Smokers and obese people to be denied routine surgery on the NHS in Devon

Piliger · 04-12-2014 07:14PM

ceadaoin. wrote: »

Some people might have mobility issues that prevent them from exercising or even moving so they might find it hard to lose weight. For some people it's not as simple as laying off the burgers.

This is not the case. They are obese from eating. Stop eating and they will lose weight.

Piliger · 04-12-2014 07:16PM

darkpagandeath wrote: »

Pretty sure refusing medical care is illegal and against the Hippocratic oath, not saying obese people should be tolerated as normal.

No one is being denied medical care. Jut not major costly surgery.

MarkAnthony · 04-12-2014 07:16PM

ceadaoin. wrote: »

Some people might have mobility issues that prevent them from exercising or even moving so they might find it hard to lose weight. For some people it's not as simple as laying off the burgers.

I don't think anyone would have a problem with individual cases being assessed as too high risk for surgery. It's the fact that it is a blanket ban purely to save money rather than the decision being made on a case by case basis based on what is best for that patient.

Again IIRC there is some statistic that even with zero exercise 5% if loseable by diet change. Could be wrong on that simply trying to suggest a reason for the figure.

Being a fatty myself I know how easy it is to lose small percentages of weight, that isn't healthy in itself but when undergoing surgery might be beneficial.

ceadaoin. · 04-12-2014 07:17PM

Piliger wrote: »

This is not the case. They are obese from eating. Stop eating and they will lose weight.

Ok so if they can't exercise because they can't walk, and might be taking medications that cause them to gain weight they should just stop eating altogether?

Tombi! · 04-12-2014 07:18PM

MarkAnthony wrote: »

There's some statistic ref 5% of body mass giving x health benefit. Can't remember it off hand. However in fairness a percentage figure is the fairest option especially given a time scale. It's not like smoking where one can simply stop.

Oh, that's interesting actually.
I figure it could be based on a case by case basis. I mean the 30 stone man vs the 15 stone man would definitely have different amounts of weight to lose.

ceadaoin. wrote: »

Some people might have mobility issues that prevent them from exercising or even moving so they might find it hard to lose weight. For some people it's not as simple as laying off the burgers.

I don't think anyone would have a problem with individual cases being assessed as too high risk for surgery. It's the fact that it is a blanket ban purely to save money rather than the decision being made on a case by case basis based on what is best for that patient.

Weight loss is generally based on calories in vs calories out. You could be bedridden and still lose weight. A lot of programs on extremely obese people do show they have beyond terrible diets and consume far more.
Me drinking a small bottle of coke every day might not be best. But you have me drinking two liters of it a day and I'll put on weight.

Shenshen · 04-12-2014 07:18PM

MarkAnthony wrote: »

There's some statistic ref 5% of body mass giving x health benefit. Can't remember it off hand. However in fairness a percentage figure is the fairest option especially given a time scale. It's not like smoking where one can simply stop.

I'm no doctor, but just from personal experience, there would be no healthy way for someone weighing 100kg to lose 5kg in 2 months.
I've been working my way down the scales for the last 3 years now, and to achieve 1kg loss in one month, I'd be restricted to 1600 kcal a day. To lose more than twice that, you'd be down to around 1000 kcal. It'll take some very interesting food plan to convince me that that would be healthy.

Not to mention that the quickest way to gain weight is a crash diet like that - the yo-yo effect would very likely to pile all that back on again after the operation, and then some.

Tombi! · 04-12-2014 07:19PM

ceadaoin. wrote: »

Ok so if they can't exercise because they can't walk, and might be taking medications that cause them to gain weight they should just stop eating altogether?

You're suggesting a very, very small amount. There will always be exceptions. And, like the article said, exceptions can be made.

MarkAnthony · 04-12-2014 07:22PM

Shenshen wrote: »

I'm no doctor, but just from personal experience, there would be no healthy way for someone weighing 100kg to lose 5kg in 2 months.
I've been working my way down the scales for the last 3 years now, and to achieve 1kg loss in one month, I'd be restricted to 1600 kcal a day. To lose more than twice that, you'd be down to around 1000 kcal. It'll take some very interesting food plan to convince me that that would be healthy.

Not to mention that the quickest way to gain weight is a crash diet like that - the yo-yo effect would very likely to pile all that back on again after the operation, and then some.

Not a doctor either but I do know there is some debate over whether calorie control is the most effective weight loss tool, but I digress.

