Losing custody of extremely obese kids

Charlie - posted on 07/13/2011 ( 48 moms have responded )

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One way to manage the nation's childhood obesity crisis might be to take the most severely overweight kids away from their parents, argues Harvard pediatrics professor and obesity expert David Ludwig in a controversial commentary published Tuesday in one of the country's most well-regarded medical journals.

The recommendation in the Journal of the American Medical Association to consign extremely obese kids facing life-threatening complications to foster care is eye-popping, but it's already transpired in a handful of U.S. cases.

That sort of radical intervention — intended as a temporary fix — might help prevent the development of severe health conditions like Type 2 diabetes, sleep apnea and liver problems in some of the 2 million or so very obese children in the U.S., Ludwig says. When children become that obese, with a BMI at or above the 99th percentile, it signals a "fundamentally different situation" than mere "poor parenting," write Ludwig and attorney Lindsey Murtagh, a Harvard public-health researcher, in JAMA. "State intervention may serve the best interests of many children with life-threatening obesity, comprising the only realistic way to control harmful behaviors."

One way to manage the nation's childhood obesity crisis might be to take the most severely overweight kids away from their parents, argues Harvard pediatrics professor and obesity expert David Ludwig in a controversial commentary published Tuesday in one of the country's most well-regarded medical journals.

The recommendation in the Journal of the American Medical Association to consign extremely obese kids facing life-threatening complications to foster care is eye-popping, but it's already transpired in a handful of U.S. cases.

That sort of radical intervention — intended as a temporary fix — might help prevent the development of severe health conditions like Type 2 diabetes, sleep apnea and liver problems in some of the 2 million or so very obese children in the U.S., Ludwig says. When children become that obese, with a BMI at or above the 99th percentile, it signals a "fundamentally different situation" than mere "poor parenting," write Ludwig and attorney Lindsey Murtagh, a Harvard public-health researcher, in JAMA. "State intervention may serve the best interests of many children with life-threatening obesity, comprising the only realistic way to control harmful behaviors."



Read more: http://healthland.time.com/2011/07/13/sh...


What do you think , has the obesity crisis come to this ?

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Stifler's - posted on 07/14/2011

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I also hate the way that people haven't realised that obesity is a form of malnutrition, it's just as bad to be fat as to be too skinny.

[deleted account]

Amanda, you'd be surprised at what people think about food. "These fruit snacks are good for the kids. They are made with real fruit!" Yeah but what about the high fructose corn syrup and preservatives? "Capri Suns are good because they are juice." "Goldfish crackers are made with whole grains." "Cereal is a good breakfast because you get milk." "My kids eat cereal bars because they have fruit in them." "The soft serve yogurt store is healthier than the ice cream store." "My kid gets the apple dippers with her happy meal." NONE of those things are 'good for you' foods. And I didn't make up any of these statements. I've seen and heard all of them.

Sara - posted on 07/14/2011

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I just keep thinking about how socioeconomic status fits into this question. Lower socio-economic levels and some demographics, particularly Latino and African-American, have a higher incidence of childhood obesity and poor nutrition due to several factors, including:



Lack of money – High calorie, low nutrient food is cheaper.



Time – Working long hours or two or more jobs; single parenting.



Lack of access – Many areas around the country are "food deserts," lacking supermarkets, with only high-priced, highly-processed foods available via fast food restaurants and convenience marts.



So would a law like this unfairly impact people of a lower socio-economic status? I mean, you can have people take nutrition classes, but unless you're going to make it possible for them to spend more time with their children or have more money or make nutritious food more accessible to them in order to change their habits, then what good is it going to do?

Katherine - posted on 07/14/2011

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Let me expand on that a little.

I think any type of malnourishment or overnourishment(for lack of a better word) should be considered a crisis situation.

Social workers, case managers and counselors should be involved to monitor. The parents SHOULD be court ordered either way to maintain a healthy weight for the child. That may even include a nutritionist.
It could be state funded. If they are going to go through all of the trouble of taking the child out of the home, they can use the monies for this before they go to that extreme of measures.

Stifler's - posted on 07/14/2011

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I have to agree with Sara B aswell. Chicken nuggets, fish fingers etc, are cheaper and also easier for parents who work to stick in the oven for their kids than coming home, doing washing, chopping up tonnes of fruit and vegetables and making nutritious meals. People need education on quick, easy, yummy yet healthy foods to make.

