Child obesity is an epidemic in the United States. Today, doctors are treating obese children for medical conditions once only seen in the adult population such as type 2 diabetes, high cholesterol, sleep apnea and more. In addition to health problems, child obesity can lead to depression and even lower math and reading scores (Mitgang, 2011).
Over the last couple of decades, many have wondered what can be done to mitigate the rising rates of child obesity. Some have proposed removing severely obese children from their parents’ custody (Murtagh & Ludwig, 2011). But is an obese child being abused and is removing them from their home really what is best for the children?
How a state can intervene in child obesity
While the law recognizes the parents’ primary responsibility for caring for their children, the state can step-in to protect a child from harm or abuse by invoking child abuse laws.
The rationale for using child abuse laws for severely obese children is that the child faces looming health risks and the parent has repeatedly failed to address these medical problems. Both morbid obesity and under nourishment are forms of malnutrition. If parents of under nourished children are routinely charged with abuse then why can’t the same standard apply for parents of obese children? Simply put, if a parent who endangers their child’s health by starving him or her can be charged with abuse then why can’t a parent who is over-feeding their child?
There have been cases where the legal system was used as a resource for health professionals to protect children from the health complications of obesity. In 2002, a Texas court of appeals upheld the termination of a mother’s parental rights based, at least partly, on her child’s severe obesity and resulting medical conditions. In this case, the five-year-old weighed 136 pounds and was having difficulty breathing along with a mildly enlarged heart and mild congestive heart failure.
Cautions and stipulations around state intervention
Support for this type of law comes with stipulations that removal of a child only occurs when necessary to address a current risk of serious harm or to prevent loss of life. Many are concerned, however, that determining exactly “when harm becomes imminent” is one of the challenges that would arise by applying this standard.
A report by Varness, Allen, Carrel, and Fost (2009) used the following criteria to justify removal from the home in cases of child obesity:
- A high likelihood of serious, imminent harm.
- A reasonable likelihood that coercive state intervention will result in effective treatment.
- No other alternative options are present to address the problem.
In addition, (Varness et al., 2009) wrote that state intervention would be justified when the co-morbid conditions predict serious harm and are not reversible in adulthood, as well as when the co-morbid conditions constitute serious harm in childhood.
Mitgang (2011) underscored the importance of objective, physical evidence in an abuse analysis and decision. She would justify state intervention when necessary to prevent loss of life or to address a current risk of serious harm but only after home-interventions had failed. Mitgang identified four factors that should be used by a court to determine whether actual medical harm caused by the child’s obesity warrants state intervention:
- The degree of severity of the child’s illness directly associated with obesity.
- The degree in which medical treatment could be used to mitigate the resulting health effects of obesity.
- The child’s complete physical and mental health picture.
- When the right answer is unclear, the child’s risk of remaining obese into adulthood should also be considered.
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