UK - Call for fertility ban for obese

[DoYouEverWonder]

30 August 2006,

Very obese women should be denied fertility treatment, experts say.

The British Fertility Society is recommending women with a body mass index of 36 and over should not be allowed access to fertility treatment.

Underweight women and those classed just as obese (BMI over 29) should be forced to address their weight before starting treatment, the society said.

NHS guidelines say overweight women should be warned of the health risks, but do not impose any ban on treatment.

Being overweight can put both the health of the mother and child at risk through problems such as gestational diabetes and high blood pressure.

http://news.bbc.co.uk/2/hi/health/5296200.stm


I know there are health issues involved but where do you draw the line? When do they start denying treatment to people for other 'health' reasons. Should they ban all the cigarette smokers? All the people who dye their hair?

[Sherman A1]

1. Nice Social Programing

Ah, let's see this group doesn't fit our profile so it will be denied X and this group will be denied Y, but this group over here is wealthy, pretty and just so very nice so they get everything... Makes ya wonder what's next and who gets to decide.

[dipsydoodle]

10. Bad analogy

Income, race, religion, ethnic background, whatever ,doesn't come into this issue. It's solely weight related - nothing else.

[zanne]

14. I think it's a perfect analogy.

We always seem to think that discrimination is just fine unless it affects us. I take it by your username you'd never be affected by this anyway.

[dipsydoodle]

25. The alternative

would be that the procesdure was made no longer available on the National Health Service. It was a relatively recent introduction anyway. Of economic necessity they focus on where they believe they will have success and I'm guessing there must be a higher failure rate with obese ladies. That report is from a think tank - not from the NHS. The NHS is still doing the stuff for all and sundry apart from me - not only male but volantarily snipped 23 years ago to stop them messing my wife about.

[zanne]

27. Are your think tanks like our think tanks?

I don't know about the UK, but here, our think tanks aren't known for their moderate views. Most are radical right.

[dipsydoodle]

31. Nope

not like that here. That would have been an independant medical panel. The overall problem is the NHS itself - it's creaking at the seams. I know that you lot quite justifyably refer to our NHS as being free medical care. That's a fairy story - it paid for by another form of tax. The problem has become that what was once a sort of pure NHS pool of money for health care and pensions is now grouped together with normal tax by Blur and Co and spent in Iraq etc.

Apart from extremist "Nazi" groups like the BNP there isn't too much in the UK that you could really call right wing these days. Labour and Conservative parties meet up the middle somewhere. It's become like Animal Farm. :)

[Dogmudgeon]

2. Wait until the 'Personal Responsibility' crowd shows up

Then you'll see some high-octane moralizing!

--p!

[krispos42]

3. Just like the Indiana gov't wanting to deny fertility to lesbians n/t

[dipsydoodle]

9. No - not at all the same.

Highly unlikely to be an issue here but I'm not sure whether that would be covered by the National Health Service - might need to be done privately.

The obesity issue is far greater than just the issue of fertility treatment. They have already made it clear that other treaments may also be denied to those with what are effectively self inflicted wounds i.e. gross over eating.

See also post 5 above - last paragraph. Recommendation is that same sex couples have same priority as hetrosexual couples.

[Lyric]

18. Absolutely ridiculous.

There are thousands of people who are obese, but do not "grossly overeat". Obesity can be caused by many endocrine system malfunctions and metabolic disorders that have little or nothing to do with overeating or lack of exercise. Hypothyroidism, Polycystic Ovarian Syndrome, Cushing's Syndrome, Insulin Resistance Syndrome--those are just a small handful of the myriad of conditions and diseases that can not only cause obesity, but make it far more difficult to lose weight once it's been gained.

Are they going to ask that the law not apply to people who are obese due to a medical condition? If not, then it's discriminatory and I object to it. Obesity is one of the few socially acceptable ways to discriminate and assign people second-class status. What's next? People with a family history of diabetes or heart disease? People who have that defective gene that can cause breast cancer? I'm all for socialized medicine, but this is a dangerous road to go down.

