UK patients ‘denied joint replacement operations because they are obese’

Nearly one in five NHS organisations are "rationing" crucial joint replacement surgeries based on patients' weight, a new report has claimed.

Arthritis UK has warned that this practice is creating a "postcode lottery" of care across the country, leaving individuals in urgent need of operations at risk of enduring prolonged pain.

The charity also expressed concerns that these policies are being implemented "in a bid to cut waiting lists and costs".

An analysis conducted by Arthritis UK found that 31 out of 42 NHS integrated care boards (ICBs) currently have policies linking body mass index (BMI) to hip and knee replacements.

Specifically, eight ICBs, representing 19% of the total, are "rationing" procedures by setting defined BMI thresholds as a criterion for surgical referral.

A further 23 have policies that encourage or mandate weight loss to become eligible for these operations, the report said.

According to Arthritis UK, ICBs justify the use of BMI policies by highlighting risks.

However, it said research only shows a significant risk for people with a very high BMI, and these policies have “been inappropriately used” to cut off patients with lower BMIs, such as 35.

This move has affected thousands of people “who would have received the significant improvements in their joint pain and function,” the charity said.

The National Institute for Health and Care Excellence (Nice) advises against using BMI to exclude patients from referral to surgery.

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Source: The Independent, 26 March 2026