A new study suggest the NHS is losing its patience with patients who are too fat or who smoke. The survey has shown that a quarter of health trusts are now restricting treatment for people with unhealthy lifestyles.
It means patients are being ordered to slim down - or being sent on stop smoking courses - before they get surgery like joint replacements or even IVF treatment. Three trusts in the East are highlighted in the report - but there's a warning that they risk breaking anti-discrimination laws if they take the process too far.
A nationwide Freedom of Information request by the medical magazine Pulse revealed many types of surgery, MRI scans and IVF treatment are being withheld from obese people and smokers.
In the Anglia region, NHS Bedfordshire has barred obese patients from hip and knee surgery until they loss 10% of their weight or their Body Mass Index drops below 35.
NHS North Essex requires patients to lose at least 5% of their weight, and keep it off for 6 months.
While NHS Hertfordshire patients must have a BMI under 30, while smokers have to attend a stop smoking course to have any type of surgery.
Lawyers warn that health authorities risk being sued by patients if they can prove they've been discriminated against.