Should very obese children be taken away from their parents by the state? This was the recent recommendation of Harvard pediatrics professor and obesity expert David Ludwig, and, as you can imagine, it created quite a brouhaha. The debate on this subject interested me especially because, not too far in the past, I was… ahem… a fat kid myself. (And I’ve included photos to prove it!)
When I was five or six I was your average, skinny kid. Over the course of the next few years, however, I began to put on weight. Initially I was probably best described as just a little husky:
Note the soon to devoured milkshake resting in front of me
It wasn’t long though, that this husky kid and his predilection for milk shakes (and other not so healthy foods) expanded into something bigger. I remember overhearing my fifth grade teacher tell another teacher, “Gee, Mike gained a lot of weight over the summer, didn’t he?”
Wearing a T-shirt with a dinosaur on it probably didn’t help the teasing.
Eventually, by the time I hit my biggest weight at the age of fourteen, there was this:
The sun flare makes it look like the sun is orbiting around me. It may have been.
Being a fat kid is not fun. All it takes is one person to call you a “Fat Ass,” or something equally as charming, and it will stick with you forever.
There are a myriad of hurtful stories I could tell you, but the one that comes to mind involves a basketball camp I went to one summer. Its instructors were teenagers who played for local high schools, and I thought they were the bee’s knees. One day the instructors announced we were going to play a game, and that they would keep score like they do at their high school games! I was stoked (to use the vernacular of the time), and after scoring half a dozen baskets and pulling down even more rebounds, I couldn’t wait to read the score-sheet.
My fellow campers and I crowded the clipboard our high school hero had kept score on, and scanned it for our names. Strangely, while all the other kids’ names were on there, mine was not. I was very confused until I saw “Fat Kid” scrawled on the sheet. Sure enough, my stats for the game were written next to it. Way to go, Fat Kid.
I tell you all of this because it explains A) why I am interested in the “should very obese children be taken from their homes,” debate, and how I might have a little more insight into the subject than the average person.
The kids Professor Ludwig suggest the state take from their homes are much larger than I was, kids whose BMI (body mass index) place them in the 99th percentile. Kids like these have life-threatening obesity, and are likely to develop type 2 diabetes, sleep apnea, high blood pressure, and liver problems. More often than not these kids have equally obese parents.
So would taking these kids from their parents help the situation?
Looking back, it’s clear to me that my being overweight had a great deal to do with the food my parents provided me. While we always had healthy dinners, we also had way too many “fourth meals” or “snacks” throughout the day. My Mom, who has issues with weight herself, would take my sister and me to get fast food after school, and there were also lots of trips to ice cream shops and the like. It seems very clear to me that there is a correlation between a kid’s weight and his or her parents eating habits.
So, in these extreme cases where a 99th percentile kid is being affected by his or her parents’ addiction to food (yes, people can be addicted to food just like drugs or alcohol), wouldn’t taking them out of that dangerous environment make sense? If only long enough for the kids to spend some time in a healthy eating environment and their to parents receive treatment/training about food? After all, we would expect the state to take a child out of a home where he or she was being affected by his or her parents’ addiction to drugs or alcohol, wouldn’t we?
It’s not as simple as that though. Taking a kid away from his family will be a highly traumatic experience, and there could be medical explanations for why a kid is in the 99th percentile. There’s also the question of whether the state could be trusted to help only those extreme cases who really needed help, and not start taking less overweight kids from their homes.
Ideally, taking kids from their home would only be a last case scenario. If I were calling the shots (President Mike!) I would first offer the parents of 99th percentile kids counseling and/or training in hopes of improving the situation. That won’t always work, however, and I personally think that in some extreme, life threatening situations the state should be able to take a very obese child from an unhealthy home.
But hey, that’s just this former fat kid’s two cents.
Tracie says:
I agree that making a blanket ruling that overweight kids be automatically removed from their homes is not the answer.
But I’m sure there are a lot of cases when counselling for the parents and child could make a big difference.
Veronika says:
Speaking as a former fat kid myself and as a currently overweight adult, I think the idea has merit in certain cases. In my own family, there have been severely obese parents literally force feeding their children into obesity from birth. I once saw a story where the child was removed from the mother and during visits, she still brought him bags of cookies and snacks! She just didn’t get it! Her child was only 4 yrs old, was severely overweight to the point that he couldn’t even run anymore and was suffering health problems and she was still feeding him junk. But if parents are prepared to listen and provide the best for their children, I don’t see why their children should be taken away. I work really hard to make sure my children don’t follow in my path and that they eat plenty of healthy food. They do get snacks and sugar, but they’re learning that it has a place. Something my parents never bothered to teach me.
