In July, the Journal of the American Medical Association (JAMA) published a subscription-only article by Lindsey Murtagh, J.D., M.P.H., and David S. Ludwig, M.D., Ph.D. It is understandable that a doctor and a lawyer have collaborated on a subject that straddles both fields, ” State Intervention in Life-Threatening Childhood Obesity.”
Some children are very endangered by their obese condition, which can lead to Type 2 diabetes, breathing problems, and a disordered liver, among many other undesirable outcomes. Taking children from their parents and putting them in foster care is a pretty radical idea, although Drs. Murtagh and Ludwig do point to a stunningly successful intervention where a boy has lost 200 pounds in a year after being removed from his mother’s custody.
The JAMA article kicked up a rumpus, pushing political hot buttons like crazy. Throughout the country, undernourished children are kept an eye on for signs of criminal neglect. But only four states have so far used their power of child protection to apply to cases of morbid obesity. Most of the estimated two million severely obese children in the U.S. would probably not be vulnerable to this kind of legal intervention anyway, points out Patrick G. Lee in The Wall Street Journal.
Lee suggests that the foster care option is not something the JAMA authors necessarily want to see widely used, but they do think it’s a better solution than surgery, should there be a choice between the two possibilities. Examining some of the implications of the idea, Lee says,
Art Caplan, a bioethicist at the University of Pennsylvania, told the AP that taking away custody of obese children might place excessive blame on the parents, who are helpless against the forces of advertising, bullying and peer pressure that contribute to obesity.
The report itself also seems to be saying that its authors would actually prefer neither alternative, tactfully suggesting that perhaps the government could do better by improving social infrastructures, diet improvement, and the promotion of physical activity. Of course, they don’t say a word about the very strong possibility that food addiction could be the issue.
Health blogger Colby Vorland mentions other possible types of help that could be provided a family with an obese child, before the big guns of surgery or foster care are brought in:
In addition to the extreme of removing the child from the home for a period of time, support services such as ‘in-home social supports, parental training, counseling, and financial assistance’ could be offered through state programs.
Vorland also provides a great list of many of the great number of published responses to the foster-care question, along with brief summaries of each article’s gist. For instance, the Yahoo News version is cited as an informative piece, although, Vorland notes,
This article has thousands of (mostly irrational) comments to it — to be expected on an emotional issue.
To sum it up even more succinctly, here is the recommendation that counts:
‘Can childhood obesity warrant child protective services?’ — WeightyMatters. Yoni provides a rational discussion. His is probably the only perspective so far (besides Ludwig) from someone who actually treats obesity, and his wife’s previous job as a child protection worker helps. If you read only 1 take, read his.
Your responses and feedback are welcome!
Source: “Foster Care Proposed as Solution for Extreme Childhood Obesity,” The Wall Street Journal, 07/13/11
Source: “Severe childhood obesity and state intervention,” nutsci.org, 07/14/11
Image (modified) by colros (Sandra Cohen-Rose and Colin Rose), used under its Creative Commons license.
Image (modified) by Tobyotter (Tony Alter), used under its Creative Commons license.
FAQs and Media Requests: 
4 Responses
As a Registered Social worker with 10 years child protection experience and an owner of a weight-loss counselling service, I think I may be able to provide some insight on this topic. Yes, it is true that lowering the risk of childhood obesity does involve the child living in a supportive family environment that emphasizes and participates in healthy lifestyle practices. Parents are a powerful influence on their children. However, efforts in promoting nutrition and exercise is not enough to address obesity. Our hectic lifestyles, addicting convenient foods and a sedentary lifestyle also play significant roles. We have also become emotionally dependent on foods, we are living to eat and no longer eating to live. We turn to foods to soothe, comfort and provide relief from mentally-taxing days. Food amps up our energy levels and feel good falling into the trap of emotional-eating.
The trauma children will experience being taken away from their families will only increase their intensity to eat for comfort. I forsee food hording. What about self-esteem? What message would we be saying? You are too fat to live with your family. I understand that Dr. Ludwig sees the alarming rates at a face to face level and would like to make North America aware of the tragic state of overweight children, however, I feel that pulling children out of their homes (sometimes having to start in a new school) would be detrimental to their emotional and mental health.
food4thoughtwellness.ca
I agree with Treena. This is something that should not be placed in law, but should be placed as a need for concern (case by case) basis. What will develop later with this is that no one will be excepted in society for being overweight at any level at a higher level. Kids that do have weight issues but not obese are already suffering from low esteem, extreme peer pressure, and already feel they are not worthy like the other kids. Sure you take a child, and do the magical things to make them skinny, and then they become a peer who calls others fat, and ugly. What groups like this are going to do is create, and mold kids into what they feel is exceptable. If a child is in extreme risk of loss of life over their weight, as in immediate danger then I can see intervention, but removing them from the home, unless the home is unfit in several factors I do not agree. In home support, weekly weigh in’s, and menu’s to be followed with excercise schedules are more appropriate. It’s called: Compassionate intervention. Not governed by groups who are health crazy in all aspects of life, and go to the gym every day, and eat yogurt for breakfast, lunch and dinner, and a grape for a snack. Get real. The key to getting these kids on track in this day and age, is for parents of today, to do what parents of yesterday did …Tell the kids ” go outside and play”! Technology, and fast food, and microwave foods have made everyone lazy. Even the rich, and famous. They can afford tummy tucks, and face lifts and get all the glamour of images by writing out a check. Nice. Great Society we live in.
Thank you for your thoughtful comment.
I’m a high school senior writing a research paper on this issue. There are pros and cons, and I have to point out that in some circumstances, removing the child from the house is sometimes productive… the child could use it as a motivation to lose the weight and get back to their family. So I agree on the sometimes clause.