Troubled firm at centre of NHS body parts scandal 'underestimated' scale of human waste
Healthcare Environmental Services (HES) allowed hundreds of tonnes of waste from hospitals, including body parts, to pile up at four of its sites in England.
Officials today announced the company, which collected in the region of £31 million last year, has been stripped of 15 contracts it held with individual NHS trusts.
And now a whistleblower has told the MailOnline the firm’s cost-cutting tactics to take on more work and win extra disposal contracts was a ‘recipe for disaster’.
He revealed he was shocked to discover HES did not own an incinerator at the site he worked at in Tyneside and had to ship its waste to other rival firms to burn it.
Healthcare Environment Services (HES) allowed hundreds of tonnes of waste from hospitals, including human body parts, to pile up at its facilities (pictured: a site in Normanton, Wakefield, which has a mountain of 350 tonnes of waste)
HES is reportedly attempting to export 750 tonnes of pharmaceutical waste to Holland, according to the Health Service Journal (pictured: the firm's office)
A spokesperson for the company today denied two of nine claims put to it by the whistleblower and said it needed to investigate the other seven.
The firm, based in Scotland, has blamed a lack of ‘incineration capacity in the market’ and desire to reduce the use of landfill on the pile-up of clinical waste.
The unnamed ex-HES employee, who worked at the firm for four months before quitting, refused to be identified over fears of reprisals, including violence.
He said the firm – ran by a husband and wife - ‘under-estimated’ the huge amount of waste it would have to deal with by taking on contracts with dozens of NHS trusts.
It has since emerged that HES took on 'too much work’ and instead of burning the hundreds of tonnes of clinical waste, it has stockpiled it for months.
The firm’s sites in Normanton, Newcastle, Nottingham and Bradford have all breached environmental permits set to them by Government officials.
The ex-employee, who left at the start of 2016, revealed HES cut costs so much it refused to buy gloves, trousers and vaccines for staff.
HES allegedly approached the man from a rival firm, when it won an undisclosed consortium contract to dispose of NHS waste in North East England in October 2015.
Healthcare Environment Services Ltd, paid millions to burn waste from hospitals at 50 trusts across England, reportedly took on too much work (biohazard signs on a vehicle at the firm's site in Normanton)
In a statement to Parliament, Health Minister Stephen Barclay said NHS Improvement concluded HES 'failed to demonstrate that they were operating within their contractual limits
The Environment Agency was first alerted to the fact that Healthcare Environment Services Ltd had a backlog of waste - including body parts - building up.
Healthcare Environment Services Ltd was hit with a series of warnings and enforcement notices giving the firm deadlines by which the waste must be incinerated by.
The Environment Agency alerts Government ministers to the problem.
New Health Secretary Matt Hancock chairs an emergency COBRA meeting to discuss the scandal.
He sets aside £1million to help affected hospitals.
The Environment Agency announced that it has found the firm in breach of its permits at five of its six sites.
It also says it is launching a criminal investigation into the debacle.
He told MailOnline: ‘It was quite clear from the outset that HES had won the contract on a very low profit margin.’
The ex-employee added: [HES] left little wiggle room for any issues they encountered or any large increase in waste levels.
‘They were asking advice on waste levels and had clearly under-estimated the amount of incineration only waste they were about to receive.
‘They were already struggling with this waste stream around various other sites and once I found out they did not own an incinerator I knew they were in for a rough ride.’
He revealed the waste pile at HES’ site in Normanton, West Yorkshire, was there in 2015 and ‘has remained there ever since’.
The site is currently housing around 350 tonnes of amputated limbs and human flesh, among other clinical waste - five times more than its permit allows.
Neighbours backing directly onto the disposal unit last week complained about the 'foul' smell coming from the HES site.
The ex-employee, who left the firm in February 2016, said he ‘dreads to think’ what is in the Normanton unit now, or how long it has been there.
The whistleblower said: ‘[HES] refused to buy latex gloves for staff, citing the cost. Yet they expected staff to handle raw untreated clinical waste.
‘They used to decant the bins daily into anything they could find, in order to get the bins back. But these waste types should not be mixed.
‘They refused to buy needle-resistant gloves and trousers for plant staff and drivers, and this placed staff at huge risk of needle injuries.’
Health officials insisted the waste would not pose a threat to patients or the wider public, adding that contingency plans were being put in place (a HES lorry in Normanton)
Officials have known for months about the stockpiled body parts scandal that has shaken the NHS, the company at the centre of the crisis claimed last week.
The Environment Agency has been updated on the crisis at sites ran by Healthcare Environmental Services every week since January, it claimed.
The firm also alleged the government was first made aware of problems as long ago as 2015.
Yet the NHS is now having to spend millions on last-minute emergency measures to deal with tonnes of stockpiled waste. Some may be stored in ‘open yards’.
The Environment Agency told the Department of Health and Social Care about the problem in July but the details were only made public on Thursday when leaked documents were revealed by the Health Service Journal.
HES, now subject to a criminal investigation over stockpiling medical waste, claimed it is a victim of a government ‘witch-hunt’.
In a letter to NHS trusts, seen by the Daily Mail, Garry Pettigrew, managing director of Healthcare Environmental Services, claimed the NHS plan to deal with the crisis was ‘completely unworkable, illegal and financially unviable’.
Two firms in Liverpool and Wrexham, for example, had been asked to store a combined 330 tonnes of waste outside their building, even though it would usually be earmarked ‘incineration only’.
Another in Pontefract, West Yorkshire, had ‘received dispensation’ to store 300 tonnes in an ‘open yard’, he claimed.
Mr Pettigrew wrote: ‘We have found ourselves in the middle of a witch-hunt towards making this company commercially unviable and [a] personal vendetta being organised behind the scenes to somehow justify putting in place emergency measures.
‘We have highlighted to the Environment Agency, and customers, since October 2015 that there was a serious reduction in incineration capacity. The main reasons for this was... ageing infrastructure, which is unreliable, coupled with no investment in new equipment due to cost constraints from the customer base.’
The Environment Agency was first alerted to the problem in March this year and hit the company with a series of warning notices and enforcement orders giving them deadline to get rid of the waste (pictured: workers outside the Normanton site)
Scottish hospitals are preparing emergency plans to store clinical waste amid claims Healthcare Environment Services may be unable to process it.
The firm, based in Shotts, Lanarkshire, has the Scotland-wide contract for clinical waste removal.
Health boards are devising plans to store waste on-site for up to three days if it cannot be removed and incinerated, amid concern that HES has taken on more work than it can handle.
One NHS source in Scotland said: 'We’ve been told it will be stored for 72 hours, but in reality there is a real prospect of it being for weeks and even longer.
'The idea is that porters will decant clinical waste into large containers that will be kept in hospitals.
'In terms of body parts, they will be stored, probably in mortuaries, but in many hospitals space will be tight as we get into winter.'
The row raises the prospect of hospitals being filled with large amounts of potentially hazardous waste for months.
It is believed the contingency plans may be activated in Scotland as soon as next week.
Scottish Tory health spokesman Miles Briggs said: 'this is an extremely worrying development and it’s absolutely right that contingency plans are being drawn up.
'It is imperative SNP ministers ensure all clinical waste is safely disposed of.