Madi G. says:
I believe the recommendation was for obese kids, not children who were chubby or husky (and I’d argue that you fell into one of these areas, though I’m so sorry that you had to endure the cruelty of others.)
I think that this, if it were implemented, would need to be done on a case-by-case basis.
Clearly, if you have a two- or three-year-old who weighs 100 lbs, there are only two scenarios: the child’s parents are inept in terms of the food they’re providing the child -OR- the child has a medical condition.
Clearly, it would not be appropriate in cases where a medical issue is the cause of the condition. And that would include childhood mental illness like anxiety or depression — remove an anxious or depressed eater from their home and the problem will only get worse.
But in cases where the parents are inept, and they’re allowing a young child to access inappropriate foods/quantities, someone should intervene. I think the child should be removed.
We would remove a severely underweight child from the same situation, if we found that the parents were inept and they were feeding inappropriately.
I don’t see an overweight child any differently. Both conditions, in the extreme, are life-threatening. And both situations involve neglectful or bad parenting.
I believe that this could *not* be applied to older children (over the age of 5 or 6). Here’s why:
It’s very easy to control what a 3-year-old eats. You can place food in a locked fridge, high/locked cabinets and so forth to prevent a young child from accessing it. In a morbidly obese 3-year-old, it’s clear to me that the child’s parents are *giving* the food to the child -or- in rare cases, the child’s body is not processing a normal portion in a healthy manner (which equals a medical condition.)
In the case of an older child, you can steal food, you can reach high cabinets and operate a lock on a fridge and so forth. It’s theoretically possible that the child’s actions are causing the weight gain; it’s not *necessarily* the parents’ fault. And in the case of a food addiction or other mental illness, it’s not a problem that will be remedied by disciplining your child.
I was a nanny for many years. I once nannied a child who had an eating disorder. She would eat when she was anxious. She would do it in secret — stealing food and taking odd foods that you wouldn’t notice missing. For instance, she’d steal sticks of butter or eat margarine. She’d eat mayonnaise, mixed with sugar. She would mix sugar into water, making it into a syrupy slurry, and she’d drink it. This all came to light eventually, but it took a while, as she was sneaky about it and she ate things that were not really “edible”. And you can see from her food choices why she was gaining weight at a rapid pace (butter, margarine, mayo and pure sugar? Ack!)
She gained weight very rapidly and it was not clear why this was occurring. And this child came from a very wealthy, loving family. (Hell, they could afford a live-in nanny! And I was rarely alone with the kids. Mom was very involved; I was really more of a mother’s helper. She didn’t dump her kids on me and expect me to be the mommy, as many parents did.) No neglect or abuse here.
So in sum, I *do* believe that children should be removed from the hands of inept parents. But it would really have to be limited to very young kids and other clear-cut cases, where the parents are clearly supplying inappropriate foods/quantities to the children.
But if there’s a chance that the child’s condition is the result of a medical issue, including a mental health issue that would cause the child to sneak food, binge, etc., then I believe it should be treated as a medical issue. Removing one of these kids from the home would only exacerbate the problem.
You *would* remove an emaciated child from the home if the parents were inept and feeding inappropriately. I don’t believe it should be any different for an extremely obese child.
And really, to implement this rule in an effective manner, they’d need to develop recovery programs — parenting classes, nutritional education for the children and parents, in-home guidance from a feeding expert, a psych eval to determine if mental health issues are contributing to the problem, etc.
In short, implement a program with measures that would help them revamp their lifestyle into a healthy one.
I think this would be a good idea for families who are on a bad track — families where the parents and kids are significantly overweight (but not morbidly obese – I believe those kids should be removed from the home if it’s found that the parents are inept.) If a one of these “bad track” families refuses the services and the child’s condition continues to decline, then it may be appropriate to consider removal from the home. But give them a chance and the resources to fix the situation, in the less severe cases.
Really, I think it’s a matter of common sense. Remove kids from dangerous situations, such as living with extremely inept parents or parents who are mentally ill and unable to properly care for their kids. And in most cases (since most cases are not severe), provide appropriate services to the families to teach them healthy living techniques -and- lead them to medical and mental health services if these are contributing factors.
*shrug* Seems like common sense, really.
-Madi G.
