York hospitals now require patients to lose weight before surgery

Camille Bienvenu
Wed, 30 Nov 2016
York hospitals now require patients to lose weight before surgery
NHS England has approved a plan that no longer let overweight patients and smokers automatically get referred for surgery, unless they take it upon themselves to improve their health first.

This new proposal, enacted in the local areas of York, Selby and Tadcaster, could affect obese patients with type 2 diabetes who can no longer afford to wait for undergoing weight loss surgery.

Losing weight through gastric bypass can help overweight patients reduce their odds for certain cancers, while even a modest weight loss achieved with the operation can result in better glucose control in people with type 2 diabetes.

Under this plan, which is expected to come into effect early next year, overweight patients with a body mass index (BMI) of at least 30 will have to lose 10 per cent of their weight before they can be granted the right to receive surgery.

BMI isn't a really good measure of obesity and shouldn't be the only basis for refusing overweight patients surgery. People that are really muscular and short may also have a high BMI. Looking at waist circumference and other factors is not in the plan.

When it comes to smokers, they will be mandated to quit for at least two months prior to requesting surgery. Failure to meet these goals for both groups of patients mean facing an operation delay of up to six months.

The NHS Vale of York Clinical Commissioning Group (CCG), who passed the new restrictions, said only routine, elective surgery for non-life threatening procedures would be affected.

Gastric bypass surgery is technically considered an elective surgery, therefore this new selection process could become a part of the risk assessment for candidates.

However, the CCG is considering excluding bariatric surgery, along with emergency surgery and operations on patients under 18, from their final plan.

According to the CCG, patients will be dealt with on a case-by-case basis according to their symptoms, but there is concern that this new policy may not act fairly.

The Royal College of Surgeons initially opposed the plan, suggesting that denying operations for patients with lifestyle-driven conditions may help to protect finances but it's not in the best interest of their health.

This could mean refusing treatment to high risk overweight patients that are taking medications that raise insulin in the body - which can greatly increase the difficulty in losing weight.

The CCG will nonetheless try and support patients who are refused surgery by having them follow a weight loss or stopping smoking programme.
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