Day 81

Have decided that I really need to get exercising more, especially while I'm on the 1000 plan and so have more energy. At the moment I can't really afford the gym so I might speak to my GP or practice nurse about it. If I'm not mistaken, they will sometimes 'prescribe' gym membership at a reduced rate for those people who are overweight or suffer from certain conditions. I think my weight, asthma and family history of diabetes and heart conditions should make me a good candidate for it, if my PCT do it. While I have mixed views on the NHS paying for things, I don't see that I have a choice. But I'm not sure, I've started doing certain exercises at home, and I'm going to start going for walks, that might be enough.

I think there are ups and downs to the NHS paying for things. I think that if by providing a person with gym membership for a fixed number of sessions you encourage them to go, then I think it's worth it. If that person goes and sees the benefits, they'll likely carry on. I think sometimes it's the boost people need to get them started.

In terms of tummy tucks etc. I have mixed views. They're expensive privately, very expensive. So I think there are a lot of people out there who will try and get one for free if they can. And that I don't agree with. However, there are also a lot of people who just could never afford one but have worked damn hard to lose a lot of weight. And so I think for those people, it should be an option. I'll have paid close to £1000 for this diet once I reach goal without any help from the NHS, so if I have really bad excess skin, I'll consider speaking to my GP if I can in no way afford it myself.

The cost of a tummy tuck or gastric band on the NHS is the equivalant to treating someone who suffers from Diabetes and other weight related illnesses for around 2 years, sometimes even less than that. So actually, if these things are done, they're reducing the cost for the NHS in the long run. A person who weighs say 24 stone and goes on to lose 12 stone will likely have gone on to cost the NHS a lot in treatment after developing Diabetes, high blood pressure or a heart condition. If by offering them a gastric band they sort their weight and save the NHS money, surely isn't that a good thing? Or if they lose the 12 stone themselves, but are left with terrible excess skin, shouldn't a tummy tuck be an option to them if it's bad enough? Personally I think so. However, the 15 stone woman who loses 3 stone, has a little bit of excess but wants a tummy tuck and breast lift, no, that I don't agree with. While there would be a bit of sagging, it's not going to be much, and it'll shrink back. If a person who has lost a lot of weight has given their body some time to try and catch up and it hasn't happened, if means testing shows they can't possibly afford a tummy tuck, then in theory I agree with one on the NHS.

The NHS website gives very little information about 'cosmetic' surgery on the NHS, however it does say this..

To qualify for surgery to improve your appearance, you must meet specific criteria as set out by your local health authority. The NHS will not pay for surgery for cosmetic reasons alone; however, reconstructive surgery and cosmetic surgery to correct or improve congenital abnormalities and injuries will usually be carried out free of charge.

In cases where a person is morbidly obese (has a body mass index (BMI) of 40kg/m2 or more) and has lost a significant amount of weight as a result of a controlled dieting programme and/or surgery, such as an apronectomy or adominoplasty (tummy tuck), further surgical procedures may be required to remove excess skin or correct any scarring or other abnormalities. Sometimes, as part of this process, liposuction may be used. Generally, however, liposuction is not available on the NHS.

It's an interesting subject which will no doubt be causing debates for all eternity! There will always be people who agree, and people who don't.