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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 th3pwn3r on 11/29/2011 8:36:59 AM , Rating: 2
Yes, as a matter of fact you can EASILY eat more fruits and vegetables than required to maintain your body. Just because you eat "clean" foods doesn't mean you won't get fat. There isn't anything screwing up our metabolism and "chemical signals". The problem is that people are lazy. They're too lazy to exercise to burn off the surplus of calories they consume and/or they're too lazy to cook or plan a diet that allows them to be in a state of maintenance. When I eat a surplus of calories I balance things out by increasing activity the next day and consuming less calories, it's really quite simple. If you eat like an average American you'll look like an average American.

RE: Once again proof....
By geddarkstorm on 11/29/2011 2:35:08 PM , Rating: 3
Show me where a kid became 200 lb when eating fruits and vegetables. Show me anyone who became clinically obese on that diet. Sure, it might be possible to get a little "portly" by overfeeding on greens, but obese? It doesn't happen (unless you're genetically screwed up, in theory), and for many reasons. There are phytochemicals in plant based foods that signal to the body chemically, more than just the typical "you feel full". Look at the diet of other countries, where they can eat as many or more calories than us, but do not become obese (such as the Mediterranean area).

People ate just fine in 1980's, why is it obesity took off only after then?

Your body does NOT operate on "this many calories go in, so you must burn x", because your body does not -store all calories-, nor are all types of calories processed remotely the same way (sugar is not equal to fat which is not equal to protein, despite the energy density determined by burning in a calorimeter--which is where the values come from you see on labels on a box. For instance, some sugars TAKE NET ENERGY to process instead of give it).

You can be a person like me, whose body stores almost nothing. I can eat the average American diet and I do not gain weight. So, sorry, but your generic catch phrase is patently false.

All this has to do with chemistry. You are not simply what you eat, your body is REGULATED by what you eat, and the range of that regulation (and responses to signals) as determined by your genetics. EGCGs, catechins, quercetin, resveratrol, carotenoids, tannins, curcumin: these are examples of phytochemicals produced by plants that have a profound impact on genetic regulation, metabolic regulation, ROS parameters, and even cancer in the human body when consumed at their naturally low levels as found in foods. Many of these function by activating signalling pathway cascades, directly modifying protein function and activity, affecting heterochromatin control (e.g. resveratrol), mitochondria health and proliferation, and more.

Your cells are bathed by the chemicals you pick up in your blood from your food, are you really going to hide your head in the sand and pretend that does nothing? Are you going to ignore the profound effects even low levels of phytochemicals have been shown to have on life span and health span, and yes, fat storage (for instance, resveratrol and quercetin signal the body to eliminate fat and not store calories; but it is a weak effect on its own)?

Dude, wisen up. There's more going on here than meets the eye, and the more we understand about bioenergetics, the more we've been discovering that. So, if we have examples of many phytochemicals with good metabolic effects, what chemicals in our foods, such as all those synthetic preservatives, might be capable of having the opposite effect?

We are poisoning ourselves in a metabolic way; question is what is the source? Lazy doesn't help, but it doesn't explain it all, not even remotely; we know this well from all the studies in animals we have done and are doing. As a molecular biologist, I can fully tell you we are screwing ourselves up on the inside--either by something we're taking, some ratio of calorie types, or by something we are lacking in the standard American diet compared to most the rest of the world. So what is it, what's the culprit? We'll never know if we hold an attitude like yours.

RE: Once again proof....
By geddarkstorm on 11/29/2011 2:37:13 PM , Rating: 2
You should also realize that your activity levels, the amount of energy and restlessness you have, is also greatly impacted by your food. Certain foods will induce sedentary behavior, other foods will increase physical activity spontaneously. There are many studies in mice and rats showing that quite nicely.

So how does that happen? I'll let you answer that question if you feel so smart, and if you believe that chemicals in our foods have no impacts on our bodies' chemistry :).

RE: Once again proof....
By geddarkstorm on 11/29/2011 2:44:30 PM , Rating: 3
Also, heard of something called... vitamins? Apparently very low level abundance chemicals we pick up from foods that have extremely critical effects on the body? Oh that's right, vitamins don't exist because the chemicals in our food have no effect on our body chemistries from what you'd have us believe.

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