Is fat a child welfare issue?

July 21, 2011

By Angela Liddle

Should the child welfare system take custody of extremely overweight children when parents can’t or won’t control their kids’ weight? An article in a distinguished medical journal says “yes,” part of an increasing chorus of medical professionals who believe “the system” should step in to help kids with extreme obesity.

It has happened a few times in the U.S., and the opinion piece in a recent Journal of the American Medical Association says putting children temporarily in foster care is better in some cases than obesity surgery. Proponents feel that state intervention “ideally will support not just the child but the whole family, with the goal of reuniting child and family as soon as possible.”

Others disagree, saying the debate puts too much blame on parents, who can’t control every aspect of their child’s life. For example, obese children are victims of advertising, marketing, peer pressure and bullying — things a parent can’t control.

Me? I’m riding the fence on this one. Maybe some specifics would help clarify the issue:

  • A 3-year-old girl weighed 90 pounds; her parents had physical disabilities, little money and difficulty controlling her weight. By age 12 she weighed 400 pounds and had developed diabetes, cholesterol problems, high blood pressure and sleep apnea. She was placed in foster care, where she received three balanced meals a day, snacks and moderate physical activity. After a year, she lost 130 pounds. Though she is still obese, her diabetes and apnea disappeared; she remains in foster care.
  • A 440-pound 16-year-old girl developed breathing problems from excess weight and nearly died in a Wisconsin hospital. Doctors discussed whether to report her family for neglect. But they didn’t need to, because her medical crisis was a “wake-up call” for her family, and the girl ended up losing about 100 pounds.
  • A single mother lost custody of her 555-pound 14-year-old son two years ago. “I was always working two jobs so we wouldn’t end up living in ghettos,” she says. She often didn’t have time to cook, so she bought her son fast food. Doctors accused her of neglect. Her sister has custody of the boy, now 16, and is helping him with a special diet and exercise, and the boy has lost more than 200 pounds. “Even though good has come out of this as far as him losing weight, he told me just last week, ‘Mommy, I want to be back with you so bad.’ They’ve done damage by pulling us apart,” the mother said.

Three families impacted by childhood obesity and medical intervention on behalf of the kids. Three families that know that healthier food is more expensive than high-calorie “junk food.” Three families that know that monitoring kids’ weight can be difficult, especially when they reach their teens and shun parental control. Three families that know the stigma associated with “the system” taking custody of your children.

How do we know when we do more harm than good?