'If this company cannot carry out its contractual obligations it is vital the SNP organises a replacement service immediately.'
Just over 300 tons of clinical waste is collected from hospitals north of the Border each year.
One insider close to the row in Scotland said: 'This isn’t a new issue – the Scottish Environment Protection Agency (SEPA) has been working on compliance with this company for some time.'
He also added: ‘The majority of staff were not offered the necessary vaccines that employees should have working with clinical waste.’
The firm allegedly went through 30 drivers during the time he spent at HES, which he blamed on the ‘very aggressive’ management style.
The ex-employee added: ‘They run on an atmosphere of fear and were prolific at enticing people from decent jobs with promises that never came true.
‘Once people were stuck, they basically used their ignorance at regulations regarding clinical waste to ensure they could break and bend the rules.’
A HES spokesperson told MailOnline on the phone it was 'b*******' that it refused to stock latex gloves, vaccines and trousers for staff.
They also denied it still does not own a high temperature incinerator needed to burn some NHS waste and said it shares with other firms.
Health Minister Stephen Barclay has announced today that NHS Improvement concluded HES 'failed to demonstrate they were operating within their contractual limits'.
Fifteen NHS trusts had served termination notices to HES, with the work being taken over by Mitie. The new contract was 'fully operational' from this morning.
In the wake of the scandal, NHS Improvement issued a letter to HES and gave them 48 hours to provide evidence it was 'operating within legal and contractual parameters'.
Mr Barclay told MPs: 'NHSI concluded that HES failed to demonstrate that they were operating within their contractual limits.
'Consequently, 15 NHS Trusts served termination notices to HES formally to terminate their contracts at 4pm on Sunday October 7.'
Shadow Health Secretary Jonathan Ashworth has been granted an urgent question on the issue in the House of Commons this afternoon, Labour said.
HES has previously denied any wrongdoing and insisted that all clinical waste is correctly stored, with anatomical waste kept in refrigerated units.
Health and Social Care Secretary Matt Hancock defended the Government's handling of the situation, given that concerns were raised in July.
NHS sources said the company had taken on too much work and was not able to dispose of the waste in a timely manner
'My clear goal throughout has been to make sure that the public are safe and also that NHS services can continue. We have secured those goals.
'We have now moved the contract away from the company that was failing to deliver, we have got a new company in and that's the point at which we could go public about this issue.
'The waste is now being removed effectively and we are across this subject to make sure that we can put in place systems that work sustainably for the long term.'
The Environment Agency last week announced it had begun a criminal investigation.
It comes as health chiefs last week asked six other waste disposal firms to step in and help NHS hospitals amid the ongoing crisis.
The Government called on the help of waste disposal firms Augean, Grundon, PHS, Stericycle/SRCL, Tradebe and Veolia, it has been reported.
Local health chiefs have already been warned that they may have to store their own waste in special trailers directly outside hospitals.
Healthcare Environment Services Ltd has breached its permits at five sites. Above: The site in Normanton, West Yorkshire
Neighbours of HES' waste disposal unit in Normanton, West Yorkshire, last week complained about the 'foul' smell.
The unnamed man, who works at YESSSelectrical, said: ‘There is a bit of a weird smell at times.’
He said he and his colleagues notice it ‘every now and again’.
The Government called on the help of waste disposal firms Augean, Grundon, PHS, Stericycle/SRCL, Tradebe and Veolia.
As well as HES' site in Normanton, its sites in Newcastle, Nottingham and Bradford have breached its environmental permits.
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October 10, 2018
Sources: Daily Mail
a rare disease in the US has returned disappointing results, researchers at Sangamo Therapeutics announced today.</p><p>Gene-editing has been hailed as the best hope to treat inherited disorders. </p><p>Sangamo's trial used proteins that bind to targeted segments of DNA to deliver gene therapy to three patients with a rare genetic disorder that disrupts their ability to process certain sugars, causing damaging build-up in the brain, bones and more. </p><p>But a year and nine months after the trial's start, the patients' levels of harmful sugars have stayed effectively the same, casting a disappointing shadow of doubt over the prospects for 'fixing' the genome. </p><p>Brian Madeux (center, file image) was among the first people to have his genome edited as part of the first US human trial to attempt to cure two genetic diseases. His genes were successfully edited, but the treatment has so far done little to change markers of the disease, according to preliminary findings of Sangamo Therapeutics trials released today </p><p>More than 6,000 deadly or debilitating diseases lurk in the genetic code. </p><p>Until very recently, all that could be done for people with these diseases was to treat their symptoms - there was no way to cure or reverse these conditions. </p><p>But the theory - and the hope - is that if we can alter the genes that carry these diseases, we could edit mutations out of existence. </p><p>One of the earliest, most promising methods for doing so uses so-called zinc finger nucleases (also referred to as simply zinc fingers, or ZFNs). </p><p>Zinc fingers are a fuse of two compounds that can be engineered to seek out and cut specific segments of DNA. </p><p>The latest advancements for gene-editing use the Nobel Prize-winning CRISPR technology, but the method is too new for human trials. </p><p>Scientists at Sangamo used these to target genes that code for two related disorders, mucopolysaccharidosis types I and II (MPS I and MPS II). </p><p>MPS I causes Hurler syndrome, a deficiency of an enzyme that, in healthy people, breaks down complex sugar chains called glycosaminoglycans (GAGs). </p><p>In those with Hurler syndrome, GAGs instead build up in the body, becoming toxic and causing symptoms like claw hands, deafness, heart problems, joint and spine abnormalities and worsening mental decline. </p><p>These children typically have coarse features, enlarged livers and spleens and may have heart and breathing abnormalities. </p><p>MPS II defects cause similar though slightly milder symptoms. Both conditions are more common among boys and affect one in 100,000 to 150,000 births. </p><p>Children with Hurler syndrome, such as this girl pictured in Sangamo's presentation of their findings, tend to have coarse features and as harmful sugar chains build up in their bodies, the compounds become toxic, damaging organs and the brain</p><p>The two diseases are cousins of the rarer, more devastating Sanfilippo syndrome, known as 'childhood Alzheimer's.' </p><p>The best treatment for this family of diseases is enzyme replacement therapy, which can slow declines but is by no means a cure. </p><p>Between its trials for MPS I and II, Sangamo enrolled nine patients who received replacement genes. </p><p>In the technical sense, the experiment worked. The scientists saw that the gene replacement worked and caused minimal side effects. The patients' bodies did begin producing more of the missing enzyme. </p><p>At least two study participants, including Brian Madeux, had their genes successfully changed. </p><p>In earlier reported preliminary results, the study participants' enzyme levels were seeing encouraging increases, and tests of their urine revealed falling levels of GAGs - the most important measure of their diseases. </p><p>In today's results, the patients' GAG levels 'did not show a meaningful change,' and some even increased, said Sangamo CEO, Dr Sandy Macrae on a conference call. </p><p>The replacement DNA 'was permanently integrated into the genome,' a significant step forward, 'but our mission is more leading the way scientifically,' he added. </p><p>'We are realistic about whether this first generation [treatment] is going to accomplish everything that these patients need it to.' </p><p>One patient struggled during the trial, and it was recommended that they return to the standard enzyme treatment (which most continued to receive though a few withdrew from it and a couple of others are considering doing the same). </p><p>The Sangamo scientists believe that, at higher doses, the therapy may still work, but today's results are inevitably a blow to the hopes of sufferers of rare diseases for whom gene-editing has been an almost singular beacon. </p><p> The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
