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.