One interesting thing to note. Polycystic Ovarian Syndrome is one of the most common reasons for infertility in women. Abdominal obesity is considered one of the hallmark symptoms of this disorder. There seems to be a link between sexual orientation and PCOS. Not only is PCOS far more prevalent in lesbian women, but there have also been studies done that suggest a link between homosexuality and being exposed to excessive male hormones (androgens) in utero. Women with PCOS almost always have excessive androgens in their bloodstream, due to a malfunction of the ovaries when they're cystic. That indicates that obese women with PCOS are going to be more likely to give birth to homosexually-oriented children. Which makes me wonder if the British government is using the obesity excuse because they can't come right out and say "We're trying to decrease the number of gay people born into our country".

Does this seem paranoid? Maybe. But if we consider that (1) Most women seeking fertility treatments have PCOS or a similar disorder, (2) There seems to be a link between mothers with PCOS and gay babies, and (3) PCOS also causes obesity--well that just scares the hell out of this overweight lesbian with PCOS. Awfully glad I don't live in the UK right now. :/

[dipsydoodle]

26. There is nothing on the world

to stop obese women in the UK from having fertility treatment. The suggestion from that think tank was that they either lose weight and get it free on the NHS or stay as they are and pay for it. The background to that was higher failure rate. Originally it was not available on the NHS anyway. Would it better for it to be withdrawn free to all women to stop any arguements ?

Given that on this subject you're glad you're not in the UK do I take it that a lady could get it done in the USA free of charge ?

[nosillies]

30. Can you provide a link please?

Regarding your PCOS info? I have two friends dealing with infertility and they might be interested.

I actually found this link that states that it affects around 30% of infertile women, which is not most.
http://infertility.about.com/cs/secondaryif/a/PCOS.htm

This link says 20-25% of infertility cases are caused by ovarian disorders.
http://www.ovarian-cysts-pcos.com/infertility.html

Then I find this link that says it's 70%! (Beware, this link advocates losing weight as a method of restarting ovulation!!!)
http://www.womens-health.co.uk/pcos5.asp

Who knows what to believe?

My friends say they hear plenty of assertions but see very few non-conflicting facts.

[rodeodance]

4. I think there is something to this ban but should be done on any individua

l basis. I used to care for newborns born of overweight moms. and the chances of diabetes showing up in the newborn at birth are very high. It is tricky.

[Lyric]

19. The newborns don't have diabetes.

They have a temporarily messed-up blood sugar system because they were inside of a diabetic mother.

The babies are getting tons of sugar from a diabetic mom's blood, so their bodies compensate by producing large amounts of insulin in-utero to get rid of the excess sugar that Mom is sending to them. When they're born, all of the excess sugar is still in their bloodsteams, so their blood sugar is high. In a day or two, their blood sugar falls down to normal levels but their bodies are still pumping out a ton of insulin. This causes temporary low blood sugar in the infant, until his or her body adjusts to normal levels of blood sugar. It looks like Diabetes, but it isn't, because it goes away in a few days.

Babies of Type 1 Diabetics are more likely to have actual diabetes, because Type 1 is genetic. But babies of Type 2 Diabetics (FAR more common than Type 1) and to women with Gestational Diabetes (which is a temporary type that occurs only during pregnancy) are no more likely to be born with actual Diabetes than any other baby. However they will have a greater chance of developing Type 2 Diabetes themselves when they grow up.

That's how this was explained to me when my son was born with high (and then low) blood sugar levels. I had Gestational Diabetes, by the way.

[intaglio]

5. Please read the WHOLE article, and find out about healthcare in the UK

Firstly; the organisation concerned is an organisation of professionals not part of the legislative process. They are, if you like, a pressure group.

Secondly; fertility treatment is provided with the NHS providing part or all of the cost and there are quite large numbers wanting this therapy. Resources are not infinite, so at some point "rationing" has to start.

The US has such "rationing" and it is based on the ability of the "patient" to pay, not on clinical factors. Even if the NHS adopts such guidelines the "patient" would still have the opportunity to "go private" (ie pay for such treatment) in this country or overseas.

The people on the verge of morbid obesity (morbid obesity=body mass index 40 or above) and persons over 40 years of age are far more likely to need many courses of treatment; any course will have little chance of success. Not only that but for people with this problem the risks of pregnancy rise expotentially with weight requiring yet more NHS resources spent on them. BTW smokers are already in the group who are counselled before such treatment is given as smoking is a known factor affecting cot death and general child health.