w' skin in withdrawal after ditching the steroid creams she had been using to treat eczema.</p><p>Larissa Carey, 32, of Portsmouth, Hampshire, had been using the strong medication religiously since her diagnosis at nine months old.</p><p>After noticing the creams weren't working during her adult life, in which stress made her skin dramatically worse, Miss Carey ditched them in January 2018.</p><p>She is believed to have developed topical steroid withdrawal (TSW), a painful skin reaction which occurs in reaction to cutting back on steroid creams.</p><p>Larissa Carey, 32, used steroid creams religiously since her diagnosis at nine months old. Pictured, in December 2017 when she realised they had stopped working</p><p>Weaning herself off the strong medication she had used for life led Miss Carey to develop a little-known condition called topical steroid withdrawal (TSW). Pictured, in March 2018, two months after she stopped using the creams</p><p>Miss Carey, pictured in January, is now on an antibody drug which helped calm her eczema</p><p>Miss Carey still suffers from flare ups, most recently the end of February. She said the only trigger she has found is stress, which became a problem in her adult life</p><p>She said: 'When I stopped using the creams, Robbie and I had just bought our first house together.</p><p>'It should have been this wonderful time, but instead I was bedbound with the pain. I'm only in my 30s, but I felt like I was 100.</p><p>'I knew how important it was to push myself to get out and see people or do things, but I just wanted to hide.</p><p>'I was so worried people would stare, and when it's something like skin that you can't even cover up, it's all the more soul-destroying.'</p><p>Doctors hoped Miss Carey, who has battled eczema for most of her life, would eventually grow out of it.</p><p>One in every five British children are affected by eczema at some stage. But 60 to 70 per cent will have got rid of the condition by their teenage years.</p><p>Miss Carey intermittently used small doses of prescribed steroid creams throughout her childhood.</p><p>'I'd find that sunshine and sea water were a massive help,' Miss Carey said. 'I remember my eczema being particularly bad on my joints and how I'd get told off for scratching in class.</p><p>'But, now I think back, it's nowhere near as severe as dealing with TSW.'</p><p>Instead of easing, Miss Carey's eczema became more severe as an adult, although stress was the only trigger she could identify.</p><p>She said: 'I look back now and try to figure out patterns, examining what was happening in my life at particular points and trying to work out why that'd make it better or worse.</p><p>'The major trigger I found was stress. I tried my best to minimise it in my life, but sometimes, it's out of our control.</p><p>'There is an awful lot of pressure in life now. People are so busy and want to do everything as fast as possible. Then there's also things like social media, and how it makes us compare ourselves to others.</p><p>'They sound like little micro-stresses, but they can all add up without you realising.'</p><p>As her skin condition became more severe, Miss Carey's use of steroid cream increased.</p><p>Miss Carey had been using steroid creams since she was diagnosed with eczema at nine months old. She used them more as she got older when stress was a main trigger for her skin</p><p>Miss Carey said her skin became red raw in the months following her ditch of steroid creams, making it painful even to shower</p><p>Miss Carey said her skin was so sore it was painful to wear underwear. The condition left her bedbound in pain, and she was worried about being judged for her appearance</p><p>By around 2015, she was applying it every few hours, having been told to use it as much as she needed.</p><p>But it appeared that the more she used the less effective it became.</p><p>Miss Carey said: 'You see that word steroid and know it's not something you want to be using every single day.</p><p>Eczema is an inflammatory condition of the skin that leads to redness, blistering, oozing, scaling and thickening.</p><p>It usually appears in the first few months of life and affects around 10 per cent of babies.</p><p>Eczema's cause is not fully understood but it is thought to be brought on by the skin's barrier to the outside world not working properly, which allows irritants and allergy-inducing substances to enter.</p><p>It may be genetic due to the condition often running in families.</p><p>As well as their skin being affected, sufferers may experience insomnia and irritability.</p><p>Many factors can make eczema worse. These may include:</p><p>There is no cure for eczema, however, 70 per cent of childhood sufferers no longer have the condition in their teens.</p><p>Patients should avoid known triggers for flare ups and use emollients.</p><p>'By the end, I was getting no relief whatsoever from the creams.</p><p>'I was still having to bandage my wrists and arms every night to minimise scratching in my sleep, and had to be incredibly careful about what products or materials I put on my skin.</p><p>'I used to love cosmetics, and have this whole vanity case of lovely makeup that I can't use. I could only apply moisturiser to my face, or use prescribed shower gel.' </p><p>At the end of January 2018, Miss Carey decided to ditch the steroid creams for good.</p><p>Miss Carey was completely unprepared for the severe reaction to come.</p><p>By March, her skin – particularly on her face – felt tight, red and raw, as if she had been burned. </p><p>After posting photos to some online eczema support groups for advice, a fellow sufferer mentioned TSW for the first time and, after reading about it, Miss Carey became convinced she had it.</p><p>Many have called the 'condition' a fad, however, it has been recognised by the National Eczema Association since 2013. </p><p>Miss Carey said: 'I contacted some friends that work in medicine and they sent me over some studies to read. The condition is such an unknown, especially as controlled studies are virtually impossible, as they'd mean withholding eczema treatment from somebody who really needs it.</p><p>'But the only change I could think of that had sparked this was coming off the creams.'</p><p>Things continued to go downhill, with Miss Carey's whole body become affected.</p><p>'It got to the point where even showering would leave me in tears, as it was so painful and my skin was so raw I couldn't even wear underwear,' she said. </p><p>Miss Carey had no choice but to start a course of the immunosuppressant drug cyclosporin which was offered by a dermatologist in April. </p><p>An immunosuppressant drug helped to calm Miss Carey's skin after she saw a dermatologist.</p><p>When she had TSW, Miss Carey's skin felt tight, red and raw, as if she had been burned</p><p>Miss Carey's skin has calmed since she was given an antibody drug called dupilumab </p><p>The antibody drug, pictured, is taken by Miss Carey who also has a hypnotherapist and cognitive behavioural therapist, to deal with the emotional turmoil of her skin condition</p><p>She has also been seeing a naturopath to discuss alternative therapies, as well as a hypnotherapist and cognitive behavioural therapist, to deal with the emotional turmoil.</p><p>Miss Carey said: 'People don't understand, and think it sounds silly to be saying this about a skin condition, but there were genuinely times when I wondered how I was going to get through, if the rest of my life was going to be like this.</p><p>'Everyday things that you take for granted were so difficult, like undressing for a shower. Not only was it painful – I also didn't want to have to look at myself.</p><p>'Thankfully, I am feeling much stronger, though the not knowing why this happened, and living with something so unpredictable is still very tough.'</p><p>Miss Carey has now moved on from taking cyclosporin and is beginning a course of an antibody called duplimab, but still gets flare-ups.