Before and after
This is 5live listener Paul Thorn. Two years ago he weighed 28 stone. In December 2007 the NHS paid for him to have a gastric bypass. He now weighs 11 stone 5. But as you can see he's been left with excess amounts of skin. You can hear his story on the programme tomorrow and also watch a film we've made with him. We'll put the video on the blog tomorrow morning.
© MMIX~RS~q~RS~~RS~z~RS~36~RS~)
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I understand that excess skin like this develops when weight loss is too rapid for the body to adapt too. Perhaps the NHS needs to do more than just pay for gastric band surgery - they should also be responsible for the plastic surgery required to remove the excess skin on this young man.
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I feel sorry for the guy as his skin looks hard to live with but he should take responsibility for himself and take care of it himself.
The problem with extreme weight loss surgery is that it is extreme - there's a clue in the name. To get over it he should be doing lots of exercise. Pushups would help his chest, arms and shoulders. Running would help his legs and waist.
The NHS is not there to help people look better, it is there to help people live healthier lives.
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What a wonderful young man. Those people who have phoned in or text to say these things about him,are so unfeeling.
If you would let me know I would love to start a fund for this brave boy and just start it with £5 and would like to know if this could be started by the bbc or if not how I could go about it.
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Paul,
You are one brave lad.
I can understand your anxiety with regards to your excess skin but I imagine you will be able to live longer since losing all that weight.
I congratulate you on being courageous enough to share your story with us.
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well done indeed...
i am similar to Paul and do a lot of work with the guys on the mens health bulletin boards.
I was 25 stone and i lost about 13 of it...
found my vocation in the process and im an qualified personal trainer now trying to make a career out of it...
i have surgery in 2007 and had 8lbs of skin removed..
I am having some additional revision and tidy up work done in 6 week to take a section out around my back and some tidy up work on the scars on my chest.. ( i have a gynomastia chest reduction as well )
I salute anyone who gets there arse in gear and looses the weight and Despair at the government and NHS refusal to help people when it comes ot this... i have had to spend over 10k on surgery to fix this... and its not fair, as they seem to be willing to fit gastric bands at the drop of a hat
( i did not have one i lost the weight through hard work and self control i might add )
The day i had surgery i went from feeling like a freak to feeling alike a human again... and yes im vain now.. i body build.. and i want to look good hence the extra surgery .it was was the best day of my life.....
i help a lot of people where i can on a number of health and fitness web pages in getting advice.. and working out if they need surgery and how / where to get it and what to expect.. as i would not wish this on my worst enemy..
Most of the information out there is vague and contradictory and really doest not help people
( my own web page will go up soon with a lot of this stuff on it )
if i can give any advice or help to the BBC or Paul or any one else who needs it im more then happy to.... got a lot of time and respect for people who work hard to get fit and change there lives and make them better
Gary Collyer
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Hey mate don't ever feel worse about yourself - you have done a fantastic job. I've been overweight since I was a kid and would love to lose a good 7 or 8 stone. I think the NHS should help you address the skin issue, but whatever you do, don't ever go back to where you were. Keep your spirits up and keep at your doctor and hospital if you decide to have skin surgery. Be proud of what you've done!
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I feel very sorry for this guy. He has heroically lost the weight after undergoing a gastric bypass op which is not for the faint hearted. The amount of excess skin that he is left with is basically a health hazard as it can get infected. He should have surgery to remove it as soon as possible so he can get on with his life.
To all those self satified smug people out there who say he only has himself to blame, I hope none of you engage in smoking or drinking or unwise sexual encounters or physical sports or driving when not concentrating fully. After all you would only have yourself to blame if you needed the services of the NHS and why should I pay for your folly?!
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The speed of the weight loss is not responsible for the excess skin geomosh. It is the excess weight over a long period that stretched it. All the push-ups in the world will not cure it. Please get your facts right.
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I'm really interested in this story because I think about it a lot and used to be really worried until I did some more research! I was 25stone... Now 23stone and am not planning on stopping until I'm at least 16stone...
I'm a little concerned that this will happen to me and have talked to many people about it (from doctors to skin specialists). Most are in agreement that I will probably suffer from some loose skin but the amount depends on lots of things... Mainly height/skeletal frame of the person... Also the fact that I'm not doing it the exteme way using a gastric band will help minimise it... I agree with greenwaterfairy about the problems of losing so much weight so quickly... Your body doesn't have time to adjust... I'm taking my time and losing 1-2lbs a week... I think it's by far the more sensible solution than asking the already stretched NHS for help on something that they shouldn't need to help people with.
We spend too much of our lives living in a "I want it now" society... It took me 25yrs to put on 25 stone... I'm not saying I'm going to take another 25yrs to get it off again but I'm happy in the knowledge that it'll probably take 1.5years (which is nothing really in the whole scheme of things).
