Should parents lose custody of super obese kids?

Erik S. Lesser/Associated Press
Stormy Bradley (left) and her daughter Maya, 14, are seen, in Atlanta. Maya, who is 5'4" tall and weighs about 200 pounds, is part of an anti-obesity ad campaign in Georgia. A provocative article in a prominent medical journal argues that parents of extremely obese children should lose custody because they can't control their kids' weight.
Tuesday, July 12, 2011 4:18 PM
Last updated 8:10 PM
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CHICAGO — Should parents of extremely obese children lose custody for not controlling their kids' weight? A provocative commentary in one of the nation's most distinguished medical journals argues yes, and its authors are joining a quiet chorus of advocates who say the government should be allowed to intervene in extreme cases.

Stormy Bradley (right) and her daughter Maya, 14, walk their dog.   Associated Press
Associated Press
Stormy Bradley (right) and her daughter Maya, 14, walk their dog.

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

Dr. David Ludwig, an obesity specialist at Harvard-affiliated Children's Hospital Boston, 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.

State intervention "ideally will support not just the child but the whole family, with the goal of reuniting child and family as soon as possible. That may require instruction on parenting," said Ludwig, who wrote the article with Lindsey Murtagh, a lawyer and a researcher at Harvard's School of Public Health.

"Despite the discomfort posed by state intervention, it may sometimes be necessary to protect a child," Murtagh said.

But University of Pennsylvania bioethicist Art Caplan said he worries that the debate risks putting too much blame on parents. Obese children are victims of advertising, marketing, peer pressure and bullying — things a parent can't control, he said.

"If you're going to change a child's weight, you're going to have to change all of them," Caplan said.

Roughly 2 million U.S. children are extremely obese. Most are not in imminent danger, Ludwig said. 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.

While some doctors promote weight-loss surgery for severely obese teens, Ludwig said it hasn't been used for very long in adolescents and can have serious, sometimes life-threatening complications.

"We don't know the long-term safety and effectiveness of these procedures done at an early age," he said.

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 apnea.

"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 apnea disappeared; she remains in foster care, he said.

In a commentary in the medical journal BMJ last year, London pediatrician Dr. Russell Viner and colleagues said obesity was a factor in several child protection cases in Britain. They argued that child protection services should be considered if parents are neglectful or actively reject efforts to control an extremely obese child's weight.

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."

That piece discussed a 440-pound 16-year-old girl who developed breathing problems from excess weight and nearly died at a University of Wisconsin hospital. Doctors discussed whether to report her family for neglect. But they didn't need to, because her medical crisis "was a wake-up call" for her family, and the girl ended up losing about 100 pounds, said co-author Dr. Norman Fost, a medical ethicist at the university's Madison campus.

State intervention in obesity "doesn't necessarily involve new legal requirements," Ludwig said. Health care providers are required to report children who are at immediate risk, and that can be for a variety of reasons, including neglect, abuse and what doctors call "failure to thrive." That's when children are severely underweight.

Jerri Gray, a Greenville, S.C., single mother who lost custody of her 555-pound 14-year-old son two years ago, said authorities don't understand the challenges families may face in trying to control their kids' weight.

"I was always working two jobs so we wouldn't end up living in ghettos," Gray said. She said she often didn't have time to cook, so she would buy her son fast food. She said she asked doctors for help for her son's big appetite but was accused of neglect.

Her sister has custody of the boy, now 16. The sister has the money to help him with a special diet and exercise, and the boy has lost more than 200 pounds, Gray said.

"Even though good has come out of this as far as him losing weight, he told me just last week, 'Mommy, I want to be back with you so bad.' They've done damage by pulling us apart," Gray said.

Stormy Bradley, an Atlanta mother whose overweight 14-year-old daughter is participating in a Georgia advocacy group's "Stop Childhood Obesity" campaign, said she sympathizes with families facing legal action because of their kids' weight.

Healthier food often costs more, and trying to monitor kids' weight can be difficult, especially when they reach their teens and shun parental control, Bradley said. But taking youngsters away from their parents "definitely seems too extreme," she said.

Dr. Lainie Ross, a medical ethicist at the University of Chicago, said: "There's a stigma with state intervention. We just have to do it with caution and humility and make sure we really can say that our interventions are going to do more good than harm."