</p><p>She is urging doctors to treat eczema patients such as herself holistically, rather than simply prescribing steroid creams.</p><p>In 2015, GPs in England wrote about 27million prescriptions for the topical agents used in the treatment of atopic dermatitis (eczema) at a cost of approximately £169million, according to Allergy UK.</p><p>Miss Carey said: 'There is a time and a place for steroid treatments. Everyone is different and they can help some people, but we also need to be looking at triggers like stress and diet.</p><p>'Every journey is different, and individuals need to do what they can to help themselves.</p><p>'There is, in my mind, a clear link between mental health and skin conditions. Stress is a huge trigger, and you are bound to feel low when there is no end in sight and every little thing you do is a huge decision about whether it'll make your skin better or worse.</p><p>'We are getting better at talking about mental health but we still need to be changing our approach and looking at things as a whole.'</p><p>Topical steroid addiction arises from the use of such creams to treat conditions like eczema. </p><p>First described in 1979 in the International Journal of Dermatology, the theory is, over time, the skin becomes ‘addicted’ to the steroids. But it is not widely accepted among the medical community. </p><p>Many have called the 'condition' a fad, however, it has been recognised by the National Eczema Association since 2013. </p><p>Also known as red skin syndrome, the disorder does not have many statistics to show how common it is. One 2003 study from Japan, found that 12 per cent of adults who were taking steroids to treat dermatitis developed RSS. </p><p>It occurs when steroids have been abruptly discontinued after a prolonged or inappropriate length of administration. Women who blush easily are thought to be most at risk. </p><p>Topical steroid addiction has not been reported with correct drug use.</p><p>Excessive sweating and itching is a sign of recovery. Many sufferers also develop insomnia. </p><p>Treatment focuses on anxiety support, sleep aids, itch management, infection prevention and immunosuppressants.</p><p>Doctors should advise patients to avoid long term or high dose steroid use. Long term is considered to be one-to-two years of regular use.</p><p>Patients are also advised to cut down on steroids slowly but using a lower dose and gradually cutting back to, for example, every other day or a few times a week. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
on which makes him vomit every time he consumes food.</p><p>Lee Baker, of Margate, Kent, suffers from gastroparesis, which affects the normal movements of the muscles in the stomach, preventing it from emptying properly.</p><p>This has left the 45-year-old - who used to work as a chocolate salesman - unable to eat solid food for the past six years and looking like a 'skeleton with skin'.</p><p>Surviving on just four milkshakes a day, he is now severely malnourished, going from 17st 9lbs (114kg) two years ago to just 7st 8lbs (50kg) today. </p><p>After doctors warned he may be forced to have a feeding tube fitted, Mr Baker is finally making 'good progress' after having a gastric pacemaker fitted to regulate the movement of his stomach. </p><p>Lee Baker claims his body is 'eating itself' due to a condition that makes him vomit every time he consumes food. He is pictured left in 2008 in his former job as a chocolate salesman, before his extreme weight loss (seen right in a recent picture) forced him to quit</p><p>Mr Baker (pictured with his wife Alison) suffers from gastroparesis, which affects the normal movements of the muscles in the stomach, preventing it from emptying. This has left him unable to eat solid food for the past six years, with the father-of-two existing on milkshakes</p><p>Speaking of his condition, Mr Baker said: 'My body doesn't stop me from physically eating anything solid.</p><p>'At the moment, if I put anything in my stomach or down my mouth, within a minute or two, five minutes at the latest, it's back as it went down, doesn't break up, doesn't do anything.</p><p>'My muscles now are being eaten away. My fat's already been eaten away by the disease, so they'll be nothing left of me.</p><p>'I can't walk very much anymore, so I find it hard to get upstairs. It's changed everything about every aspect of my life.'</p><p>Mr Baker - who is father to 11-year-old Grace and 10-year-old Kian - is so weak he is barely able to walk and regularly collapses from exhaustion. </p><p>His wife Alison said: 'He's just a skeleton with skin on at the moment. It's heartbreaking. </p><p>'He's not so energetic, he can't do as much as he used to like to do. </p><p>'So it has been harder but he always tries to keep a smile on his face.' </p><p>Just two years ago, Mr Baker weighed 17st 9lbs (seen right). Unable to eat without bringing his food straight back up again, his weight has plummeted to just 7st 8lbs today (seen left)</p><p>Mrs Baker (pictured right with her husband before he became unwell) describes him as a 'skeleton with skin' and calls the whole ordeal 'heartbreaking'. Mr Baker is so severely malnourished and skinny (seen left), he frequently collapses and struggles to walk</p><p>Mr Baker believes his gastroparesis was triggered by prescribed treatment for his sarcoidosis – a rare condition that causes small patches of red and swollen tissue in the internal organs.</p><p>After being diagnosed with sarcoidosis in 2009, Mr Baker then developed type 2 diabetes around the time he started vomiting. </p><p>The father-of-two went without a gastroparesis diagnosis for four years and hit rock bottom. </p><p>'The darkest moments I've had with this - well the whole illness from the sarcoidosis down to diabetes and gastroparesis - I was told it was in my head and I was making it up,' Mr Baker said. </p><p>'I lost a lot of my dignity. My life [was] just falling apart.' </p><p>It was not until his wife read an article about someone with similar symptoms to her husband that Mr Baker finally started to get answers. </p><p>The person was being treated by Dr Sri Kadirkamanathan, of Broomfield hospital in Chelmsford, Essex. </p><p>The couple contacted the medic who immediately diagnosed Lee with gastroparesis and advised he was fitted with a 'pacemaker', known as a gastric electrical stimulator (GES). </p><p>A GES sends mild electrical pulses to the nerves and smooth muscle of the lower stomach, easing nausea and vomiting in gastroparesis sufferers. </p><p>Pictured before the ordeal with his wife, Mr Baker believes his gastroparesis was triggered by treatment he was taking for sarcoidosis – a rare condition that causes small patches of red and swollen tissue in the internal organs. It took four years for him to be properly diagnosed </p><p>Three passport photos show the dramatic weight loss Mr Baker has been forced to endure </p><p>Two months after having the GES fitted, Mr Baker is still recovering but has been able to eat something for the first time in six years. </p><p>'The first thing I actually ate after the surgery was two slices of toast from the hospital and a peach yoghurt,' he said. </p><p>'Although the toast was probably the worst toast you've ever seen – it was the best tasting toast I've ever had.</p><p>'And since then it's just been going from strength-to-strength, I've been eating normally, no sickness, my diabetes is now gone as well, which is a bonus we [were] never told about.</p><p>'I've put on about 10 kilos (22lbs) in weight in the last two to three weeks. So we're making good leaps and good progress.'</p><p>And after years of abstaining from food altogether, Mr Baker is even starting to experiment with different cuisines. </p><p>'He's been trying foods that he's not eaten before, he's taken a liking to sushi – well it's something he can do on his own because I don't like that!,' Mrs Baker said.</p><p>'It's small steps, but big strides and it's looking really good and I just can't believe it's finally, finally happened.'</p><p>The surgery has had an impact on every aspect of Mr Baker's life and given him hope for the future. </p><p>'It's given me a goal and a purpose to do something meaningful with my life,' he said.</p><p>Mr Baker features on Body Bizarre, which is on Saturdays at 10pm on TLC UK. </p><p>Gastroparesis affects the normal movements of muscles in the stomach, preventing it from emptying properly.</p><p>It affects more than 1.5 million people in the US to some extent. Up to four per cent of people suffer in the UK. </p><p>Due to the condition affecting digestion, it can cause nausea and vomiting, as well as problems with people's blood-sugar levels and receiving adequate nutrition.</p><p>Gastroparesis can occur as a complication of diabetes, or after surgery or an infection.</p><p>It is believed to be caused due to damage to a nerve that controls stomach muscles.</p><p>Certain medications, such as antidepressants or pain relievers, can slow gastric emptying and cause similar symptoms.</p><p>Complications can include severe dehydration from vomiting, malnutrition, a reduced quality of life and undigested food hardening in the stomach, which can be life threatening.</p><p>There is no cure. Treatment focuses on dietary changes, such as eating smaller meals more frequently and chewing thoroughly. </p><p>Surgery to fit a feeding tube may be required if patients are unable to tolerate any food or liquids. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
