Foster Care and Dr. Martina M. Cartwright

Cirque Du Soleil Mystere

Spoiler alert: We’re going to start with the end of this article by Martina M. Cartwright, Ph.D., R.D., followed by a relevant real-life fact. The title is, “Separating Super Obese Kids from Their Parents: Solution or Problem?,” and it was published in Psychology Today. The author is a faculty member at the University of Arizona, and eating disorders are only one of her clinical interests. Among many other professional posts, she formerly served as nutrition consultant to the Cirque Du Soleil.

This article concludes:

The number one anti childhood obesity tip: Turn off the TV. TV is sedentary and can trigger mindless eating…so shut it off and get moving!

The relevant real-life fact is, foster homes have televisions. Strangely, Cartwright does not make this point, but it does seem rather important. Because, if the whole purpose is to put the child into a different environment, shouldn’t the environment be… different? But foster homes have televisions too, and all kinds of other screens.

Foster parents and foster kids probably watch a lot of TV. What else are strangers going to do together? It seems as if a child removed from the family and transplanted into an unfamiliar environment might find comfort in familiar TV shows. Such a child might be timid about venturing outside, and spend as much time as possible indoors with the TV or video games.

Cartwright does make several other points, one of them being that even the people who endorse foster care are only talking about “super-obese” children — those whose BMI is at or above the 99th percentile. On the other hand, the description is applicable to about two million cases in America, so that’s a lot of kids in danger of being sent to foster care.

Also, Cartwright emphasizes that childhood obesity is “multi-factorial.” Some factors are always present, and some are introduced, and the trick is to figure out, in any given case, which factors are preponderant and go after them.

She says,

Taking a child from the family home is traumatic to all involved so careful consideration of the root cause of the obesity is paramount to making the best decision for the child and family. A parent-ectomy, as we say, may not be the remedy to a complex issue like childhood obesity.

Genetics are always a factor, for better or worse. The author says,

Kids born to obese parents are more likely to become obese. If both biological parents are overweight, the child has a 60-70% chance of becoming obese, whereas if neither parent is obese, the chance is 10%. Maternal obesity is a predictor of childhood obesity. Mom’s weight has an impact on the number and size of fat cells that junior develops.

The genetic factor is relatively simple. Once you get into the areas of lifestyle and environmental influences, the factors that contribute to obesity are practically endless, especially the factors inside our own heads. Cartwright mentions the use of food as a reward and using food to cope with stress as examples of emotionally-connected behaviors that lead to trouble.

Cartwright herself has only had to call child protective services once in 20 years of practice. She tells about that case, and also another case which was resolved by counseling and educating the parents of an obese eight-year-old girl.

Cartwright says,

Her parents both worked long hours. When she came to our consultation she complained of chronic stomachaches that could only be suppressed by consumption of milk shakes….6 a day. Her parents, exhausted from working, gave in to their daughter’s demands for sugar… The first few months were difficult as the child rebelled, but eventually she dropped about 30 pounds in 6 months.

Some might say, the time was difficult because the girl was going through withdrawal. Unhealthy dependence on food is a continuum, and this particular story sounds like it was at the addiction end of that continuum. Cartwright says the girl has lost about 30 pounds in six months. But this was years ago. It sure would be interesting to know the girl’s subsequent history and how she is now. Did she become an obese teenager? Maybe she even identified addiction as the problem and got the right kind of help.

Cartwright’s position on the foster-care question is expressed succinctly:

Government intervention and interference should be a last resort but considered if the child is being harmed. If the child is removed from the home, weight management should be provided beyond foster care. Further, the parents need some counseling to address lifestyle factors that contribute to their child’s obesity.

Your responses and feedback are welcome!

Source: “Separating Super Obese Kids from Their Parents,” Psychology Today, 07/14/11
Image by justj0000lie (Julie Vazquez), used under its Creative Commons license.

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