The UK Prime Minister's recent proposal to cut sickness benefit for people who are obese and refuse treatment is ethically and financially flawed, according to an Editorial in The Lancet Diabetes & Endocrinology journal.
As part of its initiative to reduce the UK's benefits bill by £12 billion if re-elected in the May 2015 general election, the Conservative Party have proposed a cost-cutting scheme to make weight-loss programmes undergoing treatment a condition for receipt of sickness benefits in obese people. However, the journal Editors argue that such a programme would be ethically questionable and would not help to cut government spending.
Interventions for obesity could include diet and lifestyle changes, but the evidence shows that these have low long-term success rates. Another option could be treatment with antiobesity drugs, but according to the Editors, "The only treatment for obesity that has been proven to be successful for substantial long-term weight loss and improved quality of life in a high proportion of people is bariatric surgery. Requiring people to undergo a major surgical procedure as a condition of receiving benefits seems far from ethical."
The Editorial goes on to state that the costs of such a scheme might actually increase public spending due to the high costs of both delivering treatments and, importantly, monitoring compliance. Even if money could be saved, the amount would be relatively minimal. "The number of people claiming sickness benefits with obesity as the primary reason for the claim is actually very small (only 1780 people as of May, 2014) when considered in the context of the roughly 2·5 million people claiming these benefits in total...(Instead,) funds could usefully be spent on benefits such as universal free access to leisure facilities, investment in healthy outdoor spaces, and public health education about healthy diet and lifestyle."