Should Obese Kids Be Sent to Foster Care?

The parents of that plus-size baby in Texas have another thing to worry about beyond how they’re going to hold that kid (we’re going to need a bigger Bjorn!). Two Boston-based medical experts have just published a controversial opinion piece in the Journal of the American Medical Association stating that they believe removing extremely overweight children from the homes of their parents and placing them in foster care is a more ethical alternative to bariatric surgery. They argue that there are child abuse laws calling for state intervention when families undernourish their children, and that overnourishing should be held to a similar standard.

David Ludwig, an obesity doctor at Children’s Hospital Boston, and Lindsey Murtagh, a lawyer and researcher at Harvard’s School of Public Health, write that state intervention should be imposed when there is a “chronic failure” on the part of the parents to provide adequate care, and “ideally will support not just the child but the whole family, with the goal of reuniting child and family as soon as possible.” This method should not be seen as an effort to critique or blame parents, they reason, but to help them provide their children with the care that they need.

Ludwig says that he began thinking about this issue when he encountered a 400 pound 12-year-old girl in his clinic last year, who was suffering from sleep apnea, diabetes, high blood pressure and high cholesterol. Her parents had physical disabilities and did not have the money to properly provide for her, so was moved to foster care, where she began eating three square meals a day, some light snacks, and engaging in physical activity. In the year since, she has lost more than 130 pounds. She remains in foster care, but her diabetes and sleep apnea have disappeared.

More than 2 million children in the U.S. are extremely obese, with health concerns like Type 2 diabetes, liver problems and breathing issues threatening to shorten their lifespan. The duo argues that temporarily taking the children out of their homes while providing their parents with education is doing what’s best for the child.

But UPenn bioethicist Art Caplan isn’t so sure. He tells the AP that Ludwig and Murtagh’s argument places too much emphasis on the parents, and that factors like marketing to children, bullying, and peer pressure all can play a role in weight gain in children. “If you’re going to change a child’s weight, you’re going to have to change all of them,” Caplan said.

Ludwig and Murtagh realize that foster care may not be feasible for all 2 million children, but they hope that voicing their concern will make more states consider obesity intervention. But with the inevitable firestorm that is brewing on the issue, one wonders if the fighting over the presumptive “nanny state” will drown out the real problem at hand. It’d be a terrible thing for the subject to be, yes, weighed down, by politicized infighting. If we want more healthy kids, we have to be open to finding more solutions to help them.