Obese and smokers denied treatment to save money

Data shows that more than a quarter of Primary Care Trusts in England have brought in new restrictions based on patients’ lifestyle criteria in the last year. It reveals that people are being denied IVF treatment, breast reductions and fat-loss operations based on their weight and whether they smoke. In the case of one trust, NHS Hertfordshire, a controversial ban imposed last year on knee and hip operations for anyone with a body mass index (BMI) over 30 as well as smokers, has been extended to cover all routine surgery. The new Hertfordshire policy, introduced in January, makes exceptions only for neurology, cardiac and cancer operations. Freedom of Information responses from 91 PCTs, obtained by doctors’ magazine Pulse, show 25 have brought in new restrictions on treating obese patients or smokers since April 2011. Dr Clare Gerada, head of the Royal College of GPs, said some of the restrictions, particularly for IVF, were “dreadful”. She added: “It’s becoming the deserving and the undeserving. I think it’s discriminatory and I find it astonishing. “The Government should determine what should be applied universally.” The figures showed that the Peninsula health technology commissioning group, covering Cornwall, Devon, Torbay and Plymouth, is now banning both men and women from undergoing IVF treatment unless they have been non-smokers for at least six months. Men and women must also have a BMI of between 19 and 29.9 before they will be given certain fertility drugs. The two PCTs covering County Durham and Darlington will not treat people for varicose veins unless they have a BMI of 30 or under, the figures also show. The figures also showed that the three PCTs covering North Essex must not accept referrals for joint replacement surgery from people with a BMI of 40 or over.

Obesity could affect 42% of Americans by 2030

A new forecast on obesity in America has health experts fearing a dramatic jump in health care costs if nothing is done to bring it under control. The projection warns that 42% of Americans may end up obese by 2030 (up from 36% in 2010), and 11% could be severely obese, roughly 100 or more pounds over a healthy weight (vs. 6% in 2010). “If nothing is done, it’s going to hinder efforts for health care cost containment,” says Justin Trogdon, a research economist with RTI International , a non-profit organization in North Carolina’s Research Triangle Park. Extra weight takes a significant toll on health. It increases the risks of type 2 diabetes, heart disease, stroke, many types of cancer, sleep apnea and other debilitating and chronic illnesses. “The obesity problem is likely to get much worse without a major public health intervention,” says the study’s lead researcher, Eric Finkelstein, a health economist with the Duke University Global Health Institute. In an earlier study, Finkelstein and experts from the Centers for Disease Control and Prevention estimated that medical-related costs of obesity may be as high as $147 billion a year, or roughly 9% of medical expenditures. If the obesity rate stays at 2010 levels instead of rising to 42% as predicted, then the country could save more than $549.5 billion in weight-related medical expenditures from now till 2030, says study co-author Trogdon. The obesity rate analysis was presented at the CDC ‘s Weight of the Nation meeting. The study is being published online in the American Journal of Preventive Medicine. The increase in the obesity rate would mean 32 million more obese people within two decades, Finkelstein says. Obesity has been one of the biggest contributors in driving up health care spending over the past 20 years, says Kenneth Thorpe, a professor of health policy at Emory University in Atlanta. The obesity rate was relatively stable in the USA from 1960 to 1980, when about 15% of people fell into that category. It increased dramatically in the ’80s and ’90s and was up to 32% in 2000, according to CDC data. Obesity inched up slightly over the past decade, causing speculation that the obesity rate might be leveling off. Finkelstein, Trogdon and colleagues predicted future obesity rates with a statistical analysis using different CDC data, including body mass index, of several hundred thousand people. Body mass is a number that takes into account height and weight. Their estimates suggest obesity probably will continue to increase, although not as fast as it has in the past. Finkelstein says the estimates assume that the environment that promotes obesity in the USA has neared a peak. The country “is already saturated” with fast-food restaurants, cheap junk food and technologies that render people sedentary at home and work, he says. “We don’t expect the environment to get much worse than it is now, or at least we hope it doesn’t.”

Sugary drinks hard on the heart

Drinking sugar-sweetened beverages every day raises men’s risk of heart disease, a long-term study finds. Researchers analysed data from almost 43,000 men in the Health Professionals Follow-Up Study and found that those who drank one 12-oz. sugar-sweetened beverage a day had a 20% higher risk of heart disease than those who didn’t drink any sugar-sweetened beverages. They also found that consumption of sugar-sweetened beverages was linked to inflammation and higher levels of harmful fats in the blood. “There are obesity and diabetes epidemics which will ultimately lead to an increase in [the] numbers of cardiovascular deaths in years to come,” said Dr. Kevin Marzo, chief of cardiology at Winthrop University Hospital in Mineola, N.Y. “Obesity rates have increased in tandem with consumption of sugar-loaded drinks.” “The time for research should be over,” Marzo added. “The American Heart Association has already given [its] recommendation for not consuming more than 450 calories from sweetened drinks per week – less than three cans of soda.” The men in the study, mostly white and from 40 to 75 years old, were questioned about their health and eating habits every two years from 1986 until 2008. They also provided a blood sample halfway through the study period. Artificially sweetened beverages did not increase the risk of heart attack, nor did less frequent consumption (twice weekly or twice monthly) of sugar-sweetened beverages, according to the study published in the journal Circulation. The increased risk of heart disease among men who regularly drank sugar-sweetened beverages persisted even after the researchers controlled for other risk factors such as smoking, alcohol use, physical inactivity and a family history of heart disease. “This study adds to the growing evidence that sugary beverages are detrimental to cardiovascular health,” lead author Dr. Frank Hu, a professor of nutrition and epidemiology in the Harvard School of Public Health in Boston, said.

LSD may aid alcoholism treatment

Psychedelic drug LSD could be used as an effective method to treat alcoholism, scientists say. The use of lysergic acid diethylamide (LSD), coupled with relapse prevention treatments, could help alcoholics steer clear of the bottle, research published in the Journal of Psychopharmacology suggests. Teri Krebs and Pal-Orjan Johansen, who were performing research fellowships at Harvard Medical School in the US, examined a number of previous studies, mostly from the 1960s and 1970s, and found that a number of clinics used LSD to treat alcoholism with some success. They said they found evidence for a clear and consistent beneficial effect of a low dose of LSD for treating alcohol dependency. They examined 536 participants, across six medical trials, and found that 59% of LSD patients had improved compared to 38% of control patients. Researchers said the positive effects of a single dose of the drug, tested by a standardised assessment of problem alcohol use, appeared to last for up to 12 months. However, they suggested the repeated use of the medication, coupled with preventative treatments, might provide more sustained results. Investigators of one trial which was examined said: “It was rather common for patients to claim significant insights into their problems, to feel that they had been given a new lease on life, and to make a strong resolution to discontinue their drinking.” Mr Johansen said: “Given the evidence for a beneficial effect of LSD on alcoholism, it is puzzling why this treatment approach has been largely overlooked.”