[tweetiepooh]

So much arguing back and forth here but I do think a general idea of delaying treatment in some cases because of lifestyle is appropriate. Sometimes that simple lifestyle change can be part of a wider treatment, sometimes not making that change can counter other treatment regimes.

But like all things like this the judgement needs to be done at point of treatment not by a wide ranging diktat. It's easy to say deny treatment to a particular group but it should be up to the treating team to work with the patient to achieve this. So you may require an obese person to lose weight first, it's often safer that way and if the treatment is for a condition caused or aggravated by obesity it seems logical to make that a condition for the treatment. Contrawise if the treatment will lead to the patient finding it easier to be less obese then a different outcome may be indicated.