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wondersnevercease
9218
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wondersnevercease 07/12/11 - 05:28 pm
0
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"government should be allowed
Unpublished

"government should be allowed to intervene in extreme cases."

scary stuff here folks.............................

nothin2show4it
120
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nothin2show4it 07/12/11 - 05:28 pm
0
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This whole story sickens me.
Unpublished

This whole story sickens me.

Dixieman
14943
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Dixieman 07/12/11 - 05:41 pm
0
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No. Government has NO

No. Government has NO BUSINESS here.
Unless...the average weight of the parents is more than 1.7 times the average weight of the local social workers (some of those government employees need their own slimming program!!)

augusta citizen
9351
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augusta citizen 07/12/11 - 05:44 pm
0
0
NOOOOOOO!!!!!!!

NOOOOOOO!!!!!!!

seenitB4
87304
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seenitB4 07/12/11 - 06:00 pm
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So who would get the

So who would get the kids....a super obese gov. worker??

Some parents are working 2 jobs to keep a roof over the kids head...I say give them some help with info.

broad street narrow mind
348
Points
broad street narrow mind 07/12/11 - 06:11 pm
0
0
taking kids away from their
Unpublished

taking kids away from their parents is a step that i would like to see the government not feel super free and easy about. with something like this and even with cases of mess and not enough food, wouldn't it be easier on everyone involved to add a person to the household rather than smash it to pieces? could we have traveling supernannies instead of foster care? i'd like to see if that works.

scgator
1042
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scgator 07/12/11 - 06:18 pm
0
0
For years the government has

For years the government has used outdated and generic charts for ideal weights and measures; I asked my doctor what my ideal body weight was; because according to charts I am supposed to be 117 lbs. @ 60 years old. The last time I was 117, was 7th grade. My doctor told me not to worry about charts. She told me that when my blood sugars were in range and my blood pressure was in normal range...THAT was my ideal body weight. I would rather listen to someone who HAS my health history on file rather than some "do gooder" politician somewhere, who doesn't even know my name.

copperhead
1035
Points
copperhead 07/12/11 - 07:49 pm
0
0
By all means possible! The

By all means possible! The government knows what is best for us and our children. The government is here to help you! It's ALL about the children.

nothin2show4it
120
Points
nothin2show4it 07/12/11 - 08:08 pm
0
0
What is next? The child has
Unpublished

What is next? The child has too much acne or they don't wear the right kinds of clothes?

mrsmcghee
0
Points
mrsmcghee 07/12/11 - 08:32 pm
0
0
Should we also take the super

Should we also take the super dumb kids away from their parents? Or what about the kids who have bad hygiene... this can be a slippery slope.

Willow Bailey
20580
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Willow Bailey 07/12/11 - 08:59 pm
0
0
Government can't manage it's

Government can't manage it's own affairs, I wonder why they continue to believe they can manage everyone else's. Dangerous territory.

404_HXC
0
Points
404_HXC 07/12/11 - 09:15 pm
0
0
most of the time i would

most of the time i would agree that the government should stay out of people's lives. Only in extreme cases would I think it was ok for social workers to take kids out of houses where they are allowed to eat themselves to death.

cytoranger
6
Points
cytoranger 07/12/11 - 09:25 pm
0
0
I find it scary and

I find it scary and disconcerting for the govt. To find this and many other reasons acceptable to remove kids from parents when.will they stop owning we the people

sw2005
0
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sw2005 07/12/11 - 09:38 pm
0
0
To broad street narrow mind:

To broad street narrow mind: indeed, it would be much easier to put resources into preserving the family structure and educating the parents, rather than continuing to pour money into the foster care system. However, funding for prevention efforts continues to be cut more every fiscal year. It's an unfortunate situation. And to all those that seem to think that a bunch of chubby social workers are out to snatch all the kiddies......the social workers don't make laws-they abide by them within policy. I'm not one of the local obese workers but believe me, dudes, I've got better ways to spend my child protection time (ie-preventing physical and
sexual abuse and neglect) than by being the fat police :)

BigJohn767
33
Points
BigJohn767 07/13/11 - 01:27 pm
0
0
NEVER! If the government

NEVER! If the government wants to stop some obesity they should weigh those who receive government "assistance" and for every pound they are overweight, reduce their benefits by $10. I bet we would see some slimmer welfare recipients!

cytoranger
6
Points
cytoranger 07/25/11 - 01:22 am
0
0
I agree bigjohn bad bad food

I agree bigjohn bad bad food is cheap food look at any school menu

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