Parents of severely obese children should lose their custody rights for not controlling their kids weight, according to the authors of a recently published opinion piece in the Journal of the American Medical Association. In severe instances of childhood obesity, removal from the home may be justifiable [] because of imminent health risks and the parents chronic failure to address medical problems, wrote Dr. David Ludwig, an obesity expert at the Childrens Hospital Boston and author of the article, which he co-wrote with Lindsey Murtagh, a lawyer and researcher at Harvards School of Public Health. Under these circumstances, state intervention may serve the best interests of many children with life-threatening obesity, comprising the only realistic way to control harmful behaviors.
As an example, Dr. Ludwig cited a case of a three-year-old girl who weighed 90 pounds when her parents brought her in for treatment. At the age of 12, her weight exceeded 400 pounds. By then she suffered from diabetes, high cholesterol, hypertension and sleep apnea. Eventually, the state placed the girl in foster care, where she was put on a weight loss diet and lost 130 pounds.
The idea of government intervention when there is a serious threat to a childs life is not new. In cases of obesity, such actions may not even need backing up by new laws. Health care providers are already required to report instances where children are at immediate risk, and that can be for a number of reasons, including neglect, abuse and what is called failure to thrive, which is a term commonly used by doctors to describe children who are severely underweight.
Ludwig and Murtagh are not the first to call for better protection of children with weight problems. In an article published in 2009 in the journal Pediatrics, its authors argued in favor of temporary removal from the home [] when all reasonable alternative options have been exhausted.
While this discussion may just have begun in earnest, some states have already taken action on several occasions. For instance, in South Carolina, a mother lost custody over her 14-year old son who weighed 555 pounds at the time. Childhood obesity was cited as the reason for loss of custody in California, New Mexico, Texas and New York. Other countries have taken similar steps. A Scottish couple had their children removed from home because of failure to reduce the kids weight after repeated warnings from social services were ignored.
Childhood obesity in the U.S. is reaching crisis level. According to the Centers for Disease Control and Prevention (CDC), over 12 million children and adolescents are obese today. Two million children are considered morbidly obese with a body-mass-index (BMI) at or above the 99th percentile.
Not everyone in the health care community agrees with the measures proposed by Ludwig and Murtagh. Dr. David L. Katz, founder of the Yale Prevention Center, expressed doubts that state-appointed caregivers would do a better job of feeding children than the parents. Without knowing cost and benefit tradeoffs when the state takes children from their parents, its too early to say whether this is an appropriate response. A fat burning review can help you build a clear summarize of what you demand to focus on to complete your fat burning objective if you're a rookie; or serve as a reminder for the ones who are at an advanced or more advance phase of their weight loss plan. Applying are seven steps that can serve as guidelines for your special weight loss program. The first thing that one must understand is that losing weight and losing fat is not the same. Many weight loss applications have tricked people into thinking that it is the same, but most diets and weight loss programs only work by producing a person's body to burn more muscle tissue and water than actual body fat, more help please visit The Fat Loss Factor. I do believe that severe obesity in a child is a serious problem. The best approach [is] to prevent it rather than fix it. But when we need to fix it, for now, the state should identify the problem and offer solutions, but not impose them, said Katz.
Others have pointed out that it can be extremely difficult for parents to monitor their kids weight, especially when they reach adolescence and parental control is diminished. Its unfair to blame solely the parents, when theres a myriad of other factors influencing a childs weight, said Dr. Dana Rofey, professor at Pittsburgh University and director of a weight-management clinic. In her work, she said, she sees an array of contributing factors to childhood obesity, including genetic predisposition, socioeconomic status, environmental factors and exposure to advertising.
Predictably, the Ludwig/Murtagh article has caused considerable controversy. While the obesity epidemic is widely acknowledged as one of the biggest health problems today that may affect even more the next generation, there is little consensus on what countermeasures to take. Forcing heavy children out of their homes is not the solution, insists Dr. Arthur Caplan, the director of the Center for Bioethics at the University of Pennsylvania. I am not letting parents off the hook, he wrote in response to the article, but putting the blame for childhood obesity on the home and then arguing that moving kids out of homes where obesity reigns is the answer is short-sighted and doomed to fail. We need the nation to go on a diet together and the most important places to start are the grocery store, schools and media.
These are all good points, but I dont think it has to be one or the other. Parents, like the rest of us, need to be educated about the ins and outs of healthy nutrition for themselves and their kids. These messages are extremely hard to get through, as we can see from the efforts of the First Lady, Michelle Obama, who has made the fight against childhood obesity a high priority. We are dealing with multi-faceted, complex issues and it would be foolish to hope for simple solutions. Resorting to drastic measures when everything else fails may be part of the equation.
Timi Gustafson R.D. is a clinical dietitian and author of The Healthy Diner How to Eat Right and Still Have Fun, which is available on her blog http://www.timigustafson.com and at amazon.com. Her latest book, "Kids Love Healthy Foods" is now available in e-book format, also at www.amazon.com
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