Former 50-stone man frustrated at NHS surgery rules

A former 50-stone man who was refused NHS bariatric surgery because he was not classed a serious enough case, says NHS Wales should rethink how it treats morbidly obese patients.

Zac Smith, 40, of Rhoose, Vale of Glamorgan, paid £9,000 for surgery.

He lost 27st after the gastric sleeve procedure in India, which was refused on the NHS as he didn't suffer enough from high blood pressure and diabetes.

NHS Wales plans to increase bariatric surgery from 80 to 300 a year by 2018.

The body can be altered by the surgery, where a gastric band, bypass or sleeve is inserted which restricts the volume of the stomach available for food.

A public health report last week revealed a quarter of four and five-year-old children in Wales are overweight with one in 10 classed as obese.

Funeral

At his heaviest Mr Smith was three times heavier than the weight considered safe for his height.

His overeating began as a result of depression and in his 30s he realised he needed help.

"I was at my stepdad's funeral and I was down to carry the coffin and I couldn't even walk down the aisle in the church to my seat," he told BBC Wales' Week In Week Out.

"And all I could think through the whole funeral was - you're next."

Despite repeated attempts to seek help he was turned down by the NHS for gastric sleeve surgery.

Under Welsh NHS rules, although heavy enough, he didn't suffer enough from related conditions like high blood pressure and diabetes to qualify.

Mr Smith had surgery in India in 2011 but the NHS refused his request for more surgery to remove three stones of excess skin this year.

Under the rules, he would have had to reduce his weight to 15.5st - including the 3st of excess skin - and keep it off for two years.

He felt this was unachievable and paid privately to return to India, where he had a successful operation.

'Spiral'

A senior surgeon has told BBC Wales that that soaring rates of morbid obesity are threatening the future of the NHS in Wales.

Welsh government figures show that more than 15,000 people are already eligible for bariatric operations, with the number expected to increase by 2,000 a year.

Consultant bariatric surgeon Jonathan Barry, who runs Wales' only specialist centre at Morriston Hospital in Swansea, is only authorised to carry out 67 operations a year but could do more than 300, matching guidelines in England.

"If we don't care about this we are going to find our NHS falling apart in the next 15 or 20 years because the cost of treating the chronic diseases associated with obesity are going to spiral out of control," he said.

The NHS committee which approves skin removal surgery is considering new guidelines but says money is the issue.

Dr Geoffrey Carroll of the Welsh Health Specialised Services Committee (WHSSC) said: "It's about making choices with the resources that we are allocated from NHS funding for Wales."

The WHSCC agrees that more bariatric surgery needs to take place. There will be money to increase operations from 80 to 300 a year by 2018, so that Wales can catch up with guidance set by the National Institute of Health Care Excellence (NICE).

Week in Week Out: The Man Who Lost 30 Stone is on BBC One Wales at 22:35 BST on Tuesday 5 August.