Buck says:
As with most cases of child abuse or child endangering, laws already exist that allow the authorities to remove a child from an on-going detrimental environment. The juvenile or family courts of that jurisdiction then have to decide on the proper course of action for both the parents and the child. When loving, well meaning parents allow a dangerous situation to develop, including a situation where a child has been nannied into obesity, then governments must act accordingly.
Melanie B says:
As a person that worked in a group home situation for children that had been removed, no! This is not an answer and will only endanger a child’s mental health right along with their physical. Gross negligence is not the same as this. America as a whole is overweight, do you know how many kids would be in the system? Being overweight is being measured by your BMI, there’s plenty of people over a healthy BMI. It’s not right, it’s what it is though. I was pretty upset to read the article I read about this because the system as a whole is already overburdened and full of problems. I can’t imagine adding something like this!
Madi G. says:
So you’d be in agreement that removal is appropriate for instances of gross negligence?
In the case of a 100-lb 3-year-old, with no medical cause for his/her obesity?
Would you support the removal of an emaciated child from the custody of parents who are inept and negligent? If so, how is it any different to remove a dangerously overweight child from the hands of inept and negligent parents?
I think that’s what we’re talking about, really — the extreme cases of negligence or mentally ill parents — as it’s unlikely that they would remove otherwise happy, healthy kids from a good, healthy household. As you mentioned, the resources simply aren’t there to yank every overweight child from the home.
-Madi G.
Christine says:
Madi G,
No, not in any case, unless you can show me that a parent is actually verbally or physically abusive to a child. A starved child is different than a fat child.
Jennifer says:
I work in the system too, in foster care actually, and yes, I think sometimes this merits removal.
But only after in-home preventive measures have been taken. In some circumstances, overfeeding a child IS the same as not feeding them enough, as it has serious and dangerous health consequences.
A child who doesn’t have an underlying medical condition, but would be considered morbidly obese is being neglected. Children are not just removed for physical abuse (and hardly ever for verbal abuse). They are also removed for serious maltreatment and neglect, and overfeeding your young child into morbid obesity certainly qualifies.
Madi G. says:
I agree with you, Jennifer. Overfeeding your child into morbid obesity is absolutely neglect/abuse.
@Christine — Your logic makes no sense to me. Overfeeding your child to the point where they’re five or six times the recommended weight *is* physical abuse.
It’s inappropriate feeding, just like starvation. And in most cases, they’re depriving the child of appropriate treatment. Just as you’d remove an emaciated child or child with untreated broken bones, obese kids should be removed from the hands of inept parents. (Again, assuming the case is *severe* -and- there is not an underlying condition to blame.)
Fortunately, based on my discussions/interviews with lawmakers and social service workers (concerning this topic and others — I’ve written several articles on this topic), it would appear that these individuals have a lot of common sense. So I’m not all that concerned. *shrug*
Megan says:
I agree that removing a child from their home can be traumatic, but eventually, you have to draw a line. My mother has a friend who, along with her husband, is clinically considered morbidly obese. They have four children, all of whom are also morbidly obese. Their oldest daughter was wearing her mother’s materinity clothes when she was in the 6th grade, is that not child abuse?? Yes, these were loving parents, but they are also killing their kids with poor nutrition. My mother has been overweight my entire life, but she always made sure I ate healthy proper meals. Over-indulgence is just as dangerous as starvation, IMO.
Marsha says:
Well, I would have to agree to a case by case scenario because this should only be a very last resort….emotional trauma on the body is just as damaging as the physical damage obesity causes. Seriously are you going to trust a state run foster care system to care for these children??? With most foster care programs there are so many abusive foster parents it isnt even funny and their answer may be simply to starve the child thin…how is that going to help??
There would have to be some professional medical team working with these kids and let’s face it people….how many are going to be willing to accept state pay to do so!? In Illinois it has become increasingly difficult to find a private physician to provide routine medical care let alone specialized care like what these children would need.
Most families are sent to clinics that are overwhelmed with patients and do not have the time to manage these kinds of children….while everyone is on the feed them right
campaign it seems exercise is being overlooked as well.
But if I can add my 2 cents worth you have to admit it is so much more expensive to eat healthy and in today’s economy people buy what they can to feed their families….processed foods are cheaper let’s face it.
I fear that this is going to become an even bigger issue if they start making cuts to the food stamps program as many Americans these days are receiving help .
A complex issue for sure.
Lisa says:
I think childhood obesity is a definite problem. But do you really think the government can do any better? Do we have lots of foster families ready to take on all the obese kids? I think the issue is way more complex than “take the kids away”. Not saying I have the answer. Just saying government is NEVER the answer.
