More Child Removal Stakes

In 2011, the American Society of Bariatric Physicians decided that unless there are clear signs of abuse or neglect, removing a child from home is “unnecessary, unrealistic and likely damaging to that child long term.” The organization announced that it…

[…] does not support the concept that state intervention to remove a child from his or her home is the proper way to address life threatening cases of childhood obesity… ASBP believes that in most cases this type of state intervention is extreme and unjustified… ASBP does not agree that the only option is to put him through surgery or remove him from his home.

There were two major reasons for the condemnation. One is the belief that obese kids have a quality of life similar to children with cancer, and it is hard to argue that such a child can prosper in a strange environment. The other is more ominous. Since two-thirds of Americans are overweight, and half of them are on the obese end of the spectrum, what are the odds that an obese child will find placement with splendidly fit foster parents?

On the other hand

But the following year, a contrary opinion was offered by Dr. David Ludwig, the endocrinologist who, among many other credits, directs the New Balance Foundation Obesity Prevention Center. He has been mentioned by Childhood Obesity News before in several contexts, such as his doubt that body weight is determined by a non-negotiable “set point.”

Dr. Ludwig came out in favor of government intervention in extreme cases of obesity, and leaned more in favor of foster care than surgery. It is possible that a government that compels anyone to undergo surgery could face legal challenges.

There is also a sizable pragmatic objection. Bariatric surgery, especially for a child or teen, is an undertaking that needs an immense amount of support, offered unrelentingly and forever. Extreme compliance to doctor’s orders; remarkable patience; the right mixture of discipline and indulgence — these qualities might be scarce in birth families, but are likely even more difficult to find among foster parents.

Mediator and attorney Lorna Jaynes pointed out some consequences of holding parents responsible:

[T]his debate provides much fodder for high-conflict divorcing parents and their hired gun litigators with accusations about their children’s weight and nutrition in an effort to convince judges that the other parent is inadequate.

[O]besity is increasingly added to the mix of diatribes and aspersions cast from one parent to the other. The specifics vary. Sometimes it is a grossly overweight child and allegations that soft drinks and fast food comprise the child’s primary diet. Or perhaps, it is that the other parent is too obese to parent effectively.

In mid-2012, the Obesity Action Coalition released a statement that encouraged both officials and the public to recognize the complexity of obesity before making determinations of parental neglect. It pointed, as so many statements do, to multifactorialism. The statement read, in part:

The causes of obesity are numerous and much more complicated than child or parental behavior including societal, biological, genetic, and environmental factors.

Your responses and feedback are welcome!

Source: “Bariatric Physicians do not Support State Intervention for Childhood Obesity,”, 08/17/11
Source: “Childhood Obesity in California Custody & Visitation Disputes,”, 03/29/12
Source: “Child Obesity Becoming a Legal Custody Issue,”, May 2012
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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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