Is allowing too many Twinkies child abuse?

Should parents of morbidly obese children lose custody of their children? Yes, argue some medical experts. They recommend that in some extreme cases, foster care is the most ethical path to take.

It has happened a few times in the U.S., and the opinion piece in [the] Journal of the American Medical Association says putting children temporarily in foster care is in some cases more ethical than obesity surgery.

Fair enough; there might be a tiny area of argument there, since gastric bypass surgery carries with it the risk of scary complications, including death; I’m not sure it should ever be performed on any patient before he or she reaches adulthood. But only a minute fraction of parents would consider this surgery, and then usually only for obese older teens. The article states that there are roughly two million ‘extremely obese” children in the U.S. So just which kids is the study talking about? As a general rule, extreme cases make bad law, which ends up being far too liberally applied.

“Most [obese children] are not in imminent danger,” says Dr. David Ludwig, an obesity specialist at Harvard-affiliated Children’s Hospital Boston. But…

Some have obesity-related conditions such as Type 2 diabetes, breathing difficulties and liver problems that could kill them by age 30. It is these kids for whom state intervention, including education, parent training, and temporary protective custody in the most extreme cases, should be considered. […] Ludwig said the point isn’t to blame parents, but rather to act in children’s best interest and get them help that for whatever reason their parents can’t provide.

This is the point at which warning bells start going off for me, since it puts the criteria for what constitutes ‘good parenting’ entirely in the hands of elected (and sometime unelected) state officials. The obesity experts can’t have it both ways: it’s hypocritical to pretend that everything and everyone (ie. no one) is to blame for the child’s obesity, and then turn around and remove the children from their parents’ custody (as if it were precisely and entirely the parent’s fault). Basic common sense tells us that overfeeding, overindulging, ignorance of nutrition and health, an inability to instil self-control or healthy habits are all signs of poor parenting, but is it abuse? If so, at precisely what point? And who gets to decide? We’ve already reported how some schools use hidden cameras to scan children’s lunches for naughty food choices; is the next step for schools to track and monitor children’s weight and Body Mass Index?

Ludwig said he starting thinking about the issue after a 90-pound 3-year-old girl came to his obesity clinic several years ago. Her parents had physical disabilities, little money and difficulty controlling her weight. Last year, at age 12, she weighed 400 pounds and had developed diabetes, cholesterol problems, high blood pressure and sleep apnoea.

“Out of medical concern, the state placed this girl in foster care, where she simply received three balanced meals a day and a snack or two and moderate physical activity,” he said. After a year, she lost 130 pounds. Though she is still obese, her diabetes and apnoea disappeared; she remains in foster care, he said.

OK, so her physical health has improved (which is wonderful), but what of her mental health? They don’t mention that. A year-long separation is a huge chunk of time in a child’s life. And she “remains in foster care”—for how long? Is she happy with this apparently indefinite separation from her parents? Have her parents been given any assistance? If not, how is this problem likely to be solved long-term?

A 2009 opinion article in Pediatrics made similar arguments. Its authors said temporary removal from the home would be warranted “when all reasonable alternative options have been exhausted.”

Maybe that’s the core issue: there is precious little reason and common sense being employed—in all areas of society—these days: home, school and government. And it makes you wonder just how far the state is willing to intrude and intervene in family life.


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