Excess skin

janatarnhem

On the BBC news this morning was an item about excess skin after drastic weight loss.

There were two cases sighted.

The first was a diabetic middle aged man who had lost six stone following a successful gastric band operation.
The skin around his mid rift was really saggy and he had a red sore starting under one of his man boobs.He had tried toning up in the gym to no avail. He had his gastric band surgery on the NHS , but their is currently no provision on the NHS to remove the saggy skin.

One of my questions is : Should he be allowed to have the skin removal on the NHS or should he have to pay privately for this?
Cost would be in the region of £1,500

The other case was a women who had lost 11 stone over 10 years, with diet and exercise. As one could imagine, she was left with this unsightly, saggy excess skin.
She had the skin removal surgery on the NHS.
She had had, by all accounts, a troubled neglected upbringing , where her mother was an chronic alcoholic and the children's nutritional health and needs were just unable to be met.
It was not until adulthood, and leaving home , when she was able to make her own nutritional and lifestyle decisions that she was able to lose the weight over a protracted period of time.
She said that she was not to blame for her poor childhood and so losing the weight and thus having her surgery was "just".

Is there an obligation on the NHS to follow up with skin surgery on the NHS regardless of how the weight loss has come about?
It seems that by eliminating one massive health issue in the UK- obesity, another issue is being created.

MandyJokl

I was wondering about this one. There are conflicting reports. My doctor has told me that if I lose a lot of weight he can put me forward to a panel who decide. He said he had just referred someone who had lost 70 pounds but they were turned down. I have seen articles on line that say if you lose a certain amount you can get the operation on the NHS.

Part of me thinks that I got myself into this state by over eating so by being clinically obese for ten years is my own fault and I shouldn't expect the NHS to pay for removing skin, tummy tuck or boob lift.

The other side of the coin is that if I'd stayed over weight and contracted diabetes then I would be treated for free and also any heart disease would be treated too at no cost to me.

It's a tough decision. I think the NHS are fast running out of money and are trying to save money where they can. So many people demand so much from the NHS it's going to implode. People live longer. Diseases and illness are treated for longer before people die.

I will let you know what happens when I have lost all my 175 pounds!

KarenJanine

These cases are reviewed on a case-by-case basis and the individual's case history will be considered.

The bariatric surgery was felt to be necessary for the man from a health point of view. This would hopefully prevent various obesity-related health problems in later life (diabetes, orthopaedic problems, etc) which would likely add up to a greater cost than the bariatric procedure as well as causing greater problems to the patient himself. Excess skin removal in this case would likely be a cosmetic procedure more than anything else.

In the other case it seems as though this is a more psychological case and the skin removal was likely felt necessary in order to help her mental health.

I think it is right that cases should be considered individually as there is no 'one fits all' path to take.

janatarnhem

I see where you are coming from karen jannine, but I don't think that "cosmetic" is just the issue.
The diabetic man is at risk with his skin more than a non diabetic person with excess skin.
I would argue that his excess skin poses a physical ...and yes a psychological... health issue. E.g sores, fungal infections leading to skin damage that is harder to deal with.

Funding in the NHS is such a political, hot bed of competing interests, but I think that supporting those who lose weight to such a large degree is vital to save the NHS funding of the future.

pyrowill

It is my opinion that self inflicted non life threatening issues should not be fixed on the NHS. Gastric bypass op's are life saving, removing excess skin is cosmetic. Where do you draw the line then? Nose jobs, boob implants?

If however the excess skin is causing a physical problem and cannot be removed then might aswell go for it, since its most likely that it will cost the NHS more in the long run.

caroleannlight

Are you prepared to pay more taxes? The NHS does not have unlimited resources so choices on how best to spend the budget have to be made. These are not easy and straightforward. In general if a procedure is more cosmetic in nature then it is less likely to be funded. We all need to take some responsibility for our own health and well-being.

jjrichard83

Of course everyone will justify their actions and justify why they should get it (or anything).

The argument can always be made for both sides, the sneeky person is usually the one who can get through the loopholes though.

1500 ($2000 US/CAN) is not a lot of money at all for something like that. It's not like it's $40,000. Most people could save that up in no time, even if it takes a year or so. Something like that, I don't think anyone (def that lady) should have the social program pay for it.

janatarnhem

I agree that the NHS has to have restraints on what it can and can't provide, unfortunately. Rationing in the NHS isn't an new issue. Paying more tax is an option..though collecting taxes in this country would be a place to start first!!! I just find it kind of sad that when someone takes responsibility and loses the weight for their health, the NHS is not freely available for them after, that's all!

brokenjawedmuse

I think if the excess skin is a HEALTH risk, then they should pick up the tab.

If it's purely cosmetic, then no, the individual should pick up the tab.

nwg74

There is another story on the Daily Mail who has lost 13 stone by surgery and has 4 stone and had been rejected despite suffering from backache.

I have some excess skin after losing over 14 stone and it also gives me quite severe backache occasionally. I haven't had any surgery and I will not contemplate skin surgery. I have seen too many operations that leave big scars that to me, is worse. I am hoping after about another half a stone or more there will be a lot less.