Paul clearly has a small skeletal frame and, by the looks of the video, isn't particularly tall? (could be wrong though obviously)... I've been told that because I'm 6'2'' and have a large frame, the loose skin won't be as bad and, in theory, I should be able to cure it with toning exercises (something which I'm looking forward to!)... We'll see anyway... I just wanted to make a point that everyone losing weight shouldn't be too concerned and take things as they come...
Having said all that stuff about NHS, I still say well done Paul... Even though you decided to go down the gastric band route and not standard weightloss route, it's still a massive achievement...
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I am a NHS Plastic Surgeon.
To clarify matters skin reduction surgery after massive weight loss is available on the NHS.
The types of surgery available and the degree of availability vary from region to region ( postcode lottery again)
In my area (East Anglia) Abdominal reduction and lower body lift procedure for removal of circumferential skin excess are available via normal GP referral if weight loss is greater than 10 points on the BMI scale and maintained for 2 years.
The best starting point is to ask your family doctor. Some regions have a special cases committees to consider referrals which are deserving but don't fit the normal acceptance criteria. Don't give up at the first hurdle and ask your GP , if he can't refer you directly, to request that the PCT (primary care trust- decide how NHS money is spent locally) will consider you as a special case.
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There are so many people who smoke, eat or drink to excess and do nothing about it and the NHS have to spend billions due to their lifestyle choices.
Paul has made a decision to loose weight and has done it.
Total respect to him for that.
The lad deserves to have NHS help to remove the excess skin.
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My late mother also lost over 15 stone from a gastric bypass opperation she had in 1993. She was able to have an apronectomy on the NHS once she had reached and maintained a stable weight. This removed the excess skin from her stomach by taking a melon slice shaped piece of skin away but it was paintful and needed 102 metal staples whilst healing. She found by doing regular exercise the rest of the skin tightened up considerably but was always loose.
From her experience although the gastric bypass reduced her weight drastically she suffered other complications such as anemia from her resricted diet and needed to take multiple vitimin suppliments and lost her teeth too. In addition to phyiscal side effects she occasionally suffered psychological problems such as depression mainly as a result of not being able to go out for a meal with friends/family or even a night of drinking as her stomach wasn't big enough (it was aproximately the size of a shape yoghurt pot).
Well done on loosing the weight!!!
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What a lovely young man, and very brave to show himself on video and talk about it all.
Like previous contributors I would definitely give to a fund to help him have cosmetic surgery to remove the excess skin if the NHS are not willing to do so.
Maybe one of the MP's who have spent tax payers money on second homes might like to contribute to this much more worthy cause or perhaps even a lottery grant.
Good luck to Paul Thorn.
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I was 34st by aged 17 and I lost 17st with diet and exercise. I'm now a reasonable weight for my height and build (6ft 5)
I was also left with large amounts of excess skin and the NHS offered no help to me despite fighting for over 18 months and I believe they offer no help for other people also in this type of situation.
I'm 23 now and since Jan 08' I have had 7 private operations to remove this skin and enable me to live some kind of normal life. - Now obviously not all of that is totally essential but the NHS should offer some help in removing skin which creates a functional problem during day to day living.
I really feel for this guy and my only advice to him is get saving, you will need 20k+
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I listened to much of the broadcast this morning. However, that did not prepare me for the quantity of excess skin Paul now has. I would hope that those who called or texted the show to say how opposed they were to skin removal surgery would instantly change their minds once they saw Paul's current condition.
The NHS is free at the point of use. We don't charge people who injure themselves playing football, rugby, or those who injure themselves skiing, mountaineering or potholing. We don't turn away those who smoked all their lives when they develop cancer, heart or lung problems. Paul has done marvellously to get as far as he has, but not to complete his recovery could lead to him becoming depressed and added to those on long term sick benefits. Better for all for him to have the required surgery to remove the excess skin - both for him and the taxpayer.
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I feel the NHS has a moral duty to provide individuals with reconstructive surgery after going through surgical weight loss programmes. If individuals were shown the results before consenting to banding I wonder how many would go through with it. They may be slimmer and less at risk from obesity related health concerns, but who wants to have a ghostly skin shadow following you around.
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When the skin gets so overstrectched over a long period of time it looses its elasticity, so the skin does not shrink back when you loose the excess weight. I know this because I suffered the same problem after loosing 13 stone over 5 years. I was fortunate enough to be given an apronectomy on the NHS but I still have loose skin on my upper and lower sides.
I understand what Paul is going through it can be very depressing knowing you have lost all that excess weight but still have to look at the loose skin everyday. I hope Paul gets what he's looking for.
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He's such a brave guy.I know he has the determination to loose weight that's why he agreed to undergo gastricbypass though, he should be aware of the result of his operation.I can't take to look myself like this if I was him
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This is the problem with losing too much weight too quickly. The body can't keep up, and as a result the skin loses its elasticity.
