The Health and Social Care (HASC) Team has received reports of high Body Mass Index (BMI) being adopted as an exclusion criterion for several NHS ME/CFS services, resulting in patients being denied referral and access to care. In response, we have reached out to service leads to address concerns regarding referrals being declined based on weight, as this practice is not consistent with the NICE guideline [NG206]. Furthermore, this raises the issue of whether General Practitioners are assuming responsibility for the timely diagnosis of ME/CFS, as outlined in NG206, Section 1.1.4, for patients who are denied access to specialist services due to weight.
Rather than delaying or denying access to specialist care, we advocate for the approach specified in Section 1.12.22 of NG206, which recommends referring people with ME/CFS for a dietetic assessment by a dietitian with a special interest in ME/CFS if weight gain is a concern. We commend the Integrated Care Boards (ICBs) that are taking steps toward incorporating dietitian involvement into specialist ME/CFS services.
For more information on this issue, please refer to the Q&A written by our medical advisor, Dr. Charles Shepherd, which explains why using high BMI as an exclusion criterion for specialist services is discriminatory and does not align with the NICE guideline recommendations for hospital referrals.
If you have experienced a referral to an ME/CFS service being rejected due to BMI, please contact the HASC team via health@meassociation.org.uk