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Childhood obesity and parental neglect

Having an obese child doesn't make one an unfit parent. Nor does failing at helping that child control his or her weight -- so long as you're trying.

Those are some of the conclusions drawn by a group of child-health experts whose paper appeared last week at -- the online British Medical Journal. (I'm sorry that the link only gives you the start of the story; you'd have to pay to see the rest.) The group set out to devise guidelines to help medical professionals evaluate circumstances surrounding young patients' obesity with an eye toward detecting parental neglect.

Here's the foundation of the authors' discussion:

.... parents and schools have become the focus of government and media attention as agents of change in preventing childhood obesity.

It is but a short step from seeing parents as agents of change to blaming them for their child's obesity. Childhood obesity can be seen as a failure to adequately care for your children by failing to provide a healthy diet and sufficient activity, whether through direct neglect or more subtly through an inability to deny children the pleasures of energy dense fast food and television viewing. This is particularly the case when children have become morbidly obese and have potentially life threatening complications of obesity.

Because the etiology of childhood obesity is complex and can be complicated by issues related to sexual and other forms of abuse, the authors write, it's inappropriate to blame parents for their children's being obese or for their remaining that way despite efforts to help them lose weight. Also, the authors suggest, "As obesity remains extremely difficult for professionals to treat, it is untenable to criticise parents for failing to treat it successfully if they engage adequately with treatment."

But consistently failing to seek or take advantage of opportunities and resources to help a child achieve a healthful weight may constitute a form of neglect, the authors say -- and that neglect could warrant placing a child in foster care.

The paper is largely preemptive: The authors note that there have been only scattered cases in which parents have been taken to task for their children's obesity. But as child obesity continues to loom as a major personal and public health concern, the authors anticipate that more such cases may emerge, making guidelines for evaluating them necessary.

The paper also serves notice that more research into the relationships between parenting, child obesity and foster care is needed; the authors say that much of what they write is based on anecdotal rather than scientific data.

The authors note that this is a contentious issue. What do you think? Is a child's obesity ever a cause for removal from parental care?

By Jennifer LaRue Huget  |  July 19, 2010; 7:00 AM ET
Categories:  Childhood obesity , Family Health , General Health , Health Policy , Nutrition and Fitness , Obesity  
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Absolutely NOT! A child's obesity is NEVER a cause for removal from parental care.

Obesity in and of itself says nothing about about a parent's care. The reasons for obesity are complex and do not necessarily have anything to do with poor child care. Even if a child is obese solely because of poor nutrition at home (which is rarely the case -- food at school, genetics, and many other factors come into play) this is more than likely an economic and knowledge issue, not neglect.

The fact is, genetics having such a significant role in obesity, being obese does not indicate poor nutrition. It may, but that is not an assumption that should be made. Many children have poor diets and are thin. Is feeding a child a poor diet neglect? That should be the question - though the answer is still the same.

Furthermore, not "helping" a child to lose weight should not be the marker for neglect either. There are profound implications from labeling a child and restricting food. The best ways to deal with obesity in anyone, much less children, are unclear, at best. Children who are put on diets, just as adults, often begin yo you cycling, which is far more dangerous than obesity itself. As well there is the issue of eating disorders and other emotional problems.

That is not to say obesity should be ignored, but the action taken will vary dramatically depending on the circumstances.

Of course an obese child MAY be suffering from neglect. But any connection is incidental. And the notion that one's children would be put into foster care for any reason, a situation that at best, is precarious, should be done only when absolutely necessary.

The mere fact that this discussion is happening -- that one considers removing a child from the home and placing that child with strangers, simply because they are obese, not only demonstrates a profound lack of understanding of obesity, but demonstrates neglect, if not abuse, in and of itself.

Rebecca Weinstein, Esq, MSW

Posted by: rebecca19 | July 19, 2010 8:04 AM | Report abuse

The idea that a child would be removed from their family because of obesity issues is another example of the ostracizing of obese children. Ostracized at school, in extra-curricular activities, in the media, in public places, it would be abusive to remove them from loving families. They would feel even worse about themselves. I cannot believe there is any cause for such a discussion! Obesity is complex, and foster care has certainly not "worked" for children who are abused!