He could get the excess skin removed, but this would leave him with massive scarring.
Its unfortunate that for some people, the only options are such drastic measures. I think if the NHS is to continue with this method of treatment, it needs to be better managed, so the patient loses their weight much more gradually. Yes, it will take longer, but end results would be much better. There would be less strain on the patient, and the amount of excess skin would be lessened, or not be a factoe at all.
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The loose skin issue is really a matter of luck. Like some women get stretch marks and saggy tummy skin after pregnancy and other do not. I really don't think the pace of loss is the factor, and quite honestly the faster the better for many of these people. Do you know how much being overweight increases your chance of dying? Its amazingly high, Just losing 40lbs took my stats from 3 x normal to 1.5 x normal.
I think that the NHS would be better off using an operation called the Gastric Sleeve which I had done privately in the Czech Rebublic. It doesn't have the same malabsorbtion problems associated with the bypass, its mediaclly a safer and less drastic operation and it gives very similar weight loss. I would recommedn it over the lap band too. No fiddly fills and problems with band slippage and re-operations.
Due to my own situation I have done loads of research into all this and I think the NHS lets people with obesity problems down.
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Once you have people with BMI's ranging from 40 to 60+ I don't think the speed of weight loss makes any difference.
I think Paul is the has the ideal example of this, because as you can see he is now incredibly THIN - there is no fat remaining between those folds of skin at all, the skin is simply too damaged to shrink back naturally.
Many problems that are self inflicted get treated by the NHS! For instance if this guy had smashed up his face in a car whilst drink driving there would be no questions asked and he would have reconstruction on the NHS as standard practice.
So why not in this situation?
''
The NHS is not there to help people look better, it is there to help people live healthier lives.''
Again I would point to the above example - this isn't simply about looking better, and even if it were the NHS already offers treatments which could fall under this category anyway.
I would argue that fixing this excess skin is like fixing a birth defect or other deformity which would have a large impact on a persons mental health.
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I feel that the British public fails to realise what amazing public services they have when compared to other nations. By this I mean transport, school, free health care, benefits etc. Yes of course they can be improved and of course they have a lots of flairs of course it is this British attitude of always wanting better and more that has taken this country to be a heaven of human rights and social security when compared to other countries. You do not have to go that far to find worse examples. Politics in Spain and Italy are highly corrupted, France wont allow Muslim girls to wear a headscarf, East Europe is still developing... and this is without comparing to those 2bn people that live in absolute poverty.
I am deeply concerned about how much people abuse the opportunities this country provides them with. Currently you need four working people for every non working citizen to subside the country's public services. What are we going to do by 2050 when the population has increased by at least 25% and there will be a ratio of four OAP to a working adult?
I am very sorry and I am very aware that overweight, extreme overweight, is an issue to many and it can generate enormous heath problems but at the end of the day once should be careful with their diet and exercise. And in this particular case, this unemployed citizen got a free operation and even demands for more. I agree with the previous comment saying that the NHS is here to prevent people from dying not to take care of people's looks. The British public is demanding a government that takes care for them while the government very soon will not be able to do this and in fact it will have to do what is meant to do, administrate. People should take care of themselves unless they are physically or mentally incapable or have any other severe condition, medical or social that makes them unable to do so.
Please stop demanding the economically impossible, start appreciating what you have and got and start accepting the idea that 'social security' and 'socialism', unfortunately, is no longer going to be financially viable in Europe.
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I had the same problem when I lost a lot of weight. I contacted a local hospital with a burn unit and donated the excess skin to be used as grafts. The surgery was free and many people were helped.
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LadyFey, that is fantastic. I didn't know that was possible. What a win-win scenario!
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Paul,
How incredibly brave to be so open about your weight, weightloss and the subsequent problems associated with extreme weight loss.
I am understanding your weightloss surgery was funded by the NHS. They have a duty of care to assist with your severe skin problems. People are arguing they have no duty of care, but, had you stayed obese, the health problems you would have incurred as you slowly died of super morbid obesity, would have realised far more financial expenditure. Far more.
Perhaps people are not aware that these hanging folds of skin can become extremely sore and very prone to fungal infections. Mentally they can prove very distressing.
I am talking as one who knows. My weight was 24 stones. It is now 9 stones. I have had 7 pounds of skin removed from my abdomen. And yes, it was carried out under the NHS. It was a medical necessity, approved and funded by my local Primary Care Trust. As was the work carried out on my arms, armpits and other areas where skin was severely compromised.
Paul, you have a right to access the surgery you need. I wish you every success.
