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Medical experts say intervention is needed but disagree on implementation

A Cleveland, Ohio youth is making national headlines after he became the first case in state history (by officials' recollection) of state officials taking a child away from his parent(s)' on grounds of obesity.

I. Can U.S. Local Gov'ts Stop Obesity by Seizing Children?

Obesity in America has had a serious effect on numerous technology fields outside fundamental medicine, including raising new engineering challenges for transportation safety engineers, and making it harder to meet strict fuel economy standards.  Geneticists hope to one day find a "cure" to the obesity epidemic, but for now good old fashioned diet and exercise are still the standard prescription.

But perhaps its most tragic effects have been in terms of premature disease in morbidly obese children.

The youth in this story is an eight-years-old, according to reports, and currently an honor roll student in third grade.  He weighed in excess of 200 lb. (>90 kg) when he was taken from his mother.  For his age and gender, the median weight (in body mass index terms) is roughly 14.8 kg/m2, according to widely available charts [source].  That means that to be a normal weight, the boy would have roughly 8 feet (2.45 m) tall.

While the state health department estimates 12 percent of third graders in Ohio to be severely obese -- 1,380 in Cuyahoga County, the boy's home region, alone -- it says that no other children have been seized.

Fat child flexing muscles
Ohio's childhood obesity rate of 12 percent is actually below the national average.
[Image Source: Fat Children Tumblr]

The process began in 2010 when the child received treatment for sleep apnea, a potentially fatal obesity-related disorder.  The child was prescribed a machine to help him breathe at night.  Meanwhile the child's mother was strictly instructed to help him lose weight as part of a "protective supervision" program by county social workers.

The boy's mother bought him a bike and encouraged him to exercise, and it seemed to work.  The boy lost some weight.  But then he quickly gained it back.  The mother blames a sibling and friends for giving him their extra food.  She says when she became of aware of this, she tried to stop it, but by then it was too late.

While the county did not have an official policy on how to deal with extremely obese children, it decided to take away the boy after the sudden weight gain.  Mary Louise Madigan, a spokeswoman for the Cuyahoga County Department of Children and Family Services comments to a local newspaper, The Plains Observer, "This child's problem was so severe that we had to take custody."

Juvenile Public Defender Sam Amata, also interviewed by the local newspaper, wasn't so sure that seizure was the best option.  He states, "I think we would concede that some intervention is appropriate.  But what risk became imminent? When did it become an immediate problem?"

II. Idea has Support From Some Prominent Academics

On the other Dr. David Ludwig -- a top obesity expert -- and Lindsey Murtagh, a renowned lawyer and researcher at Harvard’s School of Public Health, recently wrote in a Journal of the American Medical Association (JAMA) that extreme obesity in children in many cases was symptomatic of destructive parenting and that children needed to be taken away in extreme cases to protect them.

The study, entitled "State Intervention in Life-Threatening Childhood Obesity", states, "In severe instances of childhood obesity, removal from the home may be justifiable, from a legal standpoint, because of imminent health risks and the parents' chronic failure to address medical problems."

The study provoked controversy in a nation where one in three adults and over one in six children are clinically obese [source].


Obesity rates in America have skyrocketed to epidemic proportions. [Image Source: CDC]

Arthur Caplan, a professor of bioethics and medical ethics at the University of Pennsylvania, suggests that the JAMA study was short-sighted because the government cannot hope to tackle America's chronic obesity epidemic via the protective services/foster care system.  

He comments, "A 218-pound 8-year-old is a time bomb.  But the government cannot raise these children. A third of kids are fat. We aren't going to move them all to foster care. We can't afford it, and I'm not sure there are enough foster parents to do it. "

Further complicated the bioethics issue is the fact that a great deal of research points to genetics playing a role in obesity in children and adults.

III. Should the government have a role in the obesity epidemic?

The local government's stand and other similar cases are also drawing criticism as hypocritical at a time when school lunches are considered "unhealthy" by many medical experts.  While President Obama and the first lady have made healthier school lunches a top priority with their much touted "Healthy, Hunger-Free Kids Act", a 2007 U.S. Department of Agriculture audit revealed only 20 percent of schools [PDF] to be following fat guidelines.


Four out of five schools violate federal school lunch fat guidelines.
[Image Source: Growing a Green Family]

As for the boy's mother, she is understandably upset.  In her interview with the local newspaper she shares that she feels villainized by county officials.  She comments, "They are trying to make it seem like I am unfit, like I don't love my child.  Of course I love him. Of course I want him to lose weight. It's a lifestyle change, and they are trying to make it seem like I am not embracing that. It is very hard, but I am trying."

