Is it medically legitimate to withhold treatment from overweight people?
Anaesthetically it's harder, the surgery is harder and the rehabilitation takes longer. So it's medically legitimate to withhold treatment from some very overweight people. But it should not be done for social reasons," she said.
Should obese patients be treated as a class instead of individuals?
“Patients who may be at a marginally higher risk may be treated as a class instead of individuals. That is the definition of discrimination.” Surgery involves anesthesia, of course, giving rise to another issue. There are no requirements for drug makers to figure out appropriate doses for obese patients.
Can a healthcare professional tell if you are overweight?
A healthcare professional would use clinical judgement and there’s evidence that shows if someone is overweight or has a high BMI, the chances of complications from any clinical intervention can increase.
Why are doctors refusing to operate on patients with high body mass index?
Dr. Yates said he had successfully operated on people with body mass indexes as high as 45. What is behind the refusals to operate, he said, is that doctors and hospitals have become risk-averse because they fear their ratings will fall if too many patients have complications.
Can doctors refuse to treat obese patients?
Compared with patients of normal weight, patients who are obese were more likely to be told to make lifestyle changes for their symptoms, while patients who weigh less are prescribed medication. Some doctors flat-out refuse to treat obese patients.
Is being overweight considered a medical condition?
Is obesity an illness or a disease? The American Medical Association (AMA) officially recognized obesity as a chronic disease back in 2013. The AMA also states that it's a disease state with multiple functional changes that require a range of treatment and prevention options.
How do you treat an overweight patient?
Healthy eating plan and regular physical activity. Following a healthy eating plan with fewer calories is often the first step in trying to treat overweight and obesity. ... Changing your habits. ... Weight-management programs. ... Weight-loss medicines. ... Weight-loss devices. ... Bariatric surgery. ... Special diets. ... References.
Can obesity be treated medically?
The most commonly used medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of obesity include: Bupropion-naltrexone (Contrave) Liraglutide (Saxenda) Orlistat (Alli, Xenical)
Why is overweight unhealthy?
Obesity means having an unhealthy amount of body fat. This puts your health in danger. Obesity puts you at greater risk for type 2 diabetes, heart disease, high blood pressure, arthritis, sleep apnea, some types of cancer, and stroke. Treatment involves a long-term plan for making lifestyle changes.
Is obesity a disease debate?
Despite the research on genetics in obesity, not everyone thinks obesity should be called a disease. Some argue that gaining weight due to increasing body fat is a normal function, not a disease. They argue that the problem is not our bodies, but our environments alone.
How can we prevent and treat obesity?
Obesity prevention for adultsConsume less “bad” fat and more “good” fat.Consume less processed and sugary foods.Eat more servings of vegetables and fruits. ... Eat plenty of dietary fiber.Focus on eating low–glycemic index foods. ... Get the family involved in your journey. ... Engage in regular aerobic activity.More items...
What is the most effective treatment for obesity?
Bariatric surgery, which involves sealing off most of the stomach to reduce the quantity of food you can consume, can be an effective means for morbidly obese people to lose weight and maintain that weight loss.
What is the first line of treatment for obesity?
Metformin is therefore considered a first line drug in treating patients with type 2 diabetes and obesity. The most common side effects of metformin are nausea, flatulence, diarrhea, and bloating (103).
Why do we need to prevent obesity?
Preventing obesity helps you reduce your risk of a host of associated health issues, from heart disease to diabetes to some cancers and much more. Like many chronic conditions, obesity is preventable with a healthy lifestyle—staying active, following a healthy diet, getting adequate sleep, and so on.
Is obesity hard to treat?
Part of what makes obesity so difficult to treat, according to Kolata, is that the system that controls our weight is too complex to be controlled by one type of treatment.
What are the most common medical problems in obese patients?
One of the most frequent medical problems in obese patients is arthritis of the hip or knee. It is so common, in fact, that most patients arriving at orthopedists’ offices in agonizing pain from hip or knee arthritis are obese.
Why should heavy patients be counseled to lose weight?
The group concluded that heavy patients should first be counseled to lose weight because a lower weight reduces stress on the joints and can alleviate pain without surgery. But there should not be blanket refusals to operate on fat people, the committee wrote.
What happens when obese patients cannot fit in a scanner?
