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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 FITCamaro on 11/28/2011 12:24:09 PM , Rating: 1
One of the reasons it is more expensive to eat healthy is because of all the regulations and taxes on healthy eating. How many regulations are involved in creating a gallon of milk? Between just raising the cows, procuring the milk, transportation costs to keep it cool, etc, it all adds up to cost.

Soda they just take water, mix in flavoring and all the other shit in it, and sell it.


RE: Once again, proof...
By GuinnessKMF on 11/28/2011 1:27:28 PM , Rating: 2
Why does everyone keep saying Milk should be the healthy substitute for soda?

How about water?

I love milk and all, but 16 oz of skim milk is 172 calories, 16 oz of cola is 128 calories. (Source: http://fatsecret.com)


RE: Once again, proof...
By FITCamaro on 11/28/2011 2:09:52 PM , Rating: 3
Sorry but I refuse to believe the bullshit that milk is bad for you. Generations have grown up drinking milk and not had health issues. And most of those generations drank WHOLE milk. Not 0-2%.

The nutrients provided by milk far outweigh any calories you're taking in. I drink milk almost every day. And orange juice. Oh no! Lots of sugar right?

Christ I hate the media and these health nuts who fuel them. Just as bad as the "green" crowd.


RE: Once again, proof...
By Tequilasunriser on 11/28/2011 2:45:07 PM , Rating: 3
You don't have to believe anything. The proof is in the numbers.

Belief has been taken out of the equation.

Much like anything milk should be consumed in moderation.

A calorie is a calorie whether it is derived from fats, proteins, or carbohydrates.

Also, previous generations didn't have computers, video games and internet. Hell, even TV and radio are relatively recent on the human time line. Sedentary actives are holding modern youth captive.


RE: Once again, proof...
By kyleb2112 on 11/28/2011 8:14:21 PM , Rating: 3
If "A calorie is a calorie" then I would really like to see someone become obese eating only protein. I'm not saying it can't be done, but what it would take to do it would blast "a calorie is a calorie" theory to pieces.


RE: Once again, proof...
By Tequilasunriser on 11/29/2011 11:04:38 PM , Rating: 2
They would go into kidney failure due to a build up of keytone byproducts from the breakdown of protein.

Protein isn't a calorie. Not sure you know what you're talking about.

A calorie is a unit of measure (energy) not a nutrient, so, yes, a calorie is a calorie.

Not sure what you are getting at.


RE: Once again, proof...
By someguy123 on 11/30/2011 2:33:21 AM , Rating: 2
In a normal diet that's marginal. Unless someone, as you said, went out of their way to go a pure protein and fat diet, sufficient carb intake wouldn't create the Ketogenic effects.


RE: Once again, proof...
By ClownPuncher on 11/28/2011 7:41:23 PM , Rating: 3
Milk isn't terribly good for you. Neither are empty carbs. Natural fat, however, is needed for a healthy diet.


RE: Once again, proof...
By VERBW on 11/28/2011 8:30:20 PM , Rating: 1
quote:
Sorry but I refuse to believe the bullshit that milk is bad for you. Generations have grown up drinking milk and not had health issues. And most of those generations drank WHOLE milk. Not 0-2%.


He (or she) didn't say milk was bad. "It's OK to just drink water" was the point, which I think we'll agree with.


RE: Once again, proof...
By 0ldman on 11/28/2011 8:48:51 PM , Rating: 3
Milk is for baby cows.

If someone brought you a glass of elephant milk, hamster milk, etc, you'd look at them like they were nuts. Why is cow's milk any different?

I drink milk, but seriously, it is sustenance for a baby cow. You actually absorb more calcium from raw broccoli than you do from milk. The calcium in milk is just too much, your body filters out most of it, causes kidney stones in lots of people.


RE: Once again, proof...
By wempa on 11/28/2011 3:00:24 PM , Rating: 3
quote:
I love milk and all, but 16 oz of skim milk is 172 calories, 16 oz of cola is 128 calories.


Those numbers are a bit off. Sodas range from about 130-170 calories per 12oz can. That puts the average 16oz soda at 200 calories. Skim milk is 160 calories per 16oz. Then, consider the calcium, protein and vitamins you get from milk. Milk is definitely a great drink and there are even some studies that show that dairy products help the body excrete more fat.


RE: Once again, proof...
By Tequilasunriser on 11/28/2011 4:10:39 PM , Rating: 2
Milk certainly contains a lot of vitamins and nutrients.

That still doesn't change the fact that a calorie is a calorie regardless where it comes from.

I'm not hating on milk, I drink it often, but I'm not going to shed a blind eye to negative effects of glutinous consumption of the stuff either.

Even too much water can be dangerous (water intoxication).

Simply put, too much of anything can be bad.


RE: Once again, proof...
By bupkus on 11/29/2011 9:08:19 AM , Rating: 2
quote:
cal·o·rie/'kal(?)re/ Noun: Either of two units of heat energy. The energy needed to raise the temperature of 1 gram of water through 1 °C (now usually defined as 4.1868 joules).
There is a reason why Lay's Potato Chips had a slogan that you can't eat just one. The balance of oil, sugar and salt creates a mixture that taps into the drive that humans have to acquire and consume these once difficult to find ingredients. That's why they taste so damn good.


RE: Once again, proof...
By jimbojimbo on 11/29/2011 4:04:55 PM , Rating: 2
quote:
a calorie is a calorie

You need to read up more on nutrition. There are different ways that the body absorbs and utilizes the calories. Having all the calories coming in from a simple sugar compared to coming in gradually from the various other formats is a huge difference. Look up glycemic index and how various foods affect your blood sugar and what your body does if there's too much blood sugar in your system at once. Basically it stores it away as fat.


