Tom Condliff, 62, who weighs 22st, says he needs the stomach operation to save his life.
In what is believed to be the first case of its kind, Judge Waksman, sitting at London’s High Court, said he had “considerable sympathy” for Mr Condliff but he rejected his application for judicial review today.
Mr Condliff from Talke, Staffordshire, took North Staffordshire PCT to court on the grounds that the refusal to fund a gastric bypass operation violated his rights under the Human Rights Act.
It also breached the trust’s own funding policy and was irrational, his lawyers argued.
The judge said it was still open to Mr Condliff to make a further funding request “if thought appropriate”.
Mr Condliff, a grandfather, became obese because of the drugs he has taken to treat long-term diabetes.
The weight gain is not due to overeating.