The story of shrinking violet: link has a great deal to commend it. A courageous person who has chosen to change their life and lose weight. Lose a lot of weight. I don't know the details of her attempts to get surgery from her District Health Board - perhaps there are things we do not know, perhaps there is always a wait... but the story is sufficiently interesting, that we can ask the question: should we (taxpayers) pay?
There are incentives issues, and there are substantial health issues, to consider. Not just for Violet, but for others who may see her example too. I am on the side that the system should pay, because I bet that the costs imposed by all that extra weight are much higher in the medium to long term than the cost of helping this woman feel better about herself now she has actually done all the hard work.