Devon's National Health Service authority confirmed that it will deny smokers and obese people routine surgery unless they quit cigarettes or lose weight.
The NHS in Devon, which has to cut spending due to a £14.5m (€18.5m, $22.7m) deficit, said smokers must quit eight weeks before surgery.
Obese patients with a BMI of 35 or above will be expected have to shed 5% of their body weight before going under the knife.
"All of these temporary measures relate to planned operations and treatments, not those which must be done as an emergency or to save lives," said Dr Tim Burke, chair of The Northern, Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG).
"We recognise that each patient is an individual and where their GP or consultant feels that there are exceptional circumstances we will convene a panel of clinicians to consider the case.
"We don't under estimate how difficult it will be for some people to lose weight or stop smoking and we will continue to support them.
"The CCG has a legal duty to live within its financial resources and the prioritisation of services is helping us to do that."
Britain's obesity epidemic currently costs the NHS billions of pounds each year. Government figures show that type 2 diabetes, which is closely linked to being overweight, costs the NHS over £1.5m an hour, or 10% of the NHS budget for England and Wales.
Around 3% of morbidly obese people develop type 2 diabetes each year.
Meanwhile, the Centre for Economic and Business Research warned Britain that the country faces a whopping £18.4bn in costs related to heart disease by 2020.
According to research commissioned to Action on Smoking and Health, the total cost to society (in England) from smoking is approximately £12.9bn a year.
This includes the cost to the NHS of treating diseases caused by smoking in England which is approximately £2bn a year.
Other costs include £1.1bn in social care costs of older smokers; £3bn paid in loss in productivity due to premature deaths (£3bn); and even £5bn for businesses, thanks to smoking breaks.