and the same applies to the person refused at 17.9. BMI trends apply to populations. It doesn't make that refusal of treatment feel any better to you as an individual.
And yes, people do get refused treatment for not reaching that magic weight line. Even wheb by all the other recognised measures they're deemed acceptable.
It's more about showing a willingness to change your weight. If you don't quite make the finish line then it could still go ahead as you've made a significant change to your lifestyle. Bmi after all is only good for drug calculations most prop forward are clinically obese by the Bmi......
I'm not going to be the one to tell them! "
I wish that was true, but it hasn't been in my experience. Oh you're still a few pounds away from your magic weight? Fuck off and get back to the end of the queue. |
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By (user no longer on site)
over a year ago
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"I reckon the real reason people are upset is cos they don't like being called fat, and having it pointed out as their own fault.
You may be right..but some people think that because they are slim and not over weight,that they are healthier."
I think a person with a healthy BMI is almost ALWAYS healthier than a morbidly obese person. Excusing being overweight because some fat people can be healthy is backwards, it's not helping people in the long run. |
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By (user no longer on site)
over a year ago
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It's amazing how 'some' on here judge others from their perfect little bubble or a bubble they think is perfect.
I'm large I had surgery last year planned surgery which in the end due to sepsis ended up as emergency 3 weeks prior to my planned op date. At no point was I told to loose weight I was however as a smoker warned of the anasthetic risk. I had no choice have surgery or die simple as that.
I do take offence at those who say ' your own fault
Your fat eat less ' blah blah brigade.
I eat a well balanced diet my twice a month treat is a take away and I drink maybe once every 6 months of that.
On an average working day I do around 25,000 steps (Fitbit) and I eat no more than 1400 calories a day. So not all of us FAT people need to be spoke to by judgemental condescending idiots asking or should I say telling us we are a burden on the NHS. |
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I agree with it. Slimming classes have always had nembers there to lose weight for knee or hip ops. My grandma had to lose weight to have a new knee and that was 40 years ago.
Its only an issue now as more people are overweight and we know what smoking does. I paid to have an op done and yes money talks as from my first appointment to surgery was 3 weeks at 21 abd 1/2 stone and smoker i would never have got it done. It so happens i had a really good recovery but it is one with high complication rate.
I still smoke and i wont be blaming anyone else. And i personally have never heard of anyone being refused surgery based just on the fact they are .1 over the bmi.
It just makes sense |
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