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Sarah - posted on 08/11/2014

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fighting for custody is very stressful. These are cases you definitely want to win and cannot mess around in. To obtain the victory in court, then you need the best lawyers a mother can hire. The lawyers at rosenbergfirm.com have a gift at court that allows them to win cases. I won full custody of my little guy last year by using them, and i feel now that to give back to the community, i should tell you guise about them.

[deleted account]

Also the amount of undernourished kids is probably a lot to.Just because there slim to look at its seen as okay.Thats not right either.

[deleted account]

My health nurse told me my daughter was over weight.She even said the word fat.
She was 13weeks.She was 12lbs 30z.I asked a lot of questions and i found out she was only 30z over.The go from birth weight.
I was gobsmacked.I have a friend whos child was the same birth weight 6lbs 50z and she was 16/17lbs at this age.So i don't get there weight/height formula.Then when my baby girl was 8&half mths she was just 16lbs and under.
Confused.com.
They then quizzed me about when and what i feed her lol.

Constance - posted on 07/15/2011

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Also you have to look at the age of the child. Most kids gain weight to get through puberty and end up on the obese side.

Constance - posted on 07/15/2011

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I mean I am no stranger to family that is obese. My sister had gastric bypass 7 yrs ago. She still struggles to eat properly. She was 385 when she had the surgery and went down to 175. I was proud of her but she got scared so she put on 50lbs to feel comfortable with her body. Even though she looked great she thought she looked disgusting. Her son is on the obese side. She trys to feed him healthy but she never learn how to be healthy. So now I prepare her menus, grocery list and recipes every week. She follows eveything to a T. She has lost 10lbs and so has my nephew. He has always been an active kid but she still needs help to make the right food choices. She wants to change so bad that even when she goes on a date. She will call me and tell me what she wants to eat. Then I fine tune it and tell her how to get it prepared so it is still healthy.

[deleted account]

I agree Constance, the BMI shouldn't be the determining factor. There are too many other variables to consider. If the child is being fed properly and generally gets enough exercise and is still large, it is not the parents' fault. It's genetics or a medical condition.

Stifler's - posted on 07/15/2011

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I think they would have an overall health assessment not just their BMI as the entire determining factor.

Constance - posted on 07/15/2011

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The BMI formula is rediculous to determine if a child is obese. My boys take after the men in my family. They are all big guys. My grandfather on my moms side was 6'6 and 350. He wasn't fat by any means. He was a farm boy just like the rest of the guys in my family. None of the guys in my family are shorter than 6'2. I was told that one of my sons was obese at the age of 7 because of how much he weighed. He still was in 6x clothes. I don't see that that is obese. It needs to be fully determined if in fact they are obese.

The biggest problem this is going to cause is the pain it would cause to a child. I can see it now.

Social Worker: We are removing your child from your custody.
Parent: Why?
S.W.: They are too fat.
Child: I am a bad person because I am fat. It is all my fault. I will never be able to do anything right because I am fat.

Yeah that is how the system should handle the situation. Let's label the child and make them feel bad for themselves. That fixes everything.

[deleted account]

Not formula as in infant feeding...a mathematical formula that uses height and weight to determine if a child is *too* obese.

Katherine - posted on 07/15/2011

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@ Sarah....it's been a weird week, where did I talk about formula?

Teresa - posted on 07/15/2011

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The government has no business raising children OR intervening in this kind of situation.

Katherine - posted on 07/15/2011

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Oh, I completely agree with education. I think I stated that, but I also said that there should be other involvement too.

[deleted account]

Katherine, I don't know that a formula like that would be sufficient either. I think it needs to be more of a case by case basis. Does the family eat mostly healthful foods? Do the children get exercise? Are there underlying medical conditions? If a family is not doing these things, then comes the education. If they do not change their habits, then comes possible removal.

Katherine - posted on 07/15/2011

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I suppose they would have to implement some sort of law where the child can't weigh more than X amount at X height.

Yeah Tiffany you're right, but that's not that we're debating ;)

[deleted account]

The only issue I have is determining where the line for obese is in children. My daughter was and possibly still is off the charts which according to this idea would mean I'd have her removed but anyone who has seen my daughter knows she is far from overweight. She Also gets outside almost everyday and plays for hours.
So who would choose where that line is?

[deleted account]

That is a good point Tiffany. Skinny does not equal healthy. However, obesity leads to other health problems that naturally skinny people aren't at as high a risk for.

Tiffany - posted on 07/14/2011

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That's quite a slippery slope.



