This September (2016) the national health care service in England blocked elective surgery for those with a BMI over 30. For reference, if you are 5’6″, your weight must be below 186. “Hospital leaders in North Yorkshire said that patients with a body mass index (BMI) of 30 or above – as well as smokers – will be barred from most surgery for up to a year amid increasingly desperate measures to plug a funding black hole. The restrictions will apply to standard hip and knee operations.” This ban continue for all non life threatening conditions for a year. There may be some flexibility if the patient shows they have lost 10% of their weight within a year.
Why would they do this?
They are having issues with funding, so they needed to figure out a way to limit surgeries. It is true that BMI and smoking correlate with poorer outcomes and higher risk of surgery. Higher infection rates, poorer wound healing, worse scarring are all issues. They state their focus is on trying to get patients to have healthy habits and been heading in the right direction before doing a surgery. If a person has a complication, then the cost goes higher for the surgery, as they require more treatments and visits.
As a spokesman for NHS England added: “Major surgery poses much higher risks for severely overweight patients who smoke. So local GP-led Clinical Commissioning Groups are entirely right to ensure these patients first get support to lose weight and try and stop smoking before their hip or knee operation. Reducing obesity and cutting smoking not only benefits patients, but saves the NHS and taxpayers millions of pounds.”
It will be interesting to see what happens with this, as you can imagine this created quite a stir.
But the underlying principal- safer surgeries, better outcomes, less risk- is a sound one.