A 22-stone ex-policeman trying to persuade a health authority to fund obesity surgery started the latest round of his legal fight today.
Grandfather Tom Condliff, of Talke, Staffordshire, who is 62 and 6ft 2in, says he needs stomach surgery to save his life.
But the North Staffordshire Primary Care Trust (PCT) refuses to fund a laparoscopic gastric bypass operation.
In April, the High Court refused to quash the PCT's decision not to provide the surgery.
Today, Mr Condliff's lawyers sought to overturn the High Court ruling in the Court of Appeal.
Lawyers expect the hearing in London to last two days. They say the three judges hearing the appeal are likely to reserve judgment to a later date.
Mr Condliff was not in court.
Richard Clayton QC, for Mr Condliff, argued today that a policy the authority had followed when making the decision not to fund the procedure breached human rights legislation.
Mr Clayton complained that the policy "expressly" required the PCT to "ignore" the "adverse effects on respect for his private and family life of not funding surgery" and the "potential beneficial effects on respect for his private and family life of surgery".
He said, in written arguments presented to judges, that those clauses breached Mr Condliff's legal "right to respect for private and family life".
Mr Clayton told Lord Justice Maurice Kay, Lady Justice Hallett and Lord Justice Toulson that his client is "morbidly obese" and suffers from diabetes and a number of associated illnesses.
Mr Condliff's health is deteriorating and doctors fear he could have less than a year to live, added Mr Clayton.
Mr Clayton said Mr Condliff had developed diabetes and other "health disorders" as a result of "congenital problems".
He said Mr Condliff had a "severe needle phobia", and over a number of years insulin had not been "delivered" as effectively as it might have been.
Mr Condliff had developed a "gross appetite" and started to "gorge himself" following a course of insulin.
"His weight increased and his health problems multiplied," said Mr Clayton, in a written argument.
"He tried all other relevant non-surgical interventions, including dietary and lifestyle and drug interventions, for his gain in weight but was not successful. He is rendered morbidly obese."
Mr Clayton said the PCT provided the surgery as a routine operation to anyone with a body mass index (BMI) of more than 50.
Judges heard that Mr Condliff had a BMI of about 43 and did not automatically qualify. He had therefore made an "individual funding request" under the authority's "exceptionality" policy but had been unsuccessful.
A doctor had expressed a number of concerns about the impact Mr Condliff's condition had on his private and family life, said Mr Clayton.
Mr Condliff used a wheelchair and was practically housebound, could no longer go to church - his "particular interest" in life - could no longer play the guitar, his "real passion", could not be "physically intimate" with his wife and was unable to use the toilet or shower on his own, judges were told
Mr Clayton said the doctor had noted that Mr Condliff was "more depressed and withdrawn" and felt "ashamed and humiliated".
David Lock QC, for the PCT, said judges should dismiss the appeal.
He said in written arguments that the case concerned "difficult" decisions about healthcare funding priorities.
"(Mr Condliff's) case is that Article 8 of the European Convention on Human Rights requires (the PCT) to have a decision-making system which takes non-clinical, social factors into account when making decisions as to which patient gets state-funded medical treatment," added Mr Lock.
"(The PCT's) case is that it is entitled to make such decisions without taking such factors into account."
Mr Lock said the type of surgery Mr Condliff wanted was "clinically appropriate" for him.
But he told judges: "Surgery of this type is not the only option for (Mr Condliff) to lose weight and, of itself and without accompanying lifestyle changes, it will probably not be successful."
The hearing was adjourned for the day. It is due to end tomorrow and judges are expected to reserve judgment.Reuse content