Meghan says:
I’m a social worker and I actually have such a case right now. We have not yet removed the children, but the mom and the kids are severely obese. She has been giving them Mountain Dew since they were off formula and all of their teeth are rotting. They only eat fast food. There are other issues as well, such as severe hygiene problems. Theres a lot more details that I”m leaving out, but basically it boils down to physical and medical neglect. One of the children does in fact have serious health issues. I think a blanket statement about removing obese kids is excessive, but there are, for sure, instances where the parents behavior is very harmful to the children. In this case, all three kids will need crowns by age 9…the 3 year old’s teeth are ALL rotten. Its bad…
Robin says:
and before you know it the system would be full of “fat kids” that cant get placement/ foster homes. There are enough kids in the system that cant get adopted, lets not add to it. Yes I agree something does need to be does about young children who are overly over weight, but taking them away from their homes is probably not the best solution.
Maybe our awesome president will offer free Lapbands to all children who are is the 99% for being obese?? Yeah, I wont hold my breath either.
Melissa says:
Did you even bother reading the article in question?
The article is talking about children who consume more than 1000 excess calories per day, every day; children who are not only in the 99% for weight but who are also at immediate risk of life-threatening complications, organ failure or even death – and not even most of those children, only for the very, very, very few who whose cases are so severe that other, less invasive interventions haven’t helped, where bariatric surgeries ARE just about the only other option. At least at the end of a temporary foster family intervention, the child would be able to be reunited with his family, unlike irreversable medical procedures.
The article in whole urges caution and other less invasive interventions BEFORE removal from the home is considered. It doesn’t say “If you see a super fat kid, it should be taken from its parents.”
Also, this was written by a medical professional, not by the President or anyone associated with him. Maybe you should read before you decide to sensationalize?
Vica says:
It’s such an interesting subject. And I agree with most people that a case by case basis is best. I think mandatory education is a great start and checking in to ensure people know what is good food to feed their children. But I do feel you will have those parents that don’t care and will feed their children complete crap regardless. Maybe taking them from the bad environment is best. It’s sad!
Kris says:
Just wondering who is going to foot the bill for involuntarily taking the kids away from their parents.
Also wondering what age this would go into effect. I know that for fairly young kids, BMI is pretty worthless, as a 1/4-1/2″ in height can make a kid go from overweight to healthy for BMI. Also, there could be a child whose height and weights are both 99th percentile because they are just big (note I also said height) and their BMI will come out high because they are bigger than their peers…but proportionate.
Dena says:
I’m an elementary teacher and I once had a student who weighed 400 lbs by the end of 2nd grade. The mother fed him sugar and fast food about every 2 hours. She would bring him snacks to school. The state offered her services which included a dietitian and a personal trainer.
The trainer reported that she would bring him to workouts with a bad of McDonald’s food and shakes (not just one). He was so big by the end of the year that he had to sleep sitting up and couldn’t take care of his personal hygiene.
The state would not remove him because no physician would testify that there was 100% NOT a medical cause for his size. He is 21 now and does nothing but sit on his couch all day. His life has been robbed from him because his mother wanted to keep him from ever leaving her. It worked.
Mommy says:
Yikes, that is awful. How terribly sad for both of them.
Allison says:
Interesting blog post. Like you, I was overweight as a child (and a young adult, am working on not being an overweight adult but it’s taking time). My kids’ nutrition is important to me, and I worry a lot about instilling bad habits in them that will lead them down the road to being overweight/unhealthy. It’s hard to imagine parents out there who don’t worry about the same thing, but I guess they do exist. Even so, though, I don’t support taking children away from their parents if they are morbidly obese. It would be too traumatic and stressful for that child, when instead they should be focusing their energy on learning new habits (with their parents’ help!).
It is cheaper and easier to eat unhealthy foods, as another commenter pointed out. There is a lot our government could be doing first to make healthy eating more accessible to everyone, to make it more of a focus in schools (both the food provided there and the curriculum), and for those extreme cases, some intensive behavioral inteverentions that would help the entire family in their familiar environment – their HOMES. Taking a child away is the quick fix with lots of long term, potentially very negative, ramifications.
Cadakeke says:
So, I tried to make it through all of the comments to see if there was something I could respond to. Something I could chime in with, and I just couldn’t. I am going to try and give a little bit of “other side” perspective here.