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Unbelievable! here we have a guy who has been given a second chance for life, yes for life, and he is wailing and whining about some excess skin. Why can I, over most other contributors say this without any fear of comment? Because I had Gastric bypass surgery some 5 years ago at the age of not 30 but 48 years old, I got to live. I wish I had this operation at the same age as Paul, I would have been absolutely delighted. My whole life could have been completely different. This man has a real chance to live an almost normal life. I would trade my last 5 years to have had his opportunity. You got a life Paul, be thankful you didn't have to wait till you were nearly 50 to get it, use it, enjoy it, get over this nonsense, get on with it you lucky boy. All of you who think he is a brave guy, you have no idea. he had a simple choice, live or die. Which would you choose? Which is the braver choice, there isn't one, you choose to live. Whatever challenges Paul faces are not as great as the challenge to make something of a life you have been given a second chance for. Get a job, get your future planned and get on with it.
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From the information that is available on the BBC website I am staggered at the conclusions many of the contributors have come to. My own view:
Paul Thorn is not brave. He has not fought a dragon, faced oppression or won his 7 the Tour de France after beating cancer, he has had an operation to help him lose weight because he has no self discipline.
Paul Thorn is a weak individual who needed surgery to be able to lose weight because he could not frame himself to stop eating like a whale.
Paul Thorn didn't pay for that surgery, I paid for it through my taxes.
I don't want to pay for people like Paul to lose weight, I have things I would rather spend my money on and there are more deserving causes.
I don't want to pay for Paul to have his skin tightened.
If Paul needs the operation so badly Paul needs to get a job (or even a second job), work hard, save the money and pay for it himself. It won't be easy but he might just earn a little self respect.
Paul, get a life, get a job, get some self respect and don't expect me to pay your way when you mess things up.
Life is about taking responsibility for yourself, until you do that you will continue to be a burden on the rest of us.
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I undertake assessments for both weight loss surgery and plastic surgery following massive weight loss. In Scotland we have nationally agreed guidelines to determine eligibility for removal of excess skin, no post-code lottery. Individuals are eligible for up to 2 procedures on the NHS if they have reduced their weight to a BMI 0f 27 or less, and maintained it for more than a year. No distinction is made between those who paid for weight loss surgery or had NHS treatment. The benefits both to the individual and NHS are huge (pardon the pun!) but make no mistake, unless an individual understands why they have become morbidly obese, and make sustained changes to their eating behaviour, the weight will creep back on, this is why a set period of time with a stable weight is a requirement.
We do seem to have a much more equitable NHS in Scotland than the regional variations we hear so often from England.................I'm not pretending it's perfect and we have major health problems north of the border!!
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I think the gastric bypass should be used in extremis cases, or to reduce the morbid obesity to a lightly overweight person and later reducint weight through exercise.
I have the impresion this guy lost weight too fast, and now he looks too thin. But he is great!!!
Why do he try to do something to collect the money he needs? He is one example to follow. :-) This will increase his autoestime and maybe he could meet a nice girlfriend when meeting people to his cause.
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Well done for loosing the excess weight.
It looks as though you will have to wait for two years to get the treatment you require. As has been stated this is for medical reasons, but just think what you have to look forward to in the future after the operation.
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I do think that Paul needs to get a job though. I paid for my surgery privately and I sympathise with the ReasonableJon as a taxpayer. I don't agree with his assessment of what eating disorders are about though. If Jon was paying taxes as a working person I think he would have a morally stronger argument IMHO.
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In reply to 'reasonablejon'
What other groups of people would you deny treatment to in order to preserve YOUR tax pounds?
Alcoholics? Druggies? Smokers? Self Harm? Drink drivers? Criminals? Paedophiles?
People who smash themselves to pieces
taking part in dangerous sports or hobbies?
What about people with mental disorders - they surely must all be classified as 'weak individuals' right?
People with differing political views?
Where do you draw the line?
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Just to clarify one thing about this guy, he has done exceptionally well losing all the weight and YES he does deserve to have the treatment done on the NHS. It is hard work to lose that amount of weight..Good on you!
I too was very obese and something I'm not very proud of....by this I mean I had a controlling partner who just kept buying the wrong foods and yes I was to partly to blame for eating the wrong foods.
I lost over 7 stone in weight with a slimming club and myself (which was very tough and no support from my partner whatsoever as he liked me with the excess weight) and I was EXTREMELY unhappy with the excess skin I had incurred. Before you say anything Yes I did excercise to try and tighten the loose skin but it just was not happening. I would cry to myself every night because of my unsightly stomach.
I visited my GP and he wasn't thrilled in me having an abdomino-plasty (tummy-tuck) but he knew how unhappy I was and eventually refered me to an NHS consultant. I had the operation 18 months later after keeping off the weight.
Let me say that its seems ok to treat drug addicts of their addiction and smokers to treat their addiction but WHY is it not ok for this guy to have this treatment I ask you?
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