Excess skin surgery can cost anywhere up to £5000 or more depending on how much has to be removed.

The rules for surgery is different for each Health authority. Some will not do it as they consider it to be cosmetic.

kats3boys

How come the woman's mental health was taken into consideration and not the man's ??

janatarnhem

"How come the woman's mental health was taken into consideration and not the man's?"

I don't think the story meant that the two cases were linked together by time, area health authority, postcode etc... I think the women's case was used as an illustration that skin surgery could be done..... I think.!

And yes, it did show her scars - under her upper arms were evidence of linear, bluey-grey, neat, but big surgical scars and apparently there was one all the way round her lower body. But the excess loose, with evidence of some sores looked "worse" to my mind, as surely posed a health issue.
I
What I think gals me..is that as a NHS worker, the bypass was done to "save" his life, but has generated another problem for him. How is that right? It is like doing half the job!

Falenea

Bump to read later

GrannyGwen1

BUMPING FOR A FRIEND FROM THE UK

Vailara

bump

wordgetsaround86

Last January I was told by my Doctor that if I lost a further 12lbs to be in healthy BMI range (after already losing 121lbs) he would put me forwrd for an apronescopy (I think its called) basicaly cutting the excess skin around my midrift off - not my arms, boobs or anywhere else. I was delighted and worked hard - however I then fell pregnant and Im now trying to lose the extra weight I put back on. So I am now using that weight o be my target and when I get to it I will return ot my doctore and remind him about what he said.

I am off the opinion that if I had stayed at my previous morbidly obese weight i would cost the NHS a lot more most likely over time than the surgery would cost. I lost weight through diet and exercise and I think that gastric bands shouldnt be placed on teh NHS but thats a different discussion!! But if they offer operations like that then I feel they should offer the surgery required at the end. I was so delighted to have lost all teh weight but the doctor estimated that my loose skin probably weighed around 21lbs!!! I obviously looked better but my body would look a lot better if I had the surgery which many would say is a cosmetic problem - but i was so down and mentally upset by what i looked like after all my hard work i think it is a psycholical issue too.

Koldnomore

Meh. I did this to myself - not anyone else's responsibility to fix it for me.

Considering the cost of eating 4000+ calories a day in crap. Why not put that money aside for the procedures afterwards? Losing the amount of weight that would require lose skin removal takes a LONG time. It is entirely possible for someone to save $2000 over 1-2 years assuming they aren't unemployed. I don't see any reason why other people should have to pay for cosmetic surgery after weight loss unless someone is willing to pony up for my boob lift.

Vailara

I think if the excess skin is causing disability or major health problems, then it makes sense for it to be done on the NHS.

For cosmetic reasons, I think it's more of a grey area. In the past some operations have been done for cosmetic reasons, because the problem is causing mental stress and/or having an adverse effect on the person's life. If somebody had a major disfigurement that didn't cause physical health problems but adversely affected them (social, work, etc.) wouldn't there be a case for having it treated on the NHS? I think they probably should. But it becomes more grey because any disfigurement or unattractive feature could adversely affect people. It's very subjective. In the end, most of us are going to have to deal with getting less attractive over time, and surgery isn't really the answer (we shouldn't be having face and body lifts in our 80s because our skin is sagging more than is acceptable).

I'm also worried that so many people end up putting weight back on and it can't be ideal for them to go through unnecessary surgery. Unless the surgery is causing more urgent health problems, I think it might be better to wait a few years and let things settle down.

I've read that quick weight loss causes more excess skin problems than slow weight loss, so maybe that is part of the problem too. Maybe people should be encouraged to lose weight more slowly, or at least told that excess skin and further surgery might be a risk of fast weight loss (if that is true).

Somebody posted an article recently about a man who had bad loose skin problems and, looking at the pictures, it occured to me that a well-designed support garment might make a world of difference. (I was quite large-chested at my biggest, still am, and I really NEED to have good bras. Because I've worn good bras I've never needed reduction surgery although I was big enough to "qualify").

nwg74

I've read that quick weight loss causes more excess skin problems than slow weight loss, so maybe that is part of the problem too. Maybe people should be encouraged to lose weight more slowly, or at least told that excess skin and further surgery might be a risk of fast weight loss (if that is true).

Somebody posted an article recently about a man who had bad loose skin problems and, looking at the pictures, it occured to me that a well-designed support garment might make a world of difference. (I was quite large-chested at my biggest, still am, and I really NEED to have good bras. Because I've worn good bras I've never needed reduction surgery although I was big enough to "qualify").

I lost 11 stone in my first year without surgery. Surgery stops many nutrients getting absorbed which is why so many vitamins have to be taken. That is likely why excess skin is more with surgery plus the ability not to be able to drink sufficient volumes of water without filling up easily to keep hydrated.

I don't have a lot of excess skin but use a compression vest to hold it in place and it has reduced my backache as pointed out in my previous post.