Monday, 28 November 2016

BMI, healthcare rationing and casting of runes

No posts for a while, nothing much to say. Recently my weight has been fluctuating between 114kg and 115kg. Everything has pretty much plateaued, my activity levels are good but not exceptional, finding time to fit in extra exercise is challenging. Weekends over the past few months have been taken up by DIY (painting fences, painting the garage, replacing guttering etc…) and just recently with various family commitments. Now the weather has turned the idea of going for a jog in the cold, wet, dark evenings is not one that fills me with joy.

My diet has slipped into what I'd describe as a normal pattern. I'm not pushing hard to cut out calories like I did earlier in the year, but at the same time I am showing self-restraint in what I eat and drink. Sweet things are restricted to a couple of times a week and to normal sized portions. Compare that to 12 months ago and the difference is significant, back then I would eat a chocolate bar most days, and sometimes I would have more than a single serving of a sweet or chocolate on the same day.

That step change means I'm not too worried about the Christmas season, I know I can moderate myself when temptation is all around me, although I’ll need to be tough with the inevitable influx of office mince pies. The big question is whether having achieved a level of stability the time is right for another push? I have about six weeks till my next consultant appointment in early January and it would be good to hit 111kg at that. That's around half one pound a week, achievable but challenging given the season and the fact I’m starting from a lower calorific intake than at the start of the year. It would bring my total weight loss for the year months to around 14kg, over half way in my battle.

One significant positive from the whole exercise is that my BMI is now around 36 when it was tipping 40 at the start. I don’t personally hold much faith in BMI as it’s got more than a whiff of pseudoscience about it, but it’s a pseudoscience that is increasingly being used in the rationing of NHS treatment.

I recently arranged to have a vasectomy a.k.a. “the snip”. The NHS has contracted the procedure to a private hospital and I was told at the initial consultation a BMI over 40 would have seen me rejected. As I actually got the initial GP referral over a year ago, but couldn’t get suitable time off work, I would probably have been declined had I proceeded immediately. It needs to be stressed this isn’t a rule based on genuine medical science, the hospital will still carry out the procedure on people with a BMI over 40, but they have to pay privately. This seems a bit of a nonsense as the procedure is non-emergency under all circumstances, it isn’t particularly complex, and there isn’t a massive waiting list (I was able to obtain appointment slots easily). 

Surely in this day and age there must be more sensible ways of rationing treatment (if rationing must occur at all) than the arbitrary application of pseudoscience? What next, NHS treatment allocated on the basis of casting of runes?

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