To What Extent Should the Nhs Care for and Treat Patients with Diseases Related to Obesity

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Established in 1948, the National Health Service (NHS) is a system in which allows patients to have access to government funded medical and healthcare services without having to pay the full price of the service they use as it is paid for by taxpayers. Visiting a General Practitioner (GP), meeting a midwife whilst pregnant and getting treated in the hospital are all covered by the NHS, meaning you are not required to pay any money for using this service. However, there are some exceptions where you do need to pay a fee for using a healthcare service, for example, having treatment at the dentist or using a prescription. Even though the NHS has been around a significant amount of time, there was a time before it where only the rich could afford healthcare and the poor were left to suffer, resulting in a high death rate amongst the lower class citizens; henceforth the NHS was founded on the grounds of giving free healthcare to everyone no matter how wealthy they were by Aneurin Bevan, the Minister of Health at the time. To this day, the NHS still keeps this belief as their number one priority as it treats an impressive one million people every thirty six hours; yet is there a point where we must draw the line as to who is inclined to free health care?

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With the turn of the technological age and the vast increase in the amount of office jobs and fast food chains, obesity has become a serious issue worldwide. One hundred years ago, obesity was a mere anomaly in the system, yet nowadays it affects a large portion of the global population. Many look upon obesity as just a condition that develops when one eats too much, yet that is not entirely accurate. Obesity is a serious condition where a person has gained so much body fat that it has a negative impact on their health and may affect them doing everyday tasks, such as walking to work or walking the dog, and sometimes even getting out of bed. It can be classified in many ways, the most common being Body Mass Index (BMI). BMI is a measure of identifying whether your weight is healthy; it is calculated by dividing your weight in kilograms by your height in meters squared. The average adult’s BMI is between 18.5 - 24.9; anything above that is overweight and anything between 30 and 39.9 is obese. Obesity, being a complex primary issue, has many repercussions; it acts as a gateway for more issues to become incorporated. Therefore, obesity is linked to many very important and sometimes fatal health risks, including: heart disease and stroke, cancer, diabetes, high blood pressure, arteriosclerosis, osteoarthritis, gout, gallstones and Alzheimer’s disease, a disease that affects the brain which gets worse with time as it destroys brain tissue, causing memory lapses and poor judgment etc.

Researchers have found that from 1980 to 2013, worldwide adult overweight and obesity rates have increased by 27.5% and the child and adolescent overweight and obesity rates have increased by 47.1%. Therefore, collectively, the number of people who are overweight or obese worldwide has changed from 856,000,000 (856 million) in 1980 to 2,100,000,000 (2.1 billion) in 2013. This vast increase in numbers of people who have obesity has now reached a record breaking level and continues to increase as time passes. The percentage of the UK population that are obese also continues to rise - in 2015 alone, 63% of adults were overweight or obese. Over half of the population are putting themselves at risk of developing fatal complications related to obesity, yet the numbers still continue to rise: to the onlooker, this poses the question ‘what could possibly be causing such a vast majority of the population to become overweight?’ And although there are many factors, such as psychological and environmental - there is a trend that shows that with the rise of obesity, comes the rise of the fast food market. Even though popular fast food chains such as McDonald’s and KFC have been around for well over fifty years, the market still continues to grow and expand. McDonalds made an operating income last year alone of roughly $8,500,000,000 ($8.5 billion), making it one of the biggest fast food chains in the world. Furthermore, many fast food chains provide services such as a ‘drive thru’ and home delivery, meaning the customer either does not have to leave their car or leave their house/residence to get their order. This decreases the amount of exercise the customer would get (albeit small) by picking up the food themselves and promotes the idea of having to do very little. Continuous intake of this processed food with high numbers of sodium, cholesterol, trans fats and saturated fats can do serious damage to the human body, hence why fast food is considered a delicacy that should only be eaten on occasion as they increase the chance of developing heart disease, high blood pressure and leads to obesity.

Consequently, the obesity epidemic is not free. In fact, the NHS spent £6,100,000,000 on obesity and overweight related illnesses from 2014 to 2015; this is greater than the money spent on the fire service, police and judicial system combined. The treatments currently funded by the NHS include bariatric surgery, a weight loss surgery sometimes used to treat people who are severely obese and beyond the point of helping themselves. If the patient wants the surgery, they have to meet certain circumstances or else the doctor will refuse to perform the surgery, so they will require: a BMI of 40 or more, to have tried all non-surgery related measures and have not lost a sufficient amount of weight, have to be fit enough to have anesthesia and surgery, and commit to a long-term follow up to keep themselves healthy. If they do meet all requirements, then the patient may undergo the surgery. The procedure may change dependent on the patient, but will ultimately be one of the three: gastric bypass (where the top part of the stomach is attached to the small intestine so you feel fuller sooner and absorb less calories), gastric band (a band is fitted around the stomach, so it cannot extend so much and you feel fuller after eating less) and finally, sleeve gastrectomy, where a portion of the stomach is removed, therefore decreasing the size of the stomach and decreasing the volume of food it can hold, therefore making you eat less.

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