Obesity related co morrbidities

[Roch]

As most of us know that in the pct criteria for funding for wls it usually has 2 diff criteria.
1) Bmi ... with co morbidities
2_ Bmi.....with no co morbidities.

What actually are obseity related co morbidity, i decided to look up and this is the best i found although still confusing lol as i dont understand it all lol.

Obesity, especially visceral adiposity, is associated with morbidity and mortality through endocrine and mechanical processes. Clinical manifestations due to effects of obesity on the cardiovascular, respiratory, gastrointestinal, musculoskeletal, immune, and integumentary systems have been described. Further studies are needed to understand the pathologic processes underlying these clinical manifestations to improve disease prevention.

I have seen diff lists on diff sites with lots of things that peeps say are listed as co morbidities but tbh i dont think they are very accurate. Have been looking most of this morning and these are the main ones i have come up with they come in 5 diff categories.

Airway:
Asthma
Obesity hyper ventilation syndrome
Obstructive sleep apnoea
Pulmonary hypertension.

Cardiovascular:
Hypertension
Ischaemic heart disease
Cor pulmonale

Gastrointestinal and metabolic:
Metabolic syndrome
type 2 diabetes
Hyperlipidaemia
acid reflux
fatty liver
steato hepatitis

Musculo skeletal:
osteoarthritis knee and hips
compression fractures
increased risk of injury

Other:
Urinary incontinence
skin infections
lymphodema
poor self hygiene due to obesity


Was just thinking which if any of the list i do have and i was surprised to find out i do have a few of the above.

Asthma
Acid reflux due to a enlarged hiatus hernia due to obesity
Osteoarthritis in both knees
Skin infections due to my obesity
Poss diagnosis of Apnoea

When i was at my doc the other day i asked him to read out the letter he wrote to refer me for wls and in that letter he said i have co morbidities which tbh shocked me as i did not think i did but forgot to ask him which ones i did have.
Today i got a letter which my consultant had sent to my doc a few days ago and i was shocked to find out that my doc has diagnosed me with "osteoarthritis in both my knees" i thought my knees were just collapsing due to the weight and the pain was something i have just had to get used to.
He also says i have chronic back pain and very bad sciatica and recurrent migraines which i know bout lol and have suffered from depression in the past.
So i presume that i do have co morbidities which i suppose in the long run will help me with my funding application and also the possibility of apnoea which i am seeing the private consultant tonight for and hoping to have the sleep study in the next few days.

I think most pct`s only mention in their criteria things like diabetes and apnoea and hypertension but if they are following the nice guidelines then am wondering how many of the above in my list i found could be counted as co morbidities and help others who are fighting their oct`s for funding.

The list i found is one of many on the net but have all been categorised in the same sections but not all have been broken down into diff separate probs.

What have you been told are the main co morbidities, am wondering if they vary from pct to pct from what i have seen on the net, would not surprise me if they were very different lol

 

[Caroline101061]

Think its all much of a muchness - you will be fine as your BMI is high enough for them not to matter

 

[Fashionably Late]

I was told that even though I have numerous of those issues, they weren't counted as co-morbidities. It would be useful if every area had the same rules and a set list of co-morbidities.

 

[cazbandy]

The comorbidities in my PCT are:-

Diabetes types 1 and 2
Sleep Apnoea - confirmed diagnosis

And that is it...you also have to have BMI of over 50.

 

[dreamofbeingslim]

my criteria are BMI>40 with diabetes 2 and or sleep apnea. There is no other criteria. Going by nice guidelines I should get funding just by my bmi because it is virtually 60 but not under my pct. I also have a fatty liver but they didn't seem to think this counted.

 

[Roch]

My pct just follow the nice guidelines 35 with co and 40 without but saying that a year ago when i saw one of the private consultants who worked at the Whit on a nhs basis they said my pct were so difficult for funding and he had peeps with bmi`s of 60 and still being refused and if they did not know their rights but just left it at that, but over the past months my pct have got better am told, fingers crossed
Thank god for MM and all the fab crew on here who have so much info and advice to help us through funding and appeals and the rest of our journeys xxxx

 

[Roch]

I really think that the NHS and NICE should provide a list of all the co morbidities that all the pct`s should follow if they follow the standard NICE guidelines as i think 2 many pct`s set absolutely stupid criteria and this minimises the amount of people they need to fund.

 

[farzu]

Hi,
what about infertility as a co morbidity? My BMI was 41 when i got the referral and now its 39. NICE guidelines are >35 with co morbidity. I have type 2 diabetes. I'm seeing a fertility specialist in st barts hospital for more than a year. My partner and I do not have any other problems but only my weight is causing the doctors not to start treatment and this doctor also agreed with me for the wls. do you think i will be refused? i'm so scared after reading what happened to BLUE DIAMOND . Feeling very sorry for her.

 

[BlueDiamond]

I have the listed below conditions and was still refused

asthma
gallbladder
hypertension
acid reflux
fatty liver
osteoarthritis knee and hips
pcos

At the end of the day I think its down to individual hospitals if they feel ur suitable or not......even with all those conditions I was told its not enough ! Just goes to show how one hosp varies from another. x x

 

[Roch]

I have the listed below conditions and was still refused

asthma
gallbladder
hypertension
acid reflux
fatty liver
osteoarthritis knee and hips
pcos

At the end of the day I think its down to individual hospitals if they feel ur suitable or not......even with all those conditions I was told its not enough ! Just goes to show how one hosp varies from another. x x

Hun pls dont give up pls ask ur doc for another referral to another hospital, ur so right it does vary from one hospital to another, take care xx

 

[dreamofbeingslim]

It should be standard that all hospitals/pcts go by. They shouldn't be different for each pct.

 

[cazbandy]

What people tend to forget is there is not that much money in the pot for bariatric surgery. These guidelines are there because of this. My surgeon wishes there was more as this surgery saves lives.

Sadly they cannot give this surgery to everyone who really needs it. The funds just are not there and demand is rising.

I know that is tough for those who get turned down but that is the NHS, it's not endless pot.

When I applied the criteria was lower, in the last year they have raised the bar. I would not qualify now as I do not have sleep apnoea.

 

[phatmomma]

It's all very scary now we hear that someone has been turned down. Ana at WM seemed sure i'd be getting my surgery, i weighed in at 135kg and with type 2 diabetes i am sure i qualify. But like we say, we presume we'll get it but then someone gets knocked back and all of a sudden it feels like it could happen to any of us........

Scary thoughts, i wanna go join the gym (done it before and never stuck with it) but am scared now what if a miracle happens and i actually stick at it and possibly lose weight? Although the gym is purely to get my stamina/strength up for an operation.....

It's a dark day here on mini's xxx