There are MANY MANY unhealthy families in America. Some parents let their children eat unlimited junk, smoke around their children and let them have unlimited screen time, but not all of those children turn out obese in childhood. They may be just as unhealthy, but not show the same obvious signs/symptoms as those of obese children. How would it be fair to only target the parents of the obese when other parents are doing the same thing?

Constance - posted on 07/14/2011

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A lot of the issues with parents feeding convience foods is because they don't realize how easy and quick a healthy meal can be. Also the stigma Healthy = No Taste. It is about eduacation. I agree with Katherine it should be steps before a child is removed from a loving home.

So many people don't realize if they can take one day a week to prepare things that take longer to do. Like chopping veges. Putting them in containers in the refridgerator until the time you need to use them. Picking recipes that take no more than 30 minutes to make start to finish. We all look at what our parents did or grandparents did. We are a part of a generation that both parents work outside of the home and most work very long hours. The last thing thy want to do is slave over a stove for an hour. If they knew how quick a meal they have started to prepare days earlier then it would be easier.

If we are going to fund a program then let's at least fund something that is going to make a difference.

Charlie - posted on 07/14/2011

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Katherine do you think that should also go for severly malnourished children too ?

[deleted account]

I just saw this on the news the other day! I dont think that is an absolute correct way to handle this issue however i think in some cases it should be done. Some people argue that education is key to fixing it but im not entirely on that same page. People can have as much education as they get but it was they do with that education that really determines the outcome. And i honestly dont think it will resolve it. Im all for education of course im just not too convinced that it will make a big impact but im up for being proved wrong!

Katherine - posted on 07/14/2011

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I definitely think there are some gaps to this theory.

One: The parents should be taught before anything happens. There should be phases of consequences.

Two: Taking a child away from a loving home because the parents don't have the right tools is not the way to go about it.

Three: If there is no compliance parents should be court ordered to provide healthy meals, if they don't THEN the child is removed from the home.

Four: There should be social workers involved, case managers, counselors......

I think there needs to be a lot more method to this implementation.

[deleted account]

This should only be the last resort.I believe in helping first.If you don't sit up and take notice with help your given then i believe sadly it has to come to losing custody.:-(

Its not fair on the children.We are responsible for what our kids eat.If your allowing them to get to the point there obese and don't want to make a change yourself.Then i feel very bad her those children.Who have parents who clearly don't care to help there kids to live healthy.



It should not have to come down to OTHERS wanting to force you as the parent to take action.

[deleted account]

I agree, Sara, that education is just one step, but without knowledge they're nowhere. We can change all the other things you mentioned, but if someone is ignorant about healthy eating, they're doomed.

"Do you truly believe a family of over weight people do not know that eating veggies is healthier then eating a bag of chips?"

That's exactly what I'm saying. Sara H. already talked about the misinformation and ignorance that so many people have about what is REALLY healthy and nutritious.

Sara - posted on 07/14/2011

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You say low-income is not an excuse for poor nutrition, but if that were true, then why does study after study after study of poverty yield the same results?





The point here is that sickness, poverty, and obesity are spun together in a dense web of reciprocal causality. Anyone who's fat is more likely to be poor and sick. Anyone who's poor is more likely to be fat and sick. And anyone who's sick is more likely to be poor and fat.



I just think that education is only one step in helping to prevent the spread of the obesity in our society, among children and adults. If you truly want to fix the problem, then we need better standards of care for EVERYONE. Maybe if the poor had better access to preventative care and treatment, then there wouldn't be so many obese children and we wouldn't be having this conversation about whether or not obese children should be removed from the home. But to me the biggest issue to address is the wage gap in our society. As long as there is such a big gap between the haves and the have nots in this country, then obesity and sickness will continue to be a problem, and with something like 20 percent of children in the US under 18 living in poverty, obesity among children will continue to be a problem as well.

[deleted account]

So, we are back to education. Do you agree that education about nutrition would help in SOME situations?

Amanda - posted on 07/14/2011

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Ok I agree there Sara I have heard many highly educated mothers claiming that things like those fruit snacks are good for their children.

Low income is not an excuse for bad food, I have been low income, and still made sure my children ate well. Busy two jobs I can see as an excuse, but at some point you have time off, and you can cook meals in advanced. Many families do this.

Amanda - posted on 07/14/2011

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Everyone keeps saying education is the key. Are you all serious? Do you truly believe a family of over weight people do not know that eating veggies is healthier then eating a bag of chips?



Food addictions is a serious problem in North America, and parents are now pushing their drug of choice onto their children. If you pushed any other drug on to your children you would lose them, so why is food an exception?