Firstly, part of the issue here is using the BMI to interpret health. The BMI scale was not created to be used as a health scale, and is severely flawed. (http://themiddlemanager.wordpress.com/2006/12/05/quick-hit-the-problem-with-bmi/)
Secondly, obesity does not necessarily result in all of the health problems that we are told it does. The diet industry is HUGE and very good at controlling what information the public receives.
Thirdly, as an obese parent of an underweight child, where does this end? I live in fear of the day that someone accuses me of starving my child in order to eat more myself. (For the record, my son eats like no tomorrow, and I do not. We just have vastly different bodies.)
The following link includes a lot of information, and hopefully will help enlighten someone, anyone!
http://www.bodylovewellness.com/2010/06/30/just-so-were-clear-some-fat-facts/
Christine says:
YAY! I just wrote a giant angry comment about this too. Thank you! I wish the public at large were not so ignorant.
Nicole says:
Well said!!!
Beth says:
I’m pretty sure that in the cases we’re talking about, the scientific complexities inherent in the BMI are moot. I work at a pediatric obesity program so I’m aware of the issues. But we’re not talking about taking kids who, “oh, whoops, thought you were overweight but I just re-checked your height and you’re fine. Back to your parents!” Or even kids who are “just” obese.
We’re talking kids who don’t know what it’s like to play tag because they have NEVER in their lives been able to run. Kids who gasp for air just sitting. Kids who can’t put on their own shoes, or wipe their own butts. Kids who are unquestionably physically suffering and who are at immediate risk of staph infection, cardiac arrest, diabetes, and respiratory distress.
I understand the slippery slope concern, but I think this doctor, and the people in the industry, are just trying to save a few individual lives.
The kids we’re talking about are not living anything approaching a normal life and it can be really hard to watch. Fortunately, these kids are few and far between, even at an obesity program.
sara says:
I think the other issue is that WHERE would these children be placed? The foster care system is already enormously overburdened, and while there are many wonderful foster parents, there are plenty of other situations where children can become subject to abuse or molestation. Given that, it seems totally unacceptable to be taking kids away from their parents for something like weight – which, I agree with you – could be caused by a variety of things, including but not limited to choices completely in the parents’ control.
Melissa says:
Your blogs are always thought provoking mike. I enjoy them.
PS your dad was a silver fox
Mommy says:
LOL about the silver fox comment!!! Totally! You and Heather both have beautiful parents, no wonder you guys and your daughters are so good-looking!!
Christine says:
No, a child should never, ever, ever be taken away from his or her family I don’t care if she or he is the fattest child on the planet earth and got that way from being fed three cakes a day.
First of all, until the government can find a way to make people lose weight (most people do gain it back right away, and people who “keep it off” are the anomalies), then no one is to say what the cause of a person’s “obesity” is. Second, so much of this is classist. The fattest people in the fattest states are generally also poor. You know what else poor people suffer from? A lack of healthcare and more diabetes and stress related disease than their health care provided, wealthier counterparts. There is absolutely no proof that obesity causes diabetes, etc. What has been shown is a correlation between the two, but also poverty, and areas where there are limited food choices, etc. down the line. So what the government wants the fats to do is stop being fat, because it is gross, because it is easy to blame a person who has no “will” BUT it is hard to go back and say, “Hey, this neighborhood doesn’t have any grocery stores that stock fresh foods in a few miles,” which is a lot if people don’t have access to cars or reliable transportation, or is physically unable to drag a granny cart onto the bus, through city streets to home; and then to do something about it.
And last? Dude, the foster care system is BROKEN. States are bankrupt. Why would I ever want to take a child from a home where they are not being abused because I arbitrarily decided this child is too fat? Why in the world would I trust the government to do this? There is a reason why I can buy a meal at McDonald’s for 5 bucks, but can’t buy two pounds of apples for the same amount of money, and that is government subsidies. So yeah, the government causes the alleged problem (because I don’t think it is as much as people would shout from the rooftops) of obesity, and then they have the balls to say, “Gee you and your kid are fat! Let’s take away Jr.” BAh.
I’ll give you a link, because Lesley is my Fat Guru, and frankly, is just a better writer than I can ever aspire to be. http://blog.twowholecakes.com/2011/07/real-quick-still-more-punishment-for-fat-children/
So if you’re asking, yeah the answer is NO. Will always be NO.
