‘NHS says I'm too big for surgery — now I'm spending my pension on weight-loss jabs'

Independent

06-06-2025

With every step she takes, 72-year-old Sue Smith is in agony.
The retired NHS clinician has been on the waiting list for a knee replacement for four years and walks, she says, as though her leg is broken.
Despite her daily battle with pain, Ms Smith has been repeatedly denied surgery — because she is obese. But she has also been given no help by the NHS to lose weight, as waiting lists for such programmes soar.
She is now forking out hundreds of pounds per month to pay for a weight-loss injection so she can have the operation she so desperately needs.
Speaking to The Independent, Ms Smith — who has physically deteriorated so dramatically that she now uses a mobility scooter — said: 'I'm not lazy. I want my life back, but I'm stuck in a vicious cycle of trying to lose weight for this operation. I'm 72 years old now and am desperate for a knee replacement.
'What will they do — wait until I can't walk at all? Or I fall over and break my leg?'
The Independent revealed last week that obese patients are being taken off waiting lists for life-changing hip and knee replacement surgery and being refused referrals as the NHS cuts costs.
National guidelines make clear that weight should not be used to restrict patients' access to joint replacement surgery. But research has revealed more than a third of NHS areas are blocking patient access based on their body mass index (BMI).
Ms Smith, who suffers from osteoarthritis, said she was told before the Covid outbreak that she needed an operation. At that time, she was fitter and slimmer and may have been eligible for the procedure, but was instead treated with steroids and physiotherapy.
During the coronavirus lockdowns, the former NHS speech and language therapist struggled to maintain an active lifestyle. She was referred again for the operation in 2020 but was turned down — because her BMI was 43 — and told to lose weight.
Her GP attempted to refer her for the operation three more times, but she was rejected on each occasion because of her size.
Years later, with a BMI of 42, she remains above the threshold which Maidstone and Tonbridge Wells hospital set for her to be allowed an operation, she told The Independent.
She said: 'The only way forward for me is to get down to this fantasy weight. I just want a knee replacement so I can exercise normally.'
But Ms Smith is yet to receive any specialist weight management support from the NHS. She was finally referred for support services in January 2025 — more than four years after she was first told she could not have her operation due to weight — but was told the wait was at least 18 weeks.
She is still waiting and has not heard when she will get an appointment.
The Independent revealed that, in some areas, patients are waiting years for access to NHS weight loss management services.
Desperate to get her operation, Ms Smith sought to get weight-loss jabs through the NHS. But, in another blow, she was told by her GP that they could not prescribe it. Under current rules, which are tightly controlling the use of such jabs, only specialist weight-loss management services can prescribe these drugs.
Ms Smith has paid around £1,000 since February to have the weight loss jab Mounjaro privately, which she said has helped her to lose 18 pounds.
She said: 'I get a pension from the NHS, it's about £200 a month, so really, I'm using that for this injection.
I really want to have my knees done so I can move forward. I've had to buy a mobility scooter, which I don't use every day, but I have to sometimes. I don't want to be in it; I never wanted to have one. I only use it when I have to, which is once a week... It's awful, I just feel like a lesser being.'
Ms Smith said that, following a recent X-ray, her GP told her knees are 'worn out.' Initially, Ms Smith said she only needed one knee replacement, however, the wait has led to her now needing surgery on both.
A spokesperson for Maidstone and Tunbridge Wells NHS Trust said: 'We understand how upsetting it can be for anyone living with ongoing pain, and our teams are committed to ensuring patients receive the best possible care. While we can't comment on individual cases, referrals for surgery are assessed on a case-by-case basis, and a range of clinical factors are reviewed.
'These include, but are not limited to BMI, and enable our clinicians to ensure the surgery is safe and appropriate.'