Lastly a quote from the article
snip ....The BFS, which represents health fertility professionals, also recommended single women and same sex couples be given the same priority as heterosexual couples.

[Matilda]

7. Seems reasonable to me.

Obese parents are likely to raise obese children with other health
problems.

If they're that keen to conceive, they'll make an effort to meet the
criteria.

[KitSileya]

12. I don't think that the fact that they are more likely to raise obese kids

is part of the decision.

Obesity leads to far higher risk of complications during the pregnancy - the same rationale is used to deny fertility treatments if the mother is too old.

Is it so that if a woman looses weight, she is more likely to conceive naturally? I know that the fat in our bodies play a role in hormone production, so it sounds likely that extreme fat reservoirs might put hormone production out of whack - but I am not a doctor, so I wouldn't know for sure.

[zanne]

16. Wow. That wasn't self-righteous at all.

:sarcasm: You must be perfect.

[nashville_brook]

20. wow. that's quite a claim. link?

just wondering if there might be another factor... poverty, maybe?

...and if people with genes for a slow metabolism are allowed to breed, what's next i ask you?

how about parents with sub-100 IQs? might they be more likely to raise stupid, self-righteous children?

[nosillies]

8. very good points

[nashville_brook]

21. "single women and same sex couples" get treatment IF they aren't FAT!

gotta draw the line somewhere.

[ima_sinnic]

6. with overpopulation and already so many children needing adoption

they can ban fertility treatments for everybody in the world for all I care. only the wealthy can afford them anyway (or am I wrong about that?), so who gives a shit?

[DoYouEverWonder]

11. I know a lot of people

who have gone through fertility treatments at their own expenses, who are not any where near being rich. They just wanted to have their own children very badly and would do anything they had to, to achieve that goal.

[Kelvin Mace]

13. That I don't understand

it seem narcicistic to spend yourself into penury so you can have a child, especially with so many unwanted chidlren born every year.

[DoYouEverWonder]

15. I understand

and the ones that don't succeed usually do adopt, but I guess the desire to have someone of your own flesh and blood is very powerful.

[Kelvin Mace]

17. That's the part I really don't understand

The "if it didn't come from my loins it's not really mine" view. That is what I see as narcicistic.

[mopinko]

34. evolutionary psychology

our brains evolved for one reason- to better pass on our genes. we think we are making rational decisions about reproduction, but most of that conversation we have is our ancestors tickling our neurochemistry, saying- pass it on. pass it on. passsiton.
some peoples genes don't talk very loud. be grateful if yours don't.

[Kelvin Mace]

40. Ah, thank you

a rational explanation.

[nashville_brook]

22. it's one of those "human nature" things -- irrationally sweet and human

[ima_sinnic]

23. so they went broke? too bad. some poor parentless child could

have been given a good life instead.

[Beausoir]

24. How many children have you adopted?

[ima_sinnic]

28. no, better question: how many fertility treatments have I had?

I would adopt many if I could. I can barely afford to take care of myself. As a 60-year-old single woman, if my fortune changes and someone my age is allowed to, I would love to.

[ima_sinnic]

29. also, since you asked:

despite my own poverty, I have been helping to support several children in Jamaica for the past ten years with money for food and school, whenever and however much I could.

[Irreverend IX]

42. Why not ban fertility treatment...

At least until all children eligible for adoption have been given good homes? It's a hypothetical question, but such a policy could help a lot of children escape the foster care system.

[noonwitch]

32. I have mixed feelings about this

1. A lot of infertile, overweight women find themselves fertile after losing weight.
2. The fertility treatments are somewhat risky, weight adds to those risks.

I don't like the idea of a doctor saying not to ever treat infertility in obese women, but I understand what he is suggesting. Doctors should strongly encourage obese women who want to have children to lose weight.

[T_i_B]

33. This was all over the news this morning

And a more stupid set of ideas would very extremely difficult to find.

[intaglio]

35. Subsidiary link please read all before commenting

http://news.bbc.co.uk/1/hi/health/5297686.stm

This is a short Q & A regarding Fertility treatment in the UK

[BooScout]

36. This is not a bad thing....

And what people here on DU fail to understand is that many American Fertilitiy Doctors will deny treatment for fertility problems if you weigh too much as well. A girl I worked with was overweight and her doctor wouldn't even consider treating her until the pounds came off. It's a health issue people, not a discrimination issue.