to hear properly was stunned to discover a BB gun bullet had been wedged in her ear for 11 years.</p><p>Jade Harris was referred to hospital after having her ears syringed at her GP clinic left her in agony and still unable to hear.</p><p>Once at Derriford Hospital in Plymouth, stunned medics found a BB gun ball lodged in the 28-year-old's left ear canal.</p><p>After doctors used a metal hook to pluck the bullet out, the healthcare assistant could instantly hear more clearly and even says her own voice sounded different.</p><p>Seeing the ball instantly made her remember playing with a BB gun at a house party when she was just 17, with the bullet clipping her ear after it bounced off a window. </p><p>Jade Harris (left), who became 'paranoid' when she was unable to hear properly was stunned to discover a BB gun bullet (pictured right) had been wedged in her ear for 11 years</p><p>Pictured with her daughters - eight-year-old Gracie-Mai Jade Biggs and five-year-old Hope Jade Corbin - Ms Harris went to have her ears syringed when she got water in her right ear, only for the simple procedure to leave her in agony. She was then referred to hospital </p><p>For more than a decade, Ms Harris was forced to listen to her TV at near full volume and was always asking people to repeat themselves. </p><p>'Everyone always told me off for being loud as I was shouting a lot due to not hearing myself,' she said.</p><p>'It felt awful not being able to hear properly and it was so embarrassing. </p><p>'I had no pain from the ear but had to turn the telly up and was constantly saying, "what did you say?" and "pardon" to people.</p><p>'This went on for 11 years, everyone would always laugh and say I needed my hearing to be checked.'</p><p>A woman had a cockroach stuck in her ear for more than a week after the insect crawled in while she slept.</p><p>After her husband was only able to remove a few legs with tweezers, Mrs Holley rushed to A&E while the cockroach continue to wriggle deeper into her ear canal.</p><p>Doctors thought they had removed the roach until - nine days later - Mrs Holley continued to experience pain and a loss of hearing in her ear, leading to a local medic removing six more piece of the insect's carcass.</p><p>Later that day, an ear, nose and throat (ENT) specialist managed to remove the cockroach's entire head, upper torso, remaining limbs and antennae. </p><p>'He told me he extracted bugs from peoples' ears at least once a month - and I was the second person that day who needed it,' Mrs Holley said.</p><p>Cockroaches are thought to crawl into people's ears in search of food. </p><p>Ms Harris - who is mother to eight-year-old Gracie-Mai Jade Biggs and five-year-old Hope Jade Corbin - finally went to her GP last July after getting water in her right ear, which made her hearing even worse.</p><p>During the appointment, her doctors checked her left ear and recommended she have it syringed to remove a 'build-up of wax'.</p><p>When she went to the syringe appointment on July 13, a puzzled nurse realised it was not wax and referred Ms Harris to the hospital that same day. </p><p>'The nurse started with the left ear but the "wax" wasn't budging and it was then she asked if I had put anything in there,' Ms Harris said.</p><p>'Two more doctors came to look at my ear to see what was in there, I thought they meant a family of bugs so was freaking out.</p><p>'They got me an appointment at the hospital straight away because I was a wreck.'</p><p>Once at the hospital, Ms Harris' doctor tried to use a hoover-like device to suck whatever was lodged out, with the medic initially think it was a yellow bead. </p><p>'She then got a metal hook and had to push past it which absolutely killed, my hand flew up and I almost hit her from the shock of it,' Ms Harris said.</p><p>'Once she got behind it she managed to pull it out and that's when when we realised what it was.</p><p>'She was really nice throughout the appointment and said she'd seen all sorts in ears over the years but never a BB gun bullet.'</p><p>Once at hospital, doctors discovered what appeared to be a build up of wax or a small yellow bead in her left ear. Medics were forced to use a 'metal hook' to pluck the intruding ball out, which was so painful it 'killed'. Ms Harris is pictured left and right with her daughters </p><p>Although the ordeal was painful, Ms Harris immediately felt better once the offending bullet was removed. </p><p>'As soon as it came out it felt amazing and I could instantly hear better,' she said. </p><p>'My voice sounded different and and having the wind hitting it felt really strange.</p><p>'Inside my ear was red raw from where the BB gun bullet was lodged but my ear was really clean as it had stopped anything going in. </p><p>'I was given an ear spray to put in to ease the redness, which lasted a week.'</p><p>Pictured left after the ordeal - holding an image of the bullet - Ms Harris could instantly hear better, with even her own voice sounding different. After years of asking people to repeat themselves, Ms Harris (also pictured right) is enjoying hearing the sound of her children laugh</p><p>As soon as Ms Harris saw the pellet, she was struck with the memory of how the obscure item got into her ear canal. </p><p>'I had some people in my house for a party 11 years ago and a friend was messing around with a BB gun,' she said.</p><p>'The bullet bounced off a glass and then, so I thought, hit me on the ear and pinged off.</p><p>'It hurt like it had hit me, it was so fast and powerful, but I wasn't aware it had gone into my ear which it obviously did.'</p><p>Doctors discovered - and removed - the bullet at Derriford Hospital (pictured) in Plymouth</p><p>Although not painful, having the bullet lodged in her ear had a big impact on Ms Harris' life.</p><p>'I never went swimming as I was paranoid about my hearing getting worse,' she said.</p><p>'Going to loud places such as gigs or a play centre, or [a] children's party with the kids was a no-no because I couldn't hear well as it was so I wouldn't have heard a thing.</p><p>'I used to get my friends and family to take the them to places I couldn't so they wouldn't miss out.</p><p>'I just tended to stay home a lot but would take the kids to the park.'</p><p>Ms Harris is now relishing being able to hear her children laugh while they play. </p><p> 'It's a big relief being able to hear properly now and I'm just glad it wasn't something more serious,' she said.</p><p>'Since having the bullet removed I've been able to go swimming with the girls which is lovely and I can just hear so much better and not constantly saying "pardon?" which is nice.</p><p>'It's great to be able to hear the children laughing and playing - though sadly I can also hear them when they're shouting too.</p><p>'It'll be a funny story to tell them when they're grown up, but I'm certainly staying clear of any BB guns from now on.'</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