Amazes me how parents get so outraged about a person smoking around their children, but stand by and watch parents set children up for life long failure with food.



"If the parents are willfully forcing their child to eat high fat, additive-loaded junk, while eating good and healthy foods themselves, then abuse might be involved"



So its okay to feed your children garbage as long as you are partaking in the abuse also? Confused look. Children don't have a choice when it comes to the food they eat, because its ADULTS who are preparing/buying the food for them.

Stifler's - posted on 07/14/2011

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I say bring back Mothercraft where everyone in school learns how to take care of babies/children and cook things that aren't oven bake fries and chicken nuggets.

[deleted account]

I also agree it should be a last resort, when all other avenues have been exhausted and medical conditions are ruled out.

[deleted account]

YES, I agree with this as a temporary fix. A chance to educate the parents and make necessary changes to the home, environment and overall behaviour before allowing the child to be in the home, in their care.

Education is key, and parents who aren't doing their job, need to be reprimanded. It's child abuse in my opinion.

Jane - posted on 07/13/2011

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Before you go to that extent, first try education. Odds are if the kid is obese, so are mom and dad. They are only doing what they know. There should be a lot more stress on staying healthy all the way up through school, starting with making sure kids get recess or gym every day, including home ec/health classes for every student, and changing school lunch menus. Yes, I know kids would rather eat chicken nuggets and pizza if they are there, instead of apples, salad, and grilled chicken breast, but if kids are hungry they WILL eat. And I know it is cheaper for school districts to prepare cheap crap in a central kitchen and deliver it by truck to the schools.



We might also figure out a way to make healthy, low fat food cheaper than junk food. In addition, some traditional foods are not terribly good for the human body but enough physical activity balanced it out in the old days. Now, with sedentary jobs, television and video games, plus the ever-ready family car in place of walking, folks don't use up those fats.



If the parents are willfully forcing their child to eat high fat, additive-loaded junk, while eating good and healthy foods themselves, then abuse might be involved.



Otherwise it is an educational problem as well as a cultural problem, not a child abuse problem.

Amber - posted on 07/13/2011

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I agree that it should be done only after every other possibility has failed.
Working with the family on nutrition, exercise, and a healthy lifestyle should come before removal unless the circumstances are so extreme that time cannot be given.
If a child is in danger from the way they are being fed, then the issue must be addressed.

[deleted account]

I agree with Nikki. It should be a last resort. Genetic disorders should be ruled out. Families should be connected with a dietician, nutritional and exercise trainer.

In some cases I can see how removing the child would be appropriate. But because being removed from one's family is such detrimental thing to a child, all other options should be exhausted.

Mrs. - posted on 07/13/2011

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Really sad, but I think, in extreme cases, it might just be necessary.



It should be the last ditch thing to do though. I wish there were more programs and resources out there for families mired in a generational cycle of obesity and overeating. Seems that there isn't enough, if it comes to this.



That being said, I can wish those programmes were in place all I want while children suffer needlessly. If it takes a separation to save them a lifetime of obesity and that's all that is available...well, beggars can't be choosers.

Nikki - posted on 07/13/2011

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I am well aware of that Amanda, all I was saying it that it is a decision that should not be made lightly because there are consequences.

Amanda - posted on 07/13/2011

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Its also detrimental when a child can't walk or stand for long periods of times, due to their extreme weight. Its detrimental to ones emotional health when you lose a limb to diabetics or eye sight. Its emotionally disturbing, when you are so large you can't clean your own body parts, can't fit in the average sized seat. The list goes on and on...

Nikki - posted on 07/13/2011

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I agree that something needs to be done, but this would have to be a last resort. Taking children away from their homes can be extremely detrimental to their emotional health. So there would need to be steps taken, like intensive nutrition classes, weight management groups etc before this option is looked at.

Amanda - posted on 07/13/2011

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We take children away from parents who don't feed their children well enough, so why not remove the children who are also over feed.

Clearly if a child has a medical issue causes extreme weight gain there is medical documents to protect the child from being removed from their parents.

Charlie - posted on 07/13/2011

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I think YES if a malnourished child is deemed abused and taken away for their health an extremely obese child should be afforded the same opportunity to live a healthy life until the parent can prove they can take care of the child and meet their dietry needs.

Rosie - posted on 07/13/2011

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i think it's necessary. i think they need nutrition classes and stuff before they get their kids back. i do wonder how it would all work out though. how long the kid would be gone etc.

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