Deirdre says:
While I do agree with other commenters that excessively feeding your child into obesity is paramount to child abuse and that in*theory* removal might be the answer, the question is where do you remove them to? The foster care system is not a good option as you mention. But I also find it ironic that the government is so worried about the obesity problem and has yet to figure out that they are part of the problem. I’m all for personal accountability– that you are responsible for what you eat, or what you feed your kids. However, government subsidies are part of what has made fast food such a powerhouse and as cheap as it is. If the government really wanted to help, they should stop subsidizing corn and start helping farmers discount fresh fruits, veggies and free range meats.
lucy says:
Isn’t Annie in the 99th percentile?
Mike says:
No, Annie is in 95-99 percentile for weight at her age, not BMI. She’s in proportion because she’s also 90-95% for height, so her BMI is probably in the average-ish range.
Angelique says:
You’d be surprised at how high a kid’s bmi can be, even when they look proportioned. I don’t like to use bmi. I prefer waist to height ratios.
Rachel says:
she also pretty much JUST started walking, and is in still in diapers, i.e. a baby. i’m pretty sure this article refers to kids who are at least a little bit older.
Kate says:
I just want to say that the picture of you, with the dinosaur shirt on, my brother and I had the pillowcases with those sports dinosaurs on them!!! We were just talking about them over the weekend. That cracks me up. Chubby or not Mike, you have a great sense of style.
Mike says:
Ha! Thanks! At the time I LOVED that shirt. It is kind of cute for a kid, huh?
Fostermom says:
As a fosterparent with the state of California for 30 years, I am 100% positive that no obese child in this state will be removed from their home. The goal for this state is to reunify families, even when the child is being returned towhat most of us would consider an extremely marginal home situation. This state cannot afford to provide fostercare for extremely needy kids in unsafe homes, let alone those who don’t understand the need for good nutrition and exercise, assuming they can afford good nutrition. In my observations, many foster homes (because of the need to make the child comfortable as well as economics) tend to serve very kid-friendly food which aren’t known for being calorie conscious. Counseling and education are the appropriate responses to this issues, IMHO.
Nicole says:
Seconding Christine’s recommendation of Lesley’s blog entry on the topic:
http://blog.twowholecakes.com/2011/07/real-quick-still-more-punishment-for-fat-children/
Fat is not a behavior. Yes, there are behaviors that MAY make a person become fat, but fatness is most strongly correlated with genetics. Weight is about 80 percent heritable, the same as height. Studies have shown that many fat kids actually eat LESS than normal-weight kids and are no less active. Are there exceptions? OF COURSE! But until we start talking about taking kids away from ALL parents who feed their kids crap and let them watch TV, I don’t want to hear about how fat kids are the problem.
To reiterate: FAT is not a behavior and cannot therefore be addressed in such a simplistic way. We should all be standing up for the rights of ALL kids (fat, thin and in between) to eat good, nutritious food and get outside and play. Those are behaviors, and we can all shoot for that.
Mommy says:
Yes, this!!!
Katy says:
I am a clinical psychology student and a “behavioral specialist” at a multidisciplinary weight loss clinic for kids who are obese. Additionally, I also work with kids with Type 2 Diabetes and have seen the scarily high statistics on the increase. As I just spent all of last night there, this post got me fired up! Obesity is such a tough issue right now. Part of the qualifications to be in the study I work at are 99th percentile for BMI. What a lot of people don’t understand is that the 99th percentile for BMI is not what you see on “Half Ton Mom” or “1000 pound man” but actually is fairly common in this day and age and a huge proportion of kids fall into this group (I think over 5% of kids are severely obese and 20% obese). Sadly, this is not a small proportion of the population. I love the set-up of our program and it is extremely rewarding to see a family who used to eat McDonalds EVERY night for dinner (no I am not exaggerating) learning to cook on their own and a kid who has never exercised running a mile. I have had a lot of kids who have had great success stories but most have not. Sadly, the statistics on multidisciplinary programs like this (with nutritionists, behavioral specialists, physicians, exercise physiologists) are still VERY low in their success rate across the country. But the reason why they are low is not just the parents, but the environment. The majority of families who are in my study are struggling financially. The kids are eating government-approved extra large cinnamon rolls for breakfast and cheeseburgers for lunch. And this is not me reeling off stats from obesity talks but seeing kid after kid after kid telling me the same exact thing. They are literally going to McDonalds for every meal because they think its cheaper. Although I think programs like ours are helpful to teach them to make healthier choices the whole country is surrounded by fast food/processed foods! The first step in tackling the obesity problem is changing how our nation looks at food. Specifically, those awful school lunches!!!