boob job she had after her husband and boyfriend cheated on her.</p><p>Jessie, whose name and age are unknown, said two men she had loved cheated on her with 'women with bigger boobs'.</p><p>But after several failed breast enhancements to boost her confidence, she ended up with one breast for six years.</p><p>She turned to the help of celebrity plastic surgeons Dr Terry Dubrow and Dr Paul Nassif on the TLC programme Botched.</p><p>Although there was a high chance it could go wrong, they were able to provide Jessie with a 'pretty sweet' cleavage.</p><p>Dr Terry Dubrow and Dr Paul Nassif on the TLC programme Botched helped to fix Jessie's breasts. She had one breast for six years after implants ruptured multiple times</p><p>The rupture of Jessie's implants caused her 'tremendous pain' a month after her boob job</p><p>Jessie said she had breast enhancements after the two men she loved cheated on her with 'women with big boobs'. Pictured, at a younger age with an unknown man</p><p>Jessie asked the surgeons to make her 'as big as you can go'. Pictured, younger before her surgery. It is not clear if she is the mother of the baby</p><p>Jessie, who lives in the US, recalled when she got her first boob job: 'At this point in my life, I'd loved two men and both of them cheated on me with women with big boobs.</p><p>'I decided enough's enough, maybe having bigger boobs would make my chances less likely somebody cheating on me.' </p><p>Jessie asked for 'as big as you can go', and was given huge implants on her slim frame.</p><p>However, two weeks later her right implant 'busted open' and ruptured an incision, coming out of her skin.</p><p>She said she was in 'tremendous pain' about a month after the surgery, but it is not clear what surgery she had to fix it.</p><p>Unfortunately, the implant rejection occurred a total of three times, leaving Jessie with only one breast for six years. </p><p>'There isn't a day that goes by when I don't regret getting my boobs done just to keep a man,' Jessie said.</p><p>'I just want to live free, not trapped by this breast. It consumes so much of my life.'</p><p>Jessie hoped Dr Dubrow would be able to even out the situation on her chest, but he came across some complications from the offset.</p><p>'Jessie's had some very significant early complications, despite the fact that her surgeon used preventive measures,' Dr Dubrow explained.</p><p>The implant in Jessie's right breast rejected a total of three times</p><p>Dr Dubrow revealed Jessie had 'paper thin' tissue, which would make the operation harder</p><p>He said there was a 60 per cent chance the operation would fail - which it did the first time. But Jessie said she would want the surgery even if there was a five per cent chance of success</p><p>Dr Paul Nassif and Dr Terry Dubrow are the plastic surgeons from hit TLC show Botched</p><p>While listening to Jessie tell her story, Dr Dubrow became concerned about the new patient's 'underlying soft tissue'.</p><p>He said: 'We need to figure out a way to thicken up that skin if we have any chance of having an implant survive in that pocket, for any period of time.' </p><p>Dr Dubrow revealed that the surgery had a 60 per cent chance of failing due to the patient's 'paper thin' tissue. </p><p>But Jessie wanted to go ahead with the operation, saying even if there was a five per cent chance it would work, she would take the risk. </p><p>In surgery, Dr Dubrow rotated a piece of tissue from the back part of the pocket to reinforce the thin skin. </p><p>He added two small implants for symmetry, but said Jessie could have larger implants in the future if she wanted.</p><p>Jessie's first post-operative exam went well, but it wasn't long before the right implant began rupturing.</p><p>It was removed by a local doctor in Indiana before Jessie returned to Dr Dubrow.</p><p>However, the infection helped create thicker skin which allowed Dr Dubrow to operate again for even better results. </p><p>'I was afraid that I would never be normal,' Jessie said. 'But now I have two symmetric breasts that look good in and out of clothes.</p><p>'Now I look down and cleavage. This is pretty sweet.'</p><p>Jessie said it was 'pretty sweet' to be able to have breasts again after so many years</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
da, voted this week to ban the sale of sunscreen containing chemicals believed to harm coral reefs.</p><p>The measure, which the City Commission approved Tuesday in a 6-to-1 vote, will ban sales of sunscreens containing the chemicals oxybenzone and octinoxate. The legislation will go into effect on Jan. 1, 2021.</p><p>“Our coral has been under attack by a number of stressors,” Mayor Teri Johnston said. “We just thought if there was one thing we could do, to take one of the stressors away, it was our responsibility to do so.”</p><p>Ms. Johnston said that people with medical prescriptions would be exempt from the ban, and the first offense would be met with a warning. The second offense would incur fines that are still to be determined.</p><p>She added that the reef was crucial to both the environment and the tourism-driven local economy.</p><p>Ms. Johnston said there were many sunscreens available without those two ingredients. She said she hoped that the ban would push bigger manufacturers to make and market more eco-friendly sunscreens.</p>
riptions over all, except for certain types of medications, an analysis finds. </p><p>There are many, many things that rich people buy in larger quantities. It turns out medications for certain serious diseases may be one of them.</p><p>A new analysis has found that, for some types of medications, income is a pretty strong predictor of how often someone is picking up a drug to treat an ailment.</p><p>Patients in wealthier neighborhoods were much more likely to pick up prescriptions for lifestyle problems: erectile dysfunction, baldness, anti-wrinkle Botox injections and an eye medicine that thickens eyelashes. This may be unsurprising. </p><p>These prescriptions for serious conditions were filled disproportionately in rich neighborhoods despite evidence that the rich tend to be in overall better health. In fact, people in rich neighborhoods filled fewer prescriptions than people in middle-class neighborhoods. The blend of data suggests that, while prescriptions and income don’t track well over all, there are points where they do.</p><p>The relationship between income and prescription drug purchasing is more complicated than whether someone has money to spend at the pharmacy. Depending on income and life circumstances, Americans may have different odds of developing certain illnesses and of seeking treatment — even before the direct cost of medicines becomes an issue.</p><p>Niteesh Choudhry, a professor of medicine and public health at Harvard, said that his research hadn’t shown a clear relationship between income and prescription drug use. Instead, he said, cultural and racial factors — and the details of insurance coverage — were better predictors. When it comes to treatments for very common conditions, “the income relationships are probably not linear,” he said.</p><p>Several experts in the demographics of drug use said all those factors might explain the higher usage of medications for mental health problems among wealthier people. Some mental health problems are more prevalent among Americans with lower incomes, evidence shows. But longtime holes in the health care system mean that richer patients are more likely to have private insurance or extra money to pay for psychiatric care that is not covered by insurance. And some people in lower-income communities may feel more stigma around mental health diagnoses. </p><p>A similar dynamic could explain lower prescription rates for birth control among lower-income women. Under Obamacare, all women with health insurance should be able to get contraception with no co-payment. So cost at the pharmacy counter can’t alone explain the differences. But higher-income women may be more likely to have a regular doctor to prescribe pills. (The data shows that emergency contraceptive purchases, also available without co-payment, were more common in lower-income neighborhoods.) </p><p>The high cost of EpiPens alone may explain some of the differences in usage. Current guidance is for patients to stock several of the devices, used to treat life-threatening allergic reactions, and replace them often. But their high cost may lead some poorer patients to make do with fewer or older ones, while those with more disposable income might stock extras.</p><p>Some drugs seem to be taken about equally regardless of income. The use of antibiotics appears to be roughly the same for middle-class and rich Americans. These drugs are used for some serious diseases, have few over-the-counter substitutes, and tend to be inexpensive.</p><p>Some drugs are much more commonly used at the low end of the income scale. Consider treatments for hepatitis C and H.I.V. These are diseases that disproportionately affect low-income Americans, and that pattern is reflected in the prescription purchasing patterns.</p><p>The GoodRx data looked at a sample of 53 million retail pharmacy purchases in 39 large metropolitan areas over a year ending in October 2018, then divided them according to the income characteristics of the people who lived in the census tract where the pharmacy was located.</p><p>This is not exactly the same as tracking individual customers by income, but most people buy drugs at pharmacies near their homes. The data includes drug purchases by people with both public and private health insurance, and by some customers who buy their medications using cash. Analysts at GoodRx then grouped drugs prescribed for various diagnoses to build categories. They also made some adjustments to the data in cases where the sample overrepresented one kind of insurance.</p>