RE: Once again, proof...
By Tequilasunriser on 11/29/2011 11:07:31 PM , Rating: 2
The body absorbs calories?

YOU need to read up on nutrition.

Hypocrite.


RE: Once again, proof...
By someguy123 on 11/30/2011 4:55:51 AM , Rating: 1
No...the body increases nutrient absorption rates during blood glucose/insulin spikes, but this will not form into fat unless you have calories in excess of what you require to maintain your current body weight.

you don't create fat out of the calories necessary for survival and maintenance.


RE: Once again, proof...
By senecarr on 11/29/2011 1:17:03 PM , Rating: 2
I don't understand what kind of math involves "range from 130-170" and "the average ... at 200". Did you maybe mean ranges from 130-270?
Certainly trying to get most of your liquids from either one is going to cause problems.


RE: Once again, proof...
By bankerdude on 11/29/2011 1:57:08 PM , Rating: 2
No, you need to look closer at the post. 130-170 is the range for 12 ounces, so when you extrapolate out to 16 ounces, the number becomes bigger.


RE: Once again, proof...
By its tom hanks on 11/28/2011 3:29:52 PM , Rating: 2
Why would ANYONE say milk isn't a healthy substitute for soda? not only are your calorie stats way off base, but the calories in soda are primarily from sugar @ 4 calories per gram, while the calories in milk are primarily from proteins @ 4 calories per gram. you should research the differences in what your body does when it receives a handful of sugar or a handful of protein...
there's a reason why mammals don't lactate coca cola for their young, after all


RE: Once again, proof...
By Tequilasunriser on 11/28/2011 4:23:22 PM , Rating: 3
You're leaving out the fats at 9 calories per gram.

A quick look at my milk container shows 6 grams of fat in 3/4 of a cup (4 grams of which are saturated fats)and 6 grams of protein in 3/4 of a cup.

54 calories from fat and 24 calories from the protein.

You say that milk primarily contains protein but my milk contains 8g of carbohydrate (from sugar) in 3/4 of a cup, so 32 calories. There are more sugar calories than protein calories.

Out of the 110 calories in 3/4 cup of milk only 24 are derive from protein while the rest are derived from fats and sugar.

Now that's only in 3/4 of a cup. Most people consume well beyond the recommended serving size.


RE: Once again, proof...
By its tom hanks on 11/28/2011 7:41:01 PM , Rating: 4
i left out the 9 calories per gram of fat because if you're going for healthy, you choose skim milk, with 0 grams of fat, ergo no calories from fat. you chose milk with a lot of fat in it. just because it says milk on the bottle doesn't mean it'll make you an athlete, still gotta make choices.. also, although some milk may have more calories from sugar than protein, milk contains lactose sugar. you and the guy who thinks coke is better for you than milk can compare that to the sugar in your coke all day long. lemme know how that turns out


RE: Once again, proof...
By GuinnessKMF on 11/29/2011 12:28:36 AM , Rating: 4
You people are all ridiculous, the point I'm responding to is that 'milk is more expensive than soda, and that is why Americans are obese'.

Water is free. Kids need to drink more water, every liquid they consume doesn't need to be a soda or juice.

The calorie values I pulled strait from a nutrition site (and I gave my source because I knew people would try to dispute them), honestly I don't even care if they're accurate, the point is that it's not a calorie free drink, sure milk provides more benefits than just the empty calories of soda, but it shouldn't be the only liquid kids are consuming like so many consume soda.


RE: Once again, proof...
By lemonadesoda on 12/3/2011 3:54:43 AM , Rating: 2
I'm going to add one thing about healthy milk. Dairy cows are pumped full or hormones to make them big and make them lactate. And pharmaceutical products to keep them healthy. They also eat huge quantities of special feed, and that special feed requires significant pesticides in its growth. You are then consuming (indirectly) unusually large quantities of hormones and pesticides when you drink milk. Irrespective of the quantities you eat, those hormones and pesticides will have consequences to your own health. Some people are more sensitive to this than others. Sometimes the effects take a while to build up... the body is OK with the hormones and pesticides until an intolerance builds up later in life.

I'm now in my 40's. I cannot drink regular milk without developing an allergic irritating cough. Oddly, I can drink Organic milk without symptoms. So it isnt milk per se, but industrial milk.

I'm sure the growth hormones in pork are one of the reasons that people in high-pork-eating-countries are getting fatter and fatter.

I'm not so sure it is ONLY the quantities of what we are eating today, but the cocktail of ingredients in the food chain.


RE: Once again, proof...
By Tequilasunriser on 11/29/2011 11:10:37 PM , Rating: 2
You're nuts. I would never say coke is better than milk.

Learn to read (and grammar while you're at it.)


RE: Once again, proof...
By Tequilasunriser on 11/29/2011 11:15:23 PM , Rating: 2
Also, you need fat in your diet.

Fats are what keep your appetite satiated.

They also aid in brain development.

Maybe you've been fat free too long to think rationally.

Science is your friend, turn off Fox news and learn a thing or two about a thing or two once in a while. ;)


RE: Once again, proof...
By jimbojimbo on 11/29/2011 3:59:02 PM , Rating: 2
Soda is 100% sugar, or rather corn starch. Milk's calories at least come from fat, plenty of protein, and sugars and it has various other nutrients. I would much rather have kids drinking milk than pop any day but like others have said I wouldn't let the kids drink a gallon at one sitting or something stupid like that.


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