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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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Blame the Medical Community As Well...
By Arsynic on 11/28/2011 11:46:07 AM , Rating: 1
As a parent I understand how easy it is to raise fat kids. When they are infants, pediatricians stress packing them with calories. The heavier the baby, the healthier. When a doctor sees a fat newborn or infant it's usually good news and means that the mother is doing a good job feeding the baby. My wife had breastfeeding issues early on and it was troubling seeing a baby losing weight rapidly, having dried chapped lips and sunken in eyes. We were very afraid and started packing him with formula until the breast-feeding got on track. So we, like most parents, have been conditioned to believe fat baby = healthy baby and skinny baby = dying baby.

The problem is that some parents don't know when to turn this mentality off. To them a fat baby is always a healthy baby. There is even a term for that, "baby fat". They think its cute. I think the medical community helped create this mentality and so their main focus should be on balanced nutrition once it's established that the baby is healthy. This is an area where private industry should take responsibility. Even with adults, the medical community is more focused on treatment than prevention (which most of the time is based on nutrition).

I think the medical community is so tied up with the pharmaceutical community that they are in prescription mode instead of prevention. I guess they should really have no interest in healthy people since it affects their bottom line. All MD's should be nutritionists as well or have some knowledge of proper nutrition. It seems that when the baby is born, nutrition is the #1 focus and then when the baby is fat and healthy, they throw it out the window in favor of peddling shit like Ritalin and vaccinations.




RE: Blame the Medical Community As Well...
By Dr of crap on 11/28/2011 1:21:11 PM , Rating: 2
WHAT????

I can see your kids will be messed up.

This is not even close to being a problem as you state.

Kids by design will only eat to the point that they feel full and won't eat anymore like an adult will, just because it tastes good. That I got from our Pediatrican! Either the kid has a medical condition that needs to be fixed, or the parents gave and gave him too much BAD food to the point that he over came his natrual instints and gorged to the point he is now.

Yes, baby fat is good, but after the kid crawls and then walks the "baby fat" goes away because the kid is getting exercise! If you can't see a fat kid as a problem then you have a problem. My kids are not over weight and never have been. Again it's parenting. Maybe we need to charge people a fee every year to educate them in common sense and kid rearing!


By Arsynic on 11/28/2011 4:17:23 PM , Rating: 2
Dude, we're on the same side. I'm just stressing that the medical community needs to do a better job of educating parents of older children instead of peddling meds and treating illnesses. The medical community as a whole needs to focus more on nutrition as a preventative measure.

Ultimately it's the parent's responsibility but parents have been conditioned early on to believe that fat baby=healthy baby and they never snap out of that mentality. Alot of people look at a fat 2 year old and think "baby fat". This needs to be changed. Notice that I'm putting the responsibility of education on the private sector and not the government. The private sector can only make suggestions. The government tends to put a gun to your head to force you in line.


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