A Modest Proposal: JAMA calls for removing obese children from their homes

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Should a child s morbid obesity be classified as abuse and neglect on the part of the parents, and thus grounds for state interventions like moving a child to foster care? According to the authors of a commentary in the Journal of the American Medical Association (JAMA), the answer is yes. Harvard School of Public Health s Dr. Lindsey Murtagh and Dr. David S. Ludwig believe that child protective service interventions may be the only realistic way to control harmful behaviors that lead to morbid obesity in children (who are classified as having a body-mass index in the 99th percentile).

The doctors assert that, while removing a child from the home in such cases would rarely be necessary, state interventions can provide families with services such as in-home social supports, parenting training, counseling, and financial assistance that may address underlying problems without resorting to removal from the home or to the clinical side effects of medical procedures such as bariatric surgery. Toward the end of their article, however, they acknowledge that state interventions would clearly not be desirable or practical, and probably not be legally justifiable in the majority of cases of the approximately two million morbidly obese U.S. children. For instance, many may have unknown genetic risk factors for obesity that certainly could not constitute abuse or neglect on the part of a parent.

ACSH's Dr. Gilbert Ross finds the article to be quite disturbing. To equate obesity with parental abuse and neglect seems extreme to me, he says. Child protective services is already authorized to remove children from the home if they perceive parental abuse sufficient to rise to a health-threatening situation. To add the morbid obesity issue doesn t really add anything new to these authorities mission ensuring that children are provided with a safe and healthy home. I am deeply disappointed in the authors and JAMA for publishing this scary claptrap.

ACSH s Dr. Josh Bloom agrees. So the government is going to take very obese kids away from their parents and put them in foster homes? Then you ll have unhappy, very obese kids being cared for by families who are equally unprepared to care for these kids dietary and behavioral needs, and who are also strangers. This is a terrible idea," he says. "Especially considering that there is a very strong genetic component to obesity, in which case there isn t even anyone to blame. This is not the same as removing a child who is being starved at home.