TNF and rheumatoid arthritis: In the comparison between the two condition-intervention pairs (A) rheumatoid arthritis/TNF inhibitor and (B) morbid obesity/gastric bypass (Figure 3), a decision to offer gastric bypass first and decline to offer the TNF inhibitors would maximise average individual health outcomes, but it would also increase the inequality in lifetime health, and the inequality in future health potential, between patients with rheumatoid arthritis and obese patients.