And as far as the solution to take the kids out of their home? I would would wholeheartedly say no. As a future pediatric psychologist, the only thing worse than a child being dangerously overweight is a child being dangerously overweight and being traumatically taken away from their homes. I have actually seen cases of children with diabetes and obesity who were taken out of their homes because they were eating poorly and were having really high blood sugars which could lead to serious medical complications and death. In that case I see the acute need to do that…but it should definitely be a last case scenario.
Wish I had a quick fix and an easy answer…all I know is I am going to keep working hard to make a difference in my little sliver of the world!
Melissa says:
I have to add that the article in question actually discourages children being taken from their homes, and says that it should be a last case scenario. It says almost exactly what you say here:
“which could lead to serious medical complications and death. In that case I see the acute need to do that…but it should definitely be a last case scenario.”
Mommy says:
I’m not sure how I feel about this- on one hand, allowing a 3 year old to get to 150 pounds IS a form of child abuse, in my opinion, because of the health issues that come with it. On the other hand, where do we draw the line? What about babies? Should they be taken away from their parents when they are in the 99% percentile for weight? Of course not! I know LOTS of chubilicious babies that grew up to be perfectly average kids/adults.
I think that when dealing with weight, only looking at one number (BMI or actual pounds) is not looking at the individual child closely enough. Height and muscle to fat ratio should be considered as well. For example, for a child that is high in the percentiles for height AND weight isn’t necessarily going to be a “fat kid”. Similarly, an athlete can have a higher weight than his/her peers because of having more muscle.
I am a fifth grade teacher, and in PE the kids are weighed and their BMI is calculated. This formula does use their height, but muscle mass is not taken into account. So some of my “fittest” students (the ones that play basketball or football, and are very tall/big for their age but NOT at all fat) got a BMI that was “too high” according to the state, so they got letters home saying that they were not meeting the state standards in physical education in this area. Way to encourage eating disorders, California!
The other thing is that many kids go through a chubby stage that they grow out of when they have a growth spurt. So should these parents put their kids on diets or be threatened with their kids being removed from the home? I know you said the proposed legislation would only be in extreme situations, rather than just a kid who was a little bit chubby, but still. I think passing such a thing might be leading us down a dangerous path.
One last thing to consider- when most people see an overweight child, they scrutinize every little thing that they eat/ everything that their parents provide them. The very same food in a “skinny” child is just no big deal. I see it all the time at school. There will be a birthday celebration and someone will bring cupcakes. When a chubby child asks for seconds, the parents (and sometimes teachers) will exchange looks, roll their eyes or even make a comment like, “I don’t think YOU need another cupcake, honey.” Yet a few minutes later, if a much thinner child asks for another cupcake, they get it. This hardly seems fair or right, nor is it a message I want to send my students or children. I am all for teaching healthy eating practices, but I think the message needs to be that we ALL should eat healthy, regardless of our weight. In that cupcake example, I feel like if the rule was going to be “No seconds”, it needed to be so for everyone, not just the husky kids. Furthermore, those adults were assuming that the smaller child was the healthy one and should be allowed to splurge, when everyone knows a “skinny” child or adult can still be unhealthy! In your story, you mentioned your mom taking you to McDonald’s as a kid, and you mentioned she had her own issues with weight. Did your dad ever take you there or allow you to eat unhealthy food? Probably. But because I am assuming he didn’t have the same issues with food, was it is as big of a deal? The same would probably be true if you weren’t (as you say) a “fat kid” (which, btw, you weren’t! Just a little chubby!)- you probably wouldn’t even have thought the fast food was an issue at all. I think we are all guilty of it. You see an average size kid getting ice cream with his mom, and you think it’s cute. But if a chubby kid is doing the same with his chubby mom, tsk, tsk…. She is making him fat and being such an unhealthy example.
I know I am rambling here. I just don’t know what to think about this idea of taking kids away from their parents because they are overweight. Yes, in very extreme cases, after other interventions have been made, something needs to be done. But I also think we need to be careful how much we are willing to let other people parent our children…. it’s a slippery slope, and we don’t want to get to the point where kids are being taken away because their parents let them watch too much tv, or play too many video games, because that is bad for their health and could lead to obesity, right?
Katie (Overflowing Brain) says:
This is a topic kind of near and dear to me.
I did a clinical affiliation at a pediatrics hospital in March and one of our patients was a 6 year old boy who was admitted to the hospital with respiratory compromise secondary to extreme obesity. This 6 year old weighed 160 pounds. He required a tracheostomy tube to breathe, had severe sleep apnea and type II diabetes. At age 6.
