Take responsibility for your own health and well being, lose weight and stop smoking. Until you do all these things, you won’t be eligible for surgery.

This is the bold message from several local health authorities in the UK, the latest being Herefordshire.

The NHS will ban patients from surgery indefinitely unless they lose weight or quit smoking, under controversial plans drawn up in Hertfordshire, reports The Telegraph. The restrictions, thought to be the most extreme to be introduced by health services yet, has stirred debate in the UK.

In recent years, a number of areas have introduced delays for smokers and obese patients who are told to lose weight or stop smoking before they will be considered for surgery. However, the new rules are very harsh. Under the new rules, obese patients “will not get non-urgent surgery until they reduce their weight” at all, unless the circumstances are exceptional.

The criteria also mean smokers will only be referred for operations if they have stopped smoking for at least eight weeks, with such patients undergoing a breath test before referral, reports The Telegraph.

The authorities want people “to take more responsibility for their own health and wellbeing, wherever possible, freeing up limited NHS resources for priority treatment”.

The fact is that smoking and obesity cause a whole slew of serious diseases that lower life quality and risk early death at huge cost to medical services.

Smoking and obesity have dire consequences.

Smoking causes damage to nearly every organ in the body and is directly responsible for a number of diseases.

Every year, more than 480,000 people die in the United States due to tobacco-related diseases. That is around 1 in 5 of all deaths. It is estimated that 1 in 2 smokers will die from a smoking-related disease.

Obesity in childhood can lead to a number of health problems through life. In adults, overweight and obesity are linked to increased risk of heart disease, type 2 diabetes, high blood pressure, certain cancers, and other chronic conditions.

The reasoning is that people must take responsibility for these conditions and not burden the system with procedures that could have been prevented had they taken care of their own health in the first place. The new rules aim to ban access to routine, non-urgent surgery. Reducing obesity and smoking can reduce the risk of serious complications during and after surgery and shorten hospital stays and thus reduce costs.

The time frame for improving health is set at nine months for the obese. Those with a body mass index over 40 must reduce the number by 15% over the nine months and those with a body mass over 30 must reduce it by 10%.

Smokers will be considered for operations if they have stopped smoking for at least eight weeks and if they passed a breath test.

This is really radical.

As one senior surgeon who is against the new rules pointed out: this means that someone can be turned away just based on their weight, without a physician having assessed them!

There has been two distinct reactions to this latest development in the battle between increasing health care costs and aging populations.

Some commentators commend the NHS for taking a stand and forcing people to stop indulging in sweet treats and cigarettes in spite of warnings of the consequences. Why should people who take responsibility for their own health have to contribute to the well-being of those who ignore warnings against unhealthy lifestyles?

Others say these new rules are blatant discrimination. Today it’s obese people and those who smoke that are denied treatment. Who will be next? People who do extreme sports?

Ian Eardley, senior vice president of the Royal College of Surgeons, says its’s wrong to bar NHS treatment to any group of patients.

“Singling out patients in this way goes against the principles of the NHS,” said Ian Eardley, senior vice president at the Royal College of Surgeons in the UK. “This goes against clinical guidance and leaves patients waiting long periods of time in pain and discomfort. It can even lead to worse outcomes following surgery in some cases.”

The policy also drew criticism from Robert West, professor of health psychology at the UCL Research Department of Epidemiology and Public Health who wrote in an email to CNN: “Rationing treatment on the basis of unhealthy behaviors betrays an extraordinary naivety about what drives those behaviors.”

In other words, people are not always in control of their various appetites and shouldn’t be punished for it.

What is your take on this issue? Is it ethical for a health authority to exclude people from treatment based on their lifestyle choices? Or should you be denied treatment if you blatantly ignore warnings against overeating and smoking?