Is Obesity Child Abuse?

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A study in Great Britain has resurrected the controversial question of whether in some cases, children are so obese that they should be removed from their homes and their parents charged with neglect.

“Childhood obesity can be seen as a failure to adequately care for your children by failing to provide a healthy diet and sufficient activity, whether through direct neglect or more subtly through an inability to deny children the pleasures of energy dense fast food and television viewing," says a report, Childhood Protection and Obesity: Framework for Practice, published this month by the British Medical Journal.

Such removals occur rarely. The most recent noteworthy case in the United States took place a year ago, when authorities in South Carolina removed a 555-pound 14-year-old and charged his mother with criminal neglect.  

Even before that, the Child Welfare League of America reported in two years ago that “more cases have begun to emerge, and it is likely only a matter of time before other states will face the issue.”

Courts in several states have heard cases “involving children whose obesity threatened life or health, and whose parents were unable or unwilling to follow medical orders to reduce their children’s weight,” the CWLA said. “These courts have been willing to expand their state's statutory definition of medical neglect to encompass morbid obesity.”

The states include California, Indiana, New Mexico, New York, Pennsylvania and Texas, the CWLA said.

Severe obesity can increase the risk for numerous health problems, including Type 2 diabetes, hypertension and high cholesterol.

The authors of the new report, intended as a guideline for child protection workers in Great Britain, stress that severe obesity alone is no justification to remove a child. A key issue, they argue, is whether the parents are trying to rectify the problem or are “consistently failing to attend appointments, refusing to engage with various professionals or with weight management initiatives, or actively subverting weight management initiatives.”

The position of the CWLA, as described by spokeswoman Shawn Flaherty, seems similar: “The family should receive appropriate services (nutritional and psychological counseling, and sometimes financial assistance) to try to remedy the causes of the extreme obesity. If a parent continues to not comply with the medical/nutritional treatment recommended by the child’s doctor, then a judge would need to decide if this is medical neglect and if removal is necessary. 

“This needs to be looked at on a case-by-case basis and only in extreme cases of neglect.”