When an obese patient cannot fit in a scanner, doctors may just give up. Some use X-rays to scan, hoping for the best. Others resort to more extreme measures. Dr. Kahan said another doctor had sent one of his patients to a zoo for a scan. She was so humiliated that she declined requests for an interview.
Why did Patty Nece go to an orthopedist?
Patty Nece, 58, of Alexandria, Va., went to an orthopedist because her hip was aching. She had lost nearly 70 pounds and, although she still had a way to go, was feeling good about herself. Until she saw the doctor.
Why are doctors and hospitals risk averse?
What is behind the refusals to operate, he said, is that doctors and hospitals have become risk-averse because they fear their ratings will fall if too many patients have complications.
How many Americans are obese?
One in three Americans is obese, a rate that has been steadily growing for more than two decades, but the health care system — in its attitudes, equipment and common practices — is ill prepared, and its practitioners are often unwilling, to treat the rising population of fat patients.
How many calories should I eat a day to lose weight?
You must lose weight, a doctor told Sarah Bramblette, advising a 1,200-calorie-a-day diet. But Ms. Bramblette had a basic question: How much do I weigh?
Who opposes rationing in the NHS?
The Royal College of Physicians, which represents hospital doctors, said it opposed the practice. "Lifestyle rationing is creeping into the NHS. There are reported examples where treatments have been restricted by PCTs and we wouldn't agree with that," said Professor John Saunders, chair of the college's ethics committees.
Who is the chairman of the British Medical Association's consultants committee?
Dr Mark Porter, chairman of the British Medical Association's consultants committee, blasted treatment bans as "wholly unacceptable". But he added: "There are occasions where a doctor may advise an obese person to lose weight before surgery can safely go ahead. This is a clinical rather than a rationing decision.".
Who is the chief executive of Doctors.net.uk?
Dr Tim Ringrose , Doctors .net.uk's chief executive, said the findings represented a significant shift in doctors' thinking brought on by the NHS in England's need to save £20bn by 2015. "This might appear to be only a slim majority of doctors in favour of limiting treatment to some patients who fail to look after themselves, but it represents a tectonic shift for a profession that has always sought to provide free healthcare from the cradle to the grave," he said.
Is it legal to withhold treatment from overweight people?
Operating on a very fat person is more dangerous. Anaesthetically it's harder, the surgery is harder and the rehabilitation takes longer. So it's medically legitimate to withhold treatment from some very overweight people. But it should not be done for social reasons," she said.
Is there an excuse to deny care on the basis of arbitrary blanket bans?
The Department of Health took a similar stance. "There is no excuse to deny care on the basis of arbitrary blanket bans — the individual needs of patients must be taken into account," said a spokeswoman.
Do doctors support smoking?
A majority of doctors support measures to deny treatment to smokers and the obese, according to a survey that has sparked a row over the NHS's growing use of "lifestyle rationing".
What procedures are non urgent?
That report – which looked at a range of non-urgent procedures including hip and knee surgery, hernia surgery and tonsillectomies – found that almost a third of CCGs had one or more policies restricting access to treatments based on BMI.
How long is Karen on the waiting list for surgery?
Karen has finally been placed on the 16-week waiting list for surgery and should be treated by late May, nearly 14 months after her symptoms first started. But she isn’t the only patient being denied treatment until after she’s lost weight. A 2016 report by the Royal College of Surgeons said that overweight patients were being used as “soft targets” for CCGs looking to cut costs.
Can being overweight increase your risk of complications?
East and North Hertfordshire CCG, who commission Karen’s local NHS services, told i: “There is strong evidence that being very overweight… can greatly increase your risk of developing complications both on the operating table and when you are recovering. Our policy is that if a patient’s BMI is between 30 and 40, they will need to either lose at least 10 per cent of their body weight, or reduce their weight until their BMI is less than 30. [At consultation in 2017] there was a significant level of public support for this change in policy.”
Does obesity affect post operative success?
However, a briefing paper published by the Royal College of Surgeons in November 2017 states that: “While obesity leads to poorer health outcomes, its relationship with post-operative success is less clear and there is a lack of evidence that rapid weight-loss before surgery makes much difference.”
Is overweight a target for CCGs?