ness, no matter how small, is ever wasted'.</p><p>And now research suggests a bit of self-love is even good for our health.</p><p>A study asked volunteers to listen to audio clips encouraging them to be compassionate towards themselves.</p><p>After just 11 minutes, the participants' heart rates were significantly lower than those who paid attention to their tough inner critic.</p><p>A low heart rate helps put us in a state of relaxation that 'gives us the best chance of healing', the researchers said.</p><p>People who practice self-love have lower heart rates and stronger immune systems (stock)</p><p>The research was carried out by the universities of Exeter and Oxford.</p><p>It was led by Dr Anke Karl, a senior lecturer in psychology at the University of Exeter.</p><p>The researchers divided 135 university students into five groups, which each listened to a different set of instructions.</p><p>One of the groups was guided through a 'compassionate body scan', where they were told to pay attention to different sensations in their bodies with an attitude of interest and calm.</p><p>The second group was given a 'self-focused loving kindness exercise' that involved them thinking positive thoughts about themselves and their loved ones.</p><p>The third and fourth groups either listened to recordings that triggered their critical inner voice or put them in a 'positive but competitive and self-enhancing model'.</p><p>As a control, the final group was asked to imagine they were shopping in a 'emotionally neutral' setting.</p><p>Results - published in the journal Clinical Psychological Science - revealed the hearts of those who heard the loving messages beat two-to-three times less a minute than those in the negative groups.</p><p>People who fall in love and settle down in their 20s sleep better in middle age and suffer less stress, according to a new study.</p><p>Researchers say that their findings offer a possible explanation for how marriage reduces the risk of a premature death.</p><p>It is already known that just cuddling a loved one improves the immune system by exposing it to more bacteria - protecting against infections.</p><p>And regular sex works muscles you wouldn't otherwise use and increases blood flow. </p><p>Now a research team at the University of Minnesota has found those who have positive, lasting relationships in their early adulthood experience less anxiety after the age of 32.</p><p>When the heart beats too quickly, it becomes less efficient at pumping blood - and therefore oxygen - around the body. </p><p>Over time, the cells in the heart can even become starved of oxygen and die, which raises the risk of a heart attack.</p><p>The study also found that self-love led to greater variation between the participants' heart beats, which is a sign the heart can adapt to different situations.</p><p>These volunteers also sweated less, with excessive perspiration being a sign of anxiety and stress.</p><p>On top of the physical benefits, those who heard positive instructions reported feeling more compassionate towards themselves and connected to others. </p><p>In contrast, those who were encouraged to think negatively about themselves had a raised heart rate and sweated more - both signs of feeling threatened and distressed. </p><p>Dr Karl said: 'By switching off our threat response, we boost our immune systems and give ourselves the best chance of healing.'</p><p>Co-author Willem Kuyken, professor of clinical psychology at Oxford, believes the study's findings add weight to past research that suggests self-love benefits those with mental-health disorders. </p><p>'These findings help us to understand some of our clinical trials research findings,' he said.</p><p>'[Past research shows] individuals with recurrent depression benefit particularly from mindfulness-based cognitive therapy when they learn to become more self-compassionate. </p><p>'My sense is for people prone to depression, meeting their negative thoughts and feelings with compassion is a radically different way - that these thoughts are not facts. </p><p>'It introduces a different way of being and knowing that is quite transformative for many people.'</p><p>The researchers stress, however, their study was only carried out in healthy participants and it is therefore unclear whether a one-off self-love session would help those with depression. </p><p>It also did not directly look at how being kind to ourselves boosts our mood or reduces distress. </p><p>The scientists therefore plan to study the response of people with recurring depression after completing similar exercises. </p><p> The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
ng a battering, a study found.</p><p>Experts believe offering smaller versions of our favourite take-away meals could be key to reducing levels of obesity.</p><p>Researchers at Newcastle University found that shrinking portions can drastically reduce calorie intake while also keeping customers happy. </p><p>They teamed up with a fish and chip supplier to develop a portion with around 600 calories - 1,000 less than a traditional serving and in line with national guidelines for mealtimes. </p><p>Experts at Newcastle University believe offering smaller versions of our favourite take-away meals could be key to reducing levels of obesity</p><p>These were then offered at a dozen fish and chip shops in the North-East alongside their normal menus.</p><p>Takeaway owners were given a three-hour briefing on excessive portion sizes and how market research had shown many customers wanted to be more health conscious and have smaller meals.</p><p>They were supplied with promotional posters and business incentives of free packaging and customer loyalty points.</p><p>Proposed plans to restrict the number of calories in pizzas, pies and ready meals were last year revealed as part of drastic Government moves to try and cut down on obesity.</p><p>A tax on added sugar in drinks came into force in April, requiring companies to hand over more of the money they make from drinks which contain more than 5g of sugar per 100ml of liquid.</p><p>As a result, many soft drinks have had their recipes changed in order to avoid paying the tax and putting prices up. Sugary drinks are the biggest single source of sugar for children and teenagers.</p><p>The Government is also considering making it compulsory for all restaurants and fast food outlets to display the number of calories in each meal on their menu.</p><p>Some food outlets already do this but there can be unexpected numbers of calories in popular dishes, and the Government is consulting on the plans before a decision is due in spring.</p><p>In March this year, Public Health England warned Brits to crack down on the number of calories they're eating, advising people to consume no more than 1,600 per day.</p><p>The watchdog says adults shouldn't eat any more than 400 calories for breakfast, 600 for lunch and 600 for dinner – this would allow for some snacks, experts said.</p><p>Examples of 600-calorie meals include a tuna pasta salad and a small cereal bar, a chicken salad sandwich and a pack of crisps, or half a pepperoni pizza with a quarter of a garlic baguette and a banana.</p><p>The meal boxes, called Lite-BITE, consisted of a 5oz (142g) fish and 5oz of chips, fried in vegetable oil and typically cost customers about £4 - around £1.60 less than the full-size versions.</p><p>The study found one in five people bought the smaller alternatives while four in ten said they would consider scaling down.