"Politically, adverse lifestyle choices seem to forfeit the right to healthcare."

Our treatment of patients with severe obesity is unethical – but why?

Bariatric surgery is life-saving and cost-effective but due to pervasive bias, obese patients are not a healthcare priority

"Politically, adverse lifestyle choices seem to forfeit the right to healthcare. This is reminiscent of the approach taken to patients with Aids in the 1980s, where an emphasis on ethical behaviour was preferred to prioritising treatment for those who developed the disease. In the US, the American Disability Act provides some protection for obese people from discrimination at work. The European Court of Justice has ruled that it is illegal to discriminate against employees with obesity where it constitutes a disability. Article 12 of the International Covenant on Economic, Social and Cultural Rights outlines obligations of nations to respect and protect their citizens’ right to health.

So, the current denial of bariatric care not only constitutes a breach of ethical justice but also seems unwise. Patients stand to benefit from it, reliance on other strategies such as coercive public-health measures may be harmful and surgery represents good value for money.

However, because of pervasive bias and stigma, severely obese patients are not a political priority."