Posted by: lydandy | July 19, 2010 11:11 AM | Report abuse

Whatever these doctors may know about obesity, clearly they know nothing about foster care. One major study of foster-care alumni found that they have twice the level of post-traumatic stress disorder as Gulf War veterans and only one in five is doing well in later life. Several studies have found abuse in a quarter to a third of foster homes – and the record of group homes and institutions is even worse.

Other studies including two involving 15,000 cases find that children left in their own homes typically do better even than comparably-maltreated children placed in foster care.

These doctors have forgotten one of the first lessons they were supposed to learn in medical school: First, do no harm.

Richard Wexler
Executive Director
National Coalition for Child Protection Reform

Posted by: rwexlernccpr | July 19, 2010 11:28 AM | Report abuse

It may be the parent's fault, but it should never be reason to remove a child from the parents. These people actually want and love their kids. Are you serious? Like we don't have enough kids in foster care. I can't believe the question was even asked.

Posted by: forgetthis | July 19, 2010 11:46 AM | Report abuse

While I do not at all believe that a child's obesity should be a sole cause for removal from his or her parents, I do believe that allowing one's child to become obese is a form of neglect or even abuse - just as is allowing one's child to suffer from malnutrition.
Many children in my family are obese (we are not genetically disposed) and I just had a discussion about this with another family member over the weekend. We talked about the fact that it is a parent's responsibility to keep a child safe from harm, to keep them healthy and to help them form good habits – whether it be teeth brushing, hand washing or choosing healthy snacks – and that somehow the responsibility for teaching reasonable eating has fallen by the wayside with certain parents in our own family and around the country.
I agree that there are other factors involved such as horrendously unhealthful school lunches, the comparative costs of healthy, fresh foods and unhealthy, processed foods, etc. I also agree that it is no comment on how much these parents love their children. But ultimately, the parent is the adult - the one who brings the food into the home and purchases it when a family eats out. A parent is also a child's first and most important role model and has almost total control over what goes into that child's body for the first several years. In my eyes, the bulk of the responsibility for this epidemic lies squarely on the shoulders of the parents.

Posted by: MrsDre | July 19, 2010 1:00 PM | Report abuse

First, I agree with the posts below opposing foster care for obese kids, absent some other justification. That would be far more harmful than just staying obese.

Second - while I agree that the parents have a lot of influence that impacts their kids' weight, the problem is a lot bigger than that. Our culture now is a 24/7 smorgasboard of easy-access food, and little activity. Compare a kid's experience today to our experience in the '60s and '70s, when obesity was rarer and less severe:

We lived in smaller houses with smaller rooms, and were constantly told to get outside and play. Air conditioning was not universal. We didn't have computers and TV was limited to 3 or 4 channels. I never saw a vending machine in my school until 1978. All the food you got during the day was breakfast, and the lunch you carried to school. Your drink was in your thermos. Once that was gone, there was nothing more til dinner... which you had to WAIT for. And there was only a fraction of the fast-food places that you see today.

Now, kids have little reason to leave the comfort of their homes (the yard is smaller than the house these days). TV and computers provide endless sedentary distractions. A lot of parents are afraid to let their kids play outside. Schools have vending machines, and all kinds of packaged snacks are available as soon as the kids arrive home, or they can stop in to any fast-food place for a few bucks. Food is EVERYWHERE and requires little effort or wait time for preparation. You just grab it and eat it.

Personally, I like the choices we have today and oppose the nanny-state notions of taxing or banning sodas, salt, fats, or fast foods. Schools need to step up by removing vending machines; there is NO NEED for them in schools. And parents need to step up by keeping grab-and-eat snacks OUT of the house, and limiting the amount of money they give their kids to spend on snacks and fast food.

Posted by: Lila1 | July 19, 2010 5:20 PM | Report abuse

Removing a child merely because the parents have allowed him/her to develop life-threating chronic malnutrition? Of course not!

Posted by: kcx7 | July 19, 2010 8:39 PM | Report abuse

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