Dr Rebecca Brown, a research fellow on the Individual Responsibility and Healthcare project at The Oxford Uehiro Centre for Practical Ethics, also believes overweight patients have become “an easy target” for cost-cutting CCGs. Her 2019 paper ‘Irresponsibly Infertile?’ looked at cases like Jenny’s and concluded that there isn’t sufficient evidence of IVF’s effectiveness in either obese or non-obese patients to justify excluding higher BMI patients from treatment.
Why are obese people more likely to be in lower paid jobs?
This may be because those with lower income are more likely to live in poorer areas and where healthier, more nutritious foods aren’t as readily available or outside of their budget. This may also be due to a discrimination present against people who are obese and overweight. Employers may be more likely to hire those who aren’t overweight as they see their ability to resist overeating or staying in shape as a good quality in what Acs, Lyles and Stanton (2007) describe as a “willingness to delay gratification.” Whatever the reason may be for the correlation between being overweight and having lower income, the fact remains that the lack of capital possessed by the obese population would prove to be incredibly troublesome if obese people were to finance their medical treatment in this manner. The case for increasing the tax of unhealthy foods may be less applicable as it may push both healthy foods and unhealthy foods out of reach for poorer and obese population financially. To overcome this, healthier foods have to be made cheaper and more widespread, which may again be difficult given the nature to produce healthier and organic foods are likely to cost more. Even so, it would seem any loss made would surely help the NHS spend less on obesity, which, in the 2007, was estimated at £4.2 billion.6
What are the health problems that obesity causes?
Examples of these include diabetes mellitus, increased cholesterol, coronary heart disease and hypertension amongst many others.7 It is important to discuss the seriousness of these resulting conditions in order to fully comprehend the fatality of obesity. Diabetes mellitus (otherwise known as type II diabetes) is a serious condition which occurs when the body either does not produce enough insulin or the cells do not properly react to the insulin produced. This condition is said to affect approximately 2 million people across England and Wales, supposedly with a further 750, 000 unaware that they have this condition.4 Type II diabetes can also lead to kidney disease, nerve damage or even strokes. Coronary heart disease is another serious condition which can be caused because of obesity, which affects almost 300, 000 people a year in the U.K.11
Why is BMI classified in table 1?
The results gained from the BMI can be classified in table 1 in order to specify the particular weight class of an individual.
What are the causes of obesity?
These include genetic susceptibility, socio-environmental factors, malfunctioning appetite regulation or may also be a cause of other diseases , such as Cushing’s syndrome.7 While it was previously thought that obesity was caused by a lack of willpower or a lifestyle choice, more recent studies have discovered that obesity is a chronic disease, involving a number of different biochemical and metabolic processes compared to individuals who aren’t obese.8
Is obesity a cost?
Obesity is an incredibly expensive disease, both for the patients and the hospitals. Aside from being a disease which is associated with many further complications and problems, which themselves lead to an increased cost, this disease also requires costly medication and specialised equipment for diagnosis and treatment. This results in a condition which has proven extremely costly to nearly all parties involved. It has been reported that £47 million was spent purely on anti-obesity drugs in the fiscal year of ’06 to ‘07.1 This figure, coupled with the fact that the prevalence of adult obesity in the U.K. is above 20 per cent and set to rise10, signifies the incredible cost associated with this disease and, in turn, highlights the growing problem of obesity on a social and economic scale. It’s a problem that can’t be ignored, and throughout the course of this paper I will attempt to weigh and evaluate both sides of the argument; Should obese people pay more for medical treatment?, in order to find a resolution.
Is obesity a complicated disease?
It apparent that obesity is an incredibly complicated disease in terms of the causes, secondary factors and treatments, all of which contribute towards a confusion regarding the nature of obesity in the minds of the public as well as upping the cost due it’s many treatment techniques, none of which can be considered 100 per cent effective. This encompasses all of the aspects of the disease, which is often described as an epidemic, as it’s a growing concern, and the economic burden attached is sure to evoke strong opinions regarding the question of this paper.
Is BMI gender specific?
For instance, this table of classification for BMI is not gender specific, so it is applied the same for both males and females equally, as well as this, it also doesn’t account for weight distribution in individuals nor is it possible to consider bone or muscle mass, both of which are heavier than fat. These problems will hold more significance later in this essay while discussing how obesity should be defined.