The boy has reportedly lost a few pounds in the last month, reversing the trend of recent gains.  But the foster parent he's been temporarily assigned to has reportedly been having trouble keeping up with his medical appointments.  As a result the county hopes to move him to a new foster home and possible assign a dedicated personal trainer -- at local taxpayer expense -- to help the youth lose weight.

Next month the mother's lawyers and the state will plead their cases at a preliminary hearing.  The final trial is set for the child's 9th birthday, before a Juvenile Court magistrate.

Source: Cleveland Plains Dealer



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RE: Once again, proof...
By Boze on 11/28/2011 9:35:02 AM , Rating: 4
Ugh, since when are fake boobs a plus? Disgusting in my opinion.

Its a lot easier to eat healthy than people might think.

I prepare and eat a lot of soups, which are actually quite inexpensive. My favorite is vegetable beef. For about $18, I can make four gallons of the stuff.

The key is to be smart about preparation. I buy 73 / 27 ground beef and brown it in a saute pan. Then I drain the beef in a colander so that most all of the fat that has been liquefied during the cooking process can drain off the beef. From there, I toss in mixed vegetables (carrots, corn, green beans, peas). And I mean the inexpensive 2 lbs. bag for $2 from Walmart. I dice two pounds of potatoes into 1/4" cubes. Toss that in there. 2 cans of tomato paste, 1 can of tomato sauce, and as much water as is needed, and let it sit on the stove for 5 to 6 hours on medium-low heat, stirring once or twice an hour.

Cheap. Simple. Filling. Nutritious.

Steam some rice, bake some cornbread, or buy some saltines to add to it, and it'll last even longer. That $18 allows me to eat for an entire week. Some of my friends poke fun at me about it, but the truth is, I love veggie beef soup. I don't eat it because I can't afford anything else, I eat it because its good for me and it tastes awesome with some Srirachi mixed in. However, I digress...

The biggest problem facing our nation, in my opinion, isn't high food prices, its a lack of knowledge.

People aren't taught how to cook, or what to cook.

When my mother was growing up as a child she ate mostly vegetables. Her family might have had meat once or twice a week, usually on Sunday. I'm not saying inexpensive meat is the culprit here, it isn't, its just that it wouldn't hurt to eat some lima beans and green beans and corn every now and then either...


RE: Once again, proof...
By Dr of crap on 11/28/2011 11:31:09 AM , Rating: 2
Really you think anyone will put forth that effort when a McD's will have burgers for a buck?

I agree with your point, but a vast majority will take the easy, less work trip to the local fast food place!


RE: Once again, proof...
By Iaiken on 11/28/2011 12:09:11 PM , Rating: 3
quote:
A vast majority will take the easy, less work trip to the local fast food place!


This is in no way an understatement. Out of all of the friends and family that my wife and I interact with regularly, we know of only 5 people (out of like 70) that prepare their own food. Everyone else either cooks prepared meals from boxes or grabs take-out on the way home practically every single night.

As for cost, I've actually saved a lot by shopping at local specialty markets (fruit market, fish market, butcher, bakery, etc) and only bother with the supermarket for items that they don't carry. The kicker is that not only is it cheaper, but once you zero in on the good places to go the quality is vastly superior to even yuppiemarkets like Whole Foods for a fraction of the price. $3.99/lb. for a dry-aged boneless blade steak with excellent marbling? Yes, please!

Personally, I think going out and interacting with people who pride in the food they sell is half of the fun of cooking said food. Then again, most people I talk to view shopping and cooking as hassles that eat into their valuable TV time.

I guess it just comes down to priorities, preferences and how they align...


RE: Once again, proof...
By FITCamaro on 11/28/11, Rating: 0
RE: Once again, proof...
By VERBW on 11/28/2011 8:53:18 PM , Rating: 2
quote:
Unfortunately unless we start regulating away people's ability to parent, this problem will never change. And I don't agree with the government telling people what to eat.


Well, they're not. I thought the whole point of the article was that this was an exceptional circumstance, in which exceptional measures were taken. Children can't look after themselves, and some people can't parent.

Whether you like it or not, those children are vulnerable. Not saying the state should feel free to intervene whenever they feel like it, but it's better than letting that trainwreck of a child continue as was.

quote:
This is why I'm against "free" healthcare. It doesn't encourage people to take care of themselves so they get cheaper insurance.


This argument only holds water in cases where the illness is caused solely by lifestyle factors. Using this case to justify that belief is sketchy at best.

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