A surgeon has suggested that it might be better to spend NHS funds on surgery for obese patients than on palliative care for the terminally ill.
Andrew de Beaux questioned whether it was worth paying for expensive treatments which may have little benefit for cancer patients in their last weeks of life.
He suggested money may be better spent on potentially life-changing weight-loss surgery for obese patients who are at risk of conditions like diabetes and heart disease because of their size.
Mr de Beaux, a gastric and weight-loss surgeon at Edinburgh Royal Infirmary, said: “If someone is in pain and needing palliative care I would not be against that.
“But I do have reservations about the fact that in oesophageal and gastric cancer we spend £20,000 to £30,000 on palliative care per patient and that gives them around six to eight weeks of life.
“Is that money well spent when you have so many other conditions? Health care is rationing.
“It’s trying to get a balancing act between some very expensive treatments which have very little benefit but because they have emotive benefit we spend money on them.
“There’s a perception that an overweight person is just eating too much and needs to pull themselves together, but some people have a disease which makes it impossible for them to lose weight.”
He added: “We spend a lot of money in the last few weeks of people’s lives not necessarily making them comfortable.”
Mr de Beaux, who is also an honorary senior lecturer at Edinburgh University, said the perception that obesity was a self-inflicted condition was wrong, and it is in fact a disease.
He said that around 200 people a year in Scotland are offered weight loss surgery on the NHS but many more could benefit from it.
Obesity increases the risk of diseases such as type-two diabetes, hypertension, cardiovascular disease, osteoarthritis and cancer.
It has also been linked to health problems, such as stroke, liver and gall bladder disease, respiratory problems, sleep disturbance and mental illnesses.
Mr de Beaux, who has been involved in advising the Scottish Government on managing obesity, said: “Being overweight causes terrible suffering, people don’t like going out to eat in restaurants, they can’t play with their children, they may have diabetes and heart conditions.
“These people are having their lives shortened by their size while we treat other diseases.
“There are huge inequalities.”