</p><p>Secret-shoppers, customer surveys and interviews indicated that customers were pleased with the smaller portions and takeaway owners were happy to sell them.</p><p>Public Health England wants adults to eat no more than 400 calories for breakfast, 600 for lunch and 600 for dinner.</p><p>But the rising number of fast food outlets has been blamed for fuelling the obesity crisis, with two thirds of adults and one in three children now overweight or obese.</p><p>Last year it was revealed that the number of fast-food outlets has increased by a third in eight years and is at its highest level since figures were first compiled in 2010.</p><p>Jackie Pearson, of independent fish suppliers Henry Colbeck Limited said more than 250 shops were using the boxes, selling 700,000 in the last year.</p><p>Lead author Louis Goffe said: 'The independent takeaway sector is one of the most challenging food sectors to work with to make changes.</p><p>'This research emphasises the importance of working with wholesale suppliers, who have a strong relationship with traders, to improve the health benefits of hot food takeaways.</p><p>'The sales show that there is a demand for smaller portion meals and we hope this will act as a template for others in the fast-food sector to follow.'</p><p>In proposed Government plans, calories are set to be capped on our favourite treats across the board.</p><p>Limits on ready meals, crisps, chips, biscuits, sandwiches, cooking sauces, soups, burgers and processed meats, among other food products are to be revealed in the spring.</p><p>The drastic guidelines from Public Health England state pizzas should contain no more than 928 calories and pies should be capped at 695. </p><p>The move is part of the PHE's target to reduce calorie counts in every day foods by 20 per cent by 2024, as around a quarter of adults and a fifth of children are obese in the UK.</p><p>In a major obesity crackdown, a tax on sugary drinks, a ban on two-for-one deals on junk food and adverts on London's public transport has been implemented. </p><p>Try to avoid: thin-cut chips, pies such as cheese and onion or steak and kidney, and jumbo sausages.</p><p>Healthier options: fish coated in breadcrumbs, mushy peas, thicker-cut chips without salt.</p><p>Try to avoid: large deep-pan pizzas, pizzas with a cheese-stuffed crust, triple cheese with pepperoni pizzas, creamy pasta sauces, garlic bread.</p><p>Healthier options: small or medium pizzas with a thin base and vegetable or lean meat topping, tomato-based pasta sauces, bruschetta.</p><p>Try to avoid: sweet and sour battered pork balls with special or egg-fried rice, prawn toast, spring rolls.</p><p>Healthier options: crab and corn soup, steamed dumplings, steamed vegetables and plain boiled rice, steamed fish, chicken chop suey, Szechuan prawns.</p><p>Try to avoid: fried rice, fishcakes, spring rolls, prawn crackers, satay skewers with peanut sauce, and sweet and sour dishes.</p><p>Healthier options: clear soups such as tom yum, salads, stir-fried meat, fish or vegetable dishes, and steamed seafood dishes, such as fish or mussels.</p><p>Try to avoid: any creamy curries, such as korma, passanda or masala with pilau rice, naan, bhajis, pakoras and poppadoms.</p><p>Healthier options: tandoori-cooked meat or jalfrezi or madras with chicken, prawns or vegetables, plain rice and chapatti.</p><p>Try to avoid: large doner kebab with mayonnaise and no salad, burgers with cheese and mayonnaise, thin-cut chips, chicken or fish patties deep-fried in batter.</p><p>Healthier options: shish kebab with pitta bread and salad, grilled burgers made from lean fish or meat (beef or whole chicken breast) and without cheese and mayonnaise.</p><p> The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>
oulder pain doesn't work, according to mounting evidence.</p><p>Decompression surgery is used to manage the symptoms of the most common form of shoulder pain - subacromial pain syndrome (SAPS).</p><p>However, an international panel of 20 medical experts have now said decompression surgery provides no benefit after reviewing the evidence. </p><p>SAPS, when a tendon inside the shoulder rubs on nearby tissues as the arm is lifted, is a common cause of shoulder pain in people over the age of 40 </p><p>Writing in the British Medical Journal, they said they strongly advised against the surgery and said it is no better than painkillers. </p><p>SAPS, when a tendon inside the shoulder rubs on nearby tissues as the arm is lifted, is a common cause of shoulder pain in people over the age of 40.</p><p>It is also known as subacromial pain syndrome or rotator cuff disease.</p><p>Patients are sometimes offered subacromial decompression surgery to relieve their symptoms when other treatments have not worked. </p><p>It involves widening the space around the rotator cuff tendon, making sure that it doesn't rub or catch on anything nearby, such as bone, as you move the arm. </p><p>An operation called a subacromial decompression may be an option for shoulder impingement if other treatments haven't worked, although there's some uncertainty about how much it helps.</p><p>A space between the top of your arm bone and the bone at the top of your shoulder blade, the subacromial area, allows the arm to move freely. </p><p>This area, including the muscles and tendons, is often called the rotator cuff.</p><p>If you have shoulder impingement, the amount of space is reduced. </p><p>This may be due to an injury, overuse of the shoulder or wear and tear with age - sometimes arthritis. </p><p>Subacromial decompression can open up the space by removing any swollen or inflamed bursa, the fluid-filled sac found between the tendon and acromion, or bony spurs on the acromion which grow with age.</p><p>Subacromial decompression can take around an hour, depending on how complicated your operation is.</p><p>The operation is usually done as a keyhole procedure using a narrow, flexible, tube-like telescopic camera called an arthroscope, and small cuts around the shoulder.</p><p>Specially designed surgical instruments will be inserted through the small cuts and reshape the subacromial space and perhaps tendons. </p><p>Subacromial decompression is usually done under general anaesthesia, which means that you’ll be asleep during the procedure.</p><p>The panel of experts was made up of bone surgeons, physiotherapists, clinicians and patients with experience of shoulder pain and surgery.</p><p>They carried out a detailed analysis of the latest evidence. This was based on two systematic evidence reviews.</p><p>The first review analysed if the benefits or changes were to pain, function and quality of life were worthwhile for patients with SAPS.</p><p>The second measured the benefits and harms of the surgery compared to a placebo or non-operative management strategies, such as exercise. </p><p>Some evidence showed that surgery did not have meaningful benefit over placebo surgery after one year. </p><p>The analysis also found that compared with exercise therapy, there was no important benefit of surgery on pain, function or quality of life.</p><p>About a third of all participants included in the trials continued to have symptoms, such as mild to moderate pain, at one year, irrespective of treatment. </p><p>Surgery also has potential for serious harm and is expensive, said the team led by Dr Per Olav Vandvik from Lovisenberg Diaconal Hospital, Oslo. </p><p>The panel felt that almost no one who fully understands the evidence would choose to have surgery.</p><p>They recommended a change in practice, given the risk of harm and burden to patients and waste of health care resources.</p><p>'Clinicians should not offer patients subacromial decompression surgery unprompted,' they wrote in the journal.</p><p>'And clinicians, public healthcare providers, and others should make efforts to educate the public regarding the ineffectiveness of surgery.'</p><p>There is substantial uncertainty around what would be better offered as an alternative. </p><p>Up to a quarter of adults have experienced shoulder pain over the past year, of which SAPS accounts for 70 per cent of cases. </p><p> The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. </p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p>Your comment will be posted to MailOnline as usual.</p><p>Do you want to automatically post your MailOnline comments to your Facebook Timeline?</p><p> We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.</p><p>Part of the Daily Mail, The Mail on Sunday & Metro Media Group</p>