Friday, December 15, 2017
Health

Is it child abuse if your youngster gets obese?

Marla Richter comes from, to use her term, a "fat family." Her mom was fat, as are her kids and most of her grandkids. So a recent case hit home: A 219-pound Cleveland third-grader was taken from his mother by child welfare officials, in part, because of his obesity hit home. • Richter, 61, of Corinth, Texas, says a 13-year-old relative who weighs more than 200 pounds saw a news report on the case and immediately tried to nix an upcoming medical appointment. "I'm not going to the doctor now," Richter quoted the girl as saying. "No way. I'm not going to be taken away from my mother."

Cases of children being temporarily taken from their homes due to obesity-related concerns remain extremely rare. In Florida, the Department of Children and Families has stepped in when parents fail to provide adequate medical care for their children. But children have never been removed from their homes due to weight issues, said agency spokeswoman Erin Gillespie.

Still, the Ohio case has fanned concern among obese kids, their relatives and their advocates.

"I see our freedom being stripped from us more and more every day, so I don't really see (removing kids) as so outrageous that it's not a real possibility," says Peggy Howell, a spokeswoman for the National Association to Advance Fat Acceptance. "We don't even have enough foster parents as it is in this country, so what are we going to do? Create fat concentration camps that we're going to put these children in?"

A handful of influential doctors have come forward in recent years to discuss the possibility of temporarily removing extremely obese kids from their homes. But that discussion has generally been extremely cautious and moderate, with an emphasis on a very small subset of very obese kids who face severe and immediate health risks because of their weight.

A high risk of developing diabetes as an adult, for instance, wouldn't meet the standard outlined in a 2009 article in the journal Pediatrics. A respiratory condition that could lead to death in a matter of days, on the other hand, very well could.

"These are extraordinarily unusual situations," says David Allen, a professor of pediatrics at the University of Wisconsin School of Medicine and a co-author of the Pediatrics study.

Allen and his co-authors wrote that removal of a child from his home could be justified, but only if the child faced a high risk of serious and immediate harm. Mere obesity, however severe, would not meet the standard. Plus, there would need to be effective treatment available for the child, and all other alternatives to removal would have to be exhausted.

Advocates object that the vast majority of people who lose a large amount of weight gain it back, making all obesity treatment ineffective in the long run; that claim is backed by numerous scientific studies. But Allen says kids are different, because parents and other adults really can control their calorie intake and exercise. He pointed to group homes where children with genetic syndromes that lead to obesity have lost weight.

In the Cleveland case, Allen said, news reports haven't provided a lot of detail, but it appears that child welfare workers made substantial efforts to help the family of the 8-year-old honor student who lost and then rapidly regained weight.

Fat rights advocates, however, see the Cleveland case as part of a broader threat to the well-being of fat people and their families.

"Most people I've talked to are disgusted. They think about the emotional toll it takes on the child, the parents and the other children (in the family)," says Richter.

"I have a friend who's thin, her husband is thin, her girls are thin, but she has this chubby little boy. She says, 'He eats just like we do. What are we supposed to do? Are they going to come and take him away from me?'"

Times staff writer Irene Maher contributed to this report.

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