The fact remains that losing 5Kg in 2 months is probably ideal but then neither is being 100Kg. I think we'd need a doctor to tell us which is better. Going under the knife at 100Kg or losing the weight then undergoing the operation.

Tail Docker · 04-12-2014 07:24PM

Awful to hear. Happily, the only thing I want to have to do with Devon is eat some of their creamy rice pudding. They can jam their hospitals and their dumb policy up their buttery hoop. They never were the brightest anyway.

MarkAnthony · 04-12-2014 07:25PM

Brutal Deluxe wrote: »

Oh, that's interesting actually.
I figure it could be based on a case by case basis. I mean the 30 stone man vs the 15 stone man would definitely have different amounts of weight to lose.

Just did a quick Google there - various results from medical publications saying a 5-10% loss gives significant results in X and Y. As I say something I'd definitely heard in the past.

04-12-2014 07:29PM

MarkAnthony wrote: »

Just did a quick Google there - various results from medical publications saying a 5-10% loss gives significant results in X and Y. As I say something I'd definitely heard in the past.

For the morbidly obese or the overweight? What timeframe?

Shenshen · 04-12-2014 07:29PM

MarkAnthony wrote: »

Not a doctor either but I do know there is some debate over whether calorie control is the most effective weight loss tool, but I digress.

The fact remains that losing 5Kg in 2 months is probably ideal but then neither is being 100Kg. I think we'd need a doctor to tell us which is better. Going under the knife at 100Kg or losing the weight then undergoing the operation.

It isn't for me, I find exercise much more efficient. But I may be the exception to the rule, as most of AH's qualified and accredited dietitians (tm) would be quick to point out that all us fatties need to do is just stop eating altogether.

What has me confused that the rule of 5% in 2 months seems to be applied across the board. Surely, if weight was the real issue here the rule would be simply "come back once you're under xx kg, in your own time".

Tombi! · 04-12-2014 07:30PM

Shenshen wrote: »

It isn't for me, I find exercise much more efficient. But I may be the exception to the rule, as most of AH's qualified and accredited dietitians (tm) would be quick to point out that all us fatties need to do is just stop eating altogether.

And can you point out where people told you to stop eating altogether?

Piliger · 04-12-2014 07:30PM

Shenshen wrote: »

I'm no doctor, but just from personal experience, there would be no healthy way for someone weighing 100kg to lose 5kg in 2 months.
I've been working my way down the scales for the last 3 years now, and to achieve 1kg loss in one month, I'd be restricted to 1600 kcal a day. To lose more than twice that, you'd be down to around 1000 kcal. It'll take some very interesting food plan to convince me that that would be healthy.

Not to mention that the quickest way to gain weight is a crash diet like that - the yo-yo effect would very likely to pile all that back on again after the operation, and then some.

I see absolutely no reason why not. More likely it is just difficult. And this is at the heart of the reason why these people are obese to start with. They have no self discipline and expect to lose weight in an easy way. It was very 'easy' to get obese to start with ! Not the price has to be paid to lose it.

And this yo yo effect is yet again only a psychological issue. if a person wants the public to pay for surgery they should be told to lose it or f*ck off.

Greenmachine · 04-12-2014 07:48PM

Weight can be lost 100% through diet alone. It is a question of how much however. If someone is massively overweight if most cases it is from over eating. The relative stability of the persons weight will factor in the whole thing. If a person is sufficently overweight they could drop 2lb per week with diet of 2000 kcal alone. There are quite a few variable however muscle mass vs fat, metabolism etc.

MarkAnthony · 04-12-2014 07:52PM

Greenmachine wrote: »

Weight can be lost 100% through diet alone. It is a question of how much however. If someone is massively overweight if most cases it is from over eating. The relative stability of the persons weight will factor in the whole thing. If a person is sufficently overweight they could drop 2lb per week with diet of 2000 kcal alone. There are quite a few variable however muscle mass vs fat, metabolism etc.

If you eliminate certain food groups you can see silly reductions it's how Slimming World works. I'm 18st, I think I lost 5lb in the first week without even trying. Eventually I was down to a 1.5/2lb loss per week but I wasn't hungry.

Don't know why I stopped in all honesty!

Shenshen · 04-12-2014 08:39PM

Brutal Deluxe wrote: »

And can you point out where people told you to stop eating altogether?

Post #33

Tombi! · 04-12-2014 09:15PM

Shenshen wrote: »

Post #33

This one?

Piliger wrote: »

No one is being denied medical care. Jut not major costly surgery.

Smokers and obese people to be denied routine surgery on the NHS in Devon

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