In some parts of the UK, obese people have been refused treatment for any ailment at all until they lose weight. It is mooted that smokers should not be given treatment for lung or mouth cancer unless they give up smoking - some say they should not be treated at all because the disease is their own fault. Smoking is clearly an avoidable action, but in the case of obesity, perhaps it is more complicated. Some people eat very unhealthily, and yet do not put on weight - under those strictures if they got heart disease from eating too much trans fats they would be treated by the NHS. An obese person may eat relatively more fruit and vegetables and less fat, but because they are visibly overweight be denied the treatment. Sometimes the cause of obesity is linked to a mental health problem - such as being brought up during austerity - a war, for example - and learning to eat food when it was available or face starvation - a strategy that doesn't work so well in times of plenty. Or, they were taught through the actions of their parents or carers that food is a way of showing love. Many overweight people would like to lose weight, but struggle to do so for any amount of time. Some have slow metabolisms. They should not be punished for their body type or circumstances.

This is a difficult question because practical considerations are overshadowed by ethical dilemmas. The big problem the NHS has with providing funding for operations of any kind is that their resources are finite. The present UK government will always argue that they are commited to this public service in terms of honouring financial commitments, but this is open to question. Medical staff and administrators are arguing that budgets are not matching the strain being placed on the service by the increasing numbers of the population who may be living longer, but are presenting the NHS with an ever expanding workload.

Clinical staff are being asked to make a judgement about the value of one person's life over another, when their professional career is dedicated to treating illness, regardless of how it arose. Against this backdrop, who is qualified to decide whether or not an obese person or a chainsmoker must go to the back of the treatment queue? Overeating is often a symptom of an underlying mental issue, although someone simply regarded as being overweight will never be treated as sympathetically as an anorexic. If nicotine addicts are to be denied care, then what about any other drug addiction, like prescription pills? The groups working to combat the scourge of heroin abuse in society will take exception to criteria being placed on whether or not a patient's wellbeing is being ranked according to some moral code.

Doctors and hospital managers do have to allow a certain amount of administrative practicalities to enter decision-making; again, down to those finite resources. Where patients have repeatedly refused to obey their doctor's advice about cutting out cigarettes, given the proven risk of heart disease, strokes and lung or mouth cancer, then the ethical argument becomes more ambiguous. These individuals are perhaps fortunate that they are living in times when the issue is being debated. If the NHS continues down the path of being underfunded, the eroding of pay and conditions leading to recruitment shortages, and privatisation undermining its central ethos, then the same question might become far more black and white in future. Patients might be faced with ultimatums rather than advice.

yes

If the "disease" is caused by poverty or an addiction, how can you expect the medical profession to decide who lives or dies depending on where & how they live? Addiction is an illness. Yes, drugs, alcohol and smoking have long-term health implications. If it was easy to give up - nobody would do it, but it isn't.
Similarly, how can you punish someone who suffers from obesity? This may also be a form of addiction, for whatever reason. Or, perhaps it is due to a lack of education or financial difficulties. If you are hungry, a fast-food meal will probably fill you up better than "a nice healthy salad." if you have limited funds, you will probably opt for whatever keeps you feeling full the longest - this then becomes a regular diet and by the time the consequences are showing, this has become a pattern of behaviour that is difficult to break. It's not like these people have become addicts or obese deliberately and as such, it seems unfair to penalise them for their addictions.