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Some people 'too obese to help': Your comments
Surgery is needed before you get too fat
Dr David Haslam, from the group Experts in Severe and Complex Obesity (ESCO), warns people who are biggest should just be offered "palliative care" rather than surgery for their obesity.
Weight-loss surgery has the capacity to permanently induce major weight loss. However, the availability of surgery is limited and Dr David Haslam says it should be offered to those who need it most.
BBC News website readers have sent their comments.
Your comments
As someone who used to have a BMI of 37 (now 22 due to diet and exercise) I sympathise with both Doris and Sean. Both, in my opinion, should receive the operation. I was very lucky in that sheer willpower saw me through, and although at my biggest I was "pre-diabetic", I didn't have any other underlying health problem that prevented me from losing weight. I feel my age, 25, was also a big help. Losing the weight has meant I have prevented myself from getting type-2 diabetes, a disease which affects many members of my family. Although Doris has been demonised by "smoking 40 a day", given her current quality of life I should imagine that this is one of very few pleasures in Doris' life and that she should also receive support for combating this. It is a vicious cycle but the key point here is to get Doris active again and it has got to the stage where the operation is the only means of doing this.
After careful consideration of the above facts, with Sean weight loss is achievable. He has dependents, can work, can pay taxes and with good care his treatment would be cost effective. In an ideal world both Sean and Doris should benefit from surgery but if a choice has to be made, Sean should have the surgery before Doris.
I am 57, 4ft 10 with a BMI of 43. I have my share of health problems and a family who would help all they could in getting me fit again. I would love to be able to just do the walking I did 10 years ago, or have the energy with my grandchildren that I had with my own children. Your example reminded me of attitude tests. There is one where people are trapped down a mine and there is only time to save a few, who should be first? The mother with 2 small children who represent the future was last. The big fat business man was first, even with his bad health, because he was about to sign a big new important contract. If it were a choice between Sean and myself, it would have to be Sean, and until we could both have the operation it would always have to be people like Sean.
I had a BMI of 36+ but rather than expect other people or the NHS to assist me, I undertook a personal project to reduce my weight. I used sensible eating rather than dieting, for example cutting out snacks and late evening eating, I also did concerted exercising starting small and then gradually building up to 45 minutes per day. I also undertook walking at least 10,000 steps each day by not taking the car to work and walking wherever possible. I now have a healthy BMI of 22.76 and lost a third of my body weight in the process. This took 9 months of determination on my part and support from family and friends, but I feel much better and have a better and more productive life as a result of losing all that weight. People who have to take medication for other illnesses that increase their weight should not be denied surgery or assistance to lose weight. However, for the vast majority of people, they could lose a lot of their excess weight themselves.
The sooner obesity is recognised as a mental illness the better - it is comparable to anorexia, and should be treated as such.
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John, Huddersfield, UK