Obese people and smokers will increasingly be refused operations across the NHS in order to cut costs amid a funding crisis, leading health service figures have warned.
The prediction came as one authority in North Yorkshire confirmed any patient with a body mass index (BMI) of 30 or above - classifying them as obese - will be prevented from surgery for up to a year if their conditions are not life-threatening.
Vale of York clinical commissioning group (CCG) said the decision was the "best way of achieving maximum value from the limited resources available".
But the Royal College of Surgeons warned the policy was dangerous and a measure that ranked among the “most severe the modern NHS has ever seen”.
Former health minister Norman Lamb also said that withholding treatment from obese patients was "outrageous".
Chris Hopson, the head of NHS Providers, said he expected other clinical commissioning groups would take a similar stance to save money.
“I think we are going to see more and more decisions like this," he told the Daily Telegraph. "It’s the only way providers are going to be able to balance their books, and in a way you have to applaud their honesty. You can see why they’re doing this – the service is bursting at the seams."
Under the new rules introduced by the Vale of York CCG patients could be referred for surgery within a year if they can shed 10% of their weight.
Smokers facing six-month postponements to operations could earn a quicker slot by proving they have quit the habit, while the ban would not apply to cancer patients.
A statement from the Vale of York group said: "The local system is under severe pressure. This work will help to ensure that we get the very best value from the NHS and not exceed our resources or risk the ability of the NHS being there when people really need it."
A 2014 study by Imperial College recorded an estimated 14.5 million obese people living in the UK.
Royal College of Surgeons president Clare Marx said the body supported efforts to help people to lose weight or stop smoking but condemned the move to delay surgery.
A spokesman for NHS England today said that severely obese people faced higher risks from surgery so it was "entirely right" to encourage them to lose weight first.
"This does not and cannot mean blanket bans on particular patients such as smokers getting operations, which would be inconsistent with the NHS constitution," it said.
It said that it has asked Vale of York CCG to review its proposed approach before it takes effect to ensure it is "proportionate, clinically reasonable, and consistent with applicable national clinical guidelines".