You draw the line OP, when the cost for treatment gets so high that other people who have life threatening health issues and their treatment is delayed because funding is not there for them. It's a delicate balance the NHS walks. It's not perfect, but for the most part it covers everyone.

BTW, no treatment has been denied. It's merely a suggestion by an oranization not affiliated with the NHS.

[Charlie Brown]

37. This sounds like eugenics to me

weeding "undesirable" characteristics out of the gene pool. The NAZIs did it, and now Britian is trying it. Shame

Overweight people have the same rights as everybody else.

[Nihil]

43. If it 'sounds' wrong then maybe you need to learn to read instead?

I can't believe the morons on this thread who jump straight
up to "Nazis", "eugenics", "weeding" and other such bullshit.

BTW, before you start whinging about the British NHS, try getting
yourself a free health service, find out about the difference in
funding between health and defence then work out how you split a
finite resource for the greatest good for the greatest number.

Finally, the suggestions from the think-tank (NOT the NHS itself)
in the OP did not affect "overweight people" or the merely "obese"
but only the very few at the extremes. It does not seek to prevent
even these chronically obese people from continuing their "undesirable
characteristics" (as you chose to term it) but simply suggested that
they pay for it themselves as it is a waste of time, effort & money
for the state to fund it for them (my words).

[No Exit]

38. NO NO NO!!!

Don't you guys understand?? The people on here who are against this because it's EUGENICS are RIGHT!

Doing this to the obese sets a precedent. They will move on to ANOTHER group, and bit by bit, they will restrict people's ability to reproduce.

The only traction I ever got, in talking to my wingnut "pro-life" "abortion hysteria" friend, is when I told him, "If you make the ban on abortions extremely draconian, and absolute, you set the stage for them (government and powers-that-be) to do things like the OPPOSITE--things like forcing people to HAVE abortions... do you want THAT, my wingnut buddy?" Of course he said, "No".

I can't say I'm any kind of libertarian... I'm neither for nor against it, I haven't done enough reading to even KNOW if I hold similar views to standard libertarianism... but this stuff just seems WRONG to me. NO BANS ON ANYONE'S FERTILITY!

[intaglio]

39. Really no exit what a ridiculous statement

listen very carefully

this is NOT about stopping obese people from having children

They can have children the traditional way,
They can be assisted to loose weight,
Or they can pay for fertility treatment and during any subsequent pregnancy they will still be cared for by the NHS.

A very few seek to have treatment and require the state to pay. They will require the state to administer large doses of hormones to encourage ovulation (possible complications cardiac difficulties and polycystic ovaries); these ova have then to be harvested (the obese are far more likely to have anasthesia problems); the ova have to be fertilised in vitro and implanted. There is then a 9 month period when the very obese are more likely to have circulation problems, cardiac problems, water retention problems, diabetes, thrombuses and possible toxemia so they will have to be more closely monitored and will receive more treatment. It is likely that the last month will be spent in hospital. There is greater likelyhood of perinatal mortality of both mother and child.

Resources used in this way mean fewer resources for others. Results of this oversubscription would vary; eg there could delays to operations because of fewer available nurses or bed overcrowding. Certainly there would be delays to the treatment of others who would require fewer resources in the course of their treatment.

Please remember that the reason any person seeks treatment for infertility is because there was already a "ban" put on their fertility. That ban was put there by providence or genetics or accident or, if you so desire, God.

[sutz12]

41. This is not eugenics, nor is it social engineering, it is health care.

My step daughter became morbidly obese. She had two babies, both with complications, because she developed toxemia. Both babies were born premature. The first seems OK, but the second is stunted and has severe development issues. She was in an incubator for weeks and weeks, and even after release, had to be fed through a tube for months and months. She could barely crawl at 1 year, and I don't know if she will ever learn to speak.

BTW, my step daughter nearly died both times and had her tubes tied after the second. They didn't want to risk another one.

Sorry, put all of your soap boxes away. This is health care, plain and simple.

[DemExpat]

44. I agree - and healthcare in the UK universal system without unlimited

resources and funds.

DemEx