Question

Like many people with ME I have put on quite a lot of weight. I am very aware of all the other health problems that this could cause.

So I was surprised to find that when my GP contacted out local ME/CFS clinic for a referral to help me with management this was refused because they will not see people who have a high BMI/are significantly overweight.

This is not fair and seems to be discriminatory.

Answer

Sadly, this is not the first time we have been informed about an ME/CFS clinic that is refusing to see someone who is overweight.

This appears to be based on the fact that the Fukuda definition of ME/CFS, which is used to select people for research purposes, excludes people who are significantly overweight from research studies. This makes some sense in relation to research but it should not be applied to a clinical situation.

So the decision is both stupid (as it implies that overweight people cannot develop ME/CFS) and discriminatory. And it's not consistent with the NICE guideline recommendations on hospital referral procedures.

If you want to challenge this decision there is a useful research paper which you can quote:

Research paper conclusions:

Those with a diagnosis of ME/CFS are more impaired than those with chronic fatigue, and as such they are a high risk group needing clinical attention and care. By examining patients over time, as was done in the current study, it is possible to better understand some of the current controversies within the ME/CFS area, such as possible weight gain. 

It is important to note that the idea of a weight cut-off was diagnosed for research purposes in mind, therefore if a patient had previously not had a BMI of over 40, but had satisfied the criteria, they shouldn’t necessarily be excluded from a clinical diagnosis if their weight increases over the arbitrary threshold.

Flores et al

See Also: Diabetes, Treatment: Drugs and Weight Gain