Patients who are too fat could be denied routine operations to save money , a survey of health bosses has revealed . More than a third of NHS trusts are considering rationing some types of surgery and other treatments . Several have admitted they may impose 'eligibility ' rules which could affect smokers as well as the overweight . More than a third of health trusts are considering rationing some types of surgery and other treatments to save money , according to a new study . The criteria for accepting patients for operations would be based on their Body Mass Index , which measures obesity . When senior managers at 67 Clinical Commissioning Groups – local health trusts – were asked , 39 per cent said they were planning to 'limit access ' to routine treatment for financial reasons . Procedures affected include varicose vein treatment , hip and knee replacement , and breast reduction surgery . Others said smokers might be denied some treatments , most commonly IVF . Senior doctors criticised the plans and accused health managers of denying patients vital treatment simply because they were considered to be 'undeserving ' . Dr David Paynton , of the Royal College of GPs , said : 'Decisions about whether our patients are eligible for surgery or treatment need to be made on a case-by-case basis and by whether surgery will benefit a patient 's long-term physical and mental health . 'It should not be the role of CCGs to impose blanket bans on patients ' access to surgery , nor to decide who is and who is not deserving of potentially life-saving treatments based on their lifestyle choices . Obese patients could be denied varicose vein treatment , hip and knee replacement , pictured , and breast reduction surgery , while smokers could be banned from having IVF on the NHS . 'Of course , some procedures can not be performed on patients who are above a certain weight . 'In these cases , a clinical decision needs to be made about whether surgery would be beneficial if the patient lost weight – but this is a separate issue . ' Katherine Murphy , chief executive of the Patients Association , said : 'Each case must be individually assessed and each decision must be ethical and in the best interests of the patient . 'It is easy to target vulnerable patients and we must be very careful not to unfairly discriminate against people who are n't always able to speak out . ' A Conservative Party spokesman said : 'If health bodies stop patients from having treatments on the basis of cost alone , then we will take action against them . ' There are 211 CCGs in England so the survey by the Health Service Journal covered just under a third . Last year , a CCG in Devon threatened to ban all non-urgent treatments for anyone severely obese with a BMI above 35 . This is equivalent to a 5ft 6in woman of 16st or a 6ft man being 18st 13lb . After an outcry , the policy was dropped . A survey by GP magazine last month found that 80 per cent of CCGs ration at least one procedure to patients who are very obese . Doctors have blamed excess sugar and carbohydrates for the surge in obesity – not the lack of exercise . They said poor diet was now recognised as being responsible for more disease than physical inactivity , alcohol and smoking combined . Yet , said the experts led by cardiologist Dr Aseem Malhotra , the public wrongly believed that obesity was due to a sedentary lifestyle . The doctors claimed that obesity has rocketed in the past 30 years , despite little change in physical activity levels . ‘ This places the blame for our expanding waistlines directly on the type and amount of calories consumed , ’ said Dr Malhotra . ‘ Let us bust the myth of physical inactivity and obesity . You can not outrun a bad diet. ’ In the British Journal Of Sports Medicine , the doctors added that the ‘ false perception ’ on the cause of obesity stems from corporate marketing ‘ chillingly similar ’ to that used by the tobacco industry . They cited Coca-Cola associating its products with sport ‘ suggesting it is OK to consume their drinks as long as you exercise ’ . Dr Malhotra , who works at Frimley Park Hospital , Surrey , is an adviser to the campaign group Action on Sugar . Around two-thirds of Britons are overweight or obese . The Government ’ s obesity adviser Professor Susan Jebb said the doctors failed to note that the best way to lose weight was combining a better diet with physical activity . ‘ Rather than trade one off against the other – sugar vs fat , diet vs activity , individual vs population – we need to take action across the full range , ’ she added . Tackling obesity without addressing physical activity was ‘ tying one hand behind our backs ’ said the professor . ‘ It makes good sense to seek to change both diet and activity behaviours . ’
More than a third of health trusts are considering rationing some surgery . Several admit they may impose 'eligibility ' rules refusing some patients . Obese patients could be denied knee and hip replacements and breast ops . While smokers may be told they can not have IVF procedures on the NHS .