He was seen by us 2x a day for exercise and somehow just wasn’t losing weight. They ran tests and scans and did bloodwork and could not figure out how he wasn’t losing weight. And then they asked his parents to not visit for a few days and he dropped 12 pounds. His parents were sneaking him food, even while he was in the hospital because of his weight.
Department of Children and Families eventually removed him from his parents custody for good because they were killing their son. And in the next few weeks he dropped another 30 pounds. Eventually he was discharged to a foster family, hopefully for the long haul.
I don’t think that every chubby kid needs to be taken from their families, but I’ve gotten to see first hand a situation where it was the only thing that would save a young boy’s life.
Melissa says:
Mike, I’m disappointed. From what you’ve written, I get the impression that you didn’t read the article, and you’re contributing to the sensationalist nature of the story.
The article states that children should NOT be taken from their homes except in the most extreme cases; not just kids who are in the 99th percentile, but who are at IMMEDIATE risk for life threatening complications. These are kids for whom the only other option being looked at is pediatric bariatric surgery (irreversible) so the article states that in those cases, temporary removal from the home may be preferable. It states that, with this alternative (reversible) option, irreversible surgery may indeed be unethical. Also, it states that this is not appropriate for most of those kids and that the government should use less intrusive options whenever possible.
It also states that the government should look at social infrastructure changes to reduce childhood obesity, like ways to improve diet and increase physical activity.
It’s not an article that says, in any way, that fat kids should be taken from their parents. Sensationalization makes for fun reading, but it’s inaccurate and alarming for those who read only the sensationalist articles and not the original work of scholarship.
Mike says:
Wow. How did you get that I didn’t read the article? I said that children only in the most extreme cases ( I even underlined extreme for emphasis) should be taken. I also mentioned less intrusive options like training and therapy for the kids and parents. If you read my post again I think you will see this wasn’t sensationalist.
Jennifer says:
I love your thought-provoking posts, lately, Mike! I really enjoy reading the comments, too. Overall, I cannot agree that taking kids away from their parents for obesity would be a good thing. The psychological trauma this could create may be just as harmful as the obesity, and could very well make a bad situation even worse. Also, the stories about kids in foster care are simply appalling. The foster care system is something to avoided, we can’t voluntarily add kids to that mess. There’s a few other things to be said, but my toddler is whining so off I go.
Becca_Masters says:
here in the UK labelling children as “fat” caused quite a stir. Kids at school had their height and weight checked and BMI recorded. A fair few children had letters sent home saying their children were morbidly obese. These kids were between 5 and 7, and to look at them there is no way in this world you would call them obese. Stories like this appeared in National newspapers every few days (however I can’t actually track any links down right now)
If the UK changed laws to have “obese” kids removed from their parents, it would be ridiculous. I think the figures were that nearly 50% of children were classed as obese due to their BMI recordings.
One thing to remember is that Children are still growing. Personally I don’t take any notice of the BMI until someone has finished growing. Obviously if I had a child who was clearly obese (rather than one who clincally matched the BMI description of obese) then I would start to think of what I can do to combat it, on the flipside of that I firmly believe in healthy nutrious (and proportioned) meals and would carefully ensure my child didn’t overeat or eat all the wrong things. Bearing in mind that obviously not all parents think like me, and everyone parents there kids differently.
Here in the UK I sometimes cringe at what parents feed their children. They go to McDonals for breakfast. Have fries for lunch and for dinner have pizza or burgers.
I think you would have to be very careful with taking someones kids away from them just for being “fat”. You would need an entire case study first, and I believe that no child should be removed from a parent unless they are endangered. I think more education is needed for parents and children who eat unhealthily and are very over weight. Just taking the kids away won’t solve the problems, as there are lots of factors involved.
For example, you have a 9 year old, who’s parents tried for years to have a child and said 9 year old is born and will end up to being their only child. The parent (not in most cases) may spoil the child, with constant sweets, treats, games consoles, and the child eventually becomes over weight. Can you imagine just removing this child from his/her parents because the parents loved their kid so much they were blindsighted? Imagine the heartbreak of having your only child removed from your custody. Imagine the fright of the child being pulled away from his/her parents and placed into care with strangers. I don’t think it’s right, and personally believe each case should be looked on individually.
Parents and children should be educated, by doctors, schools, etc.
I am babbling now….
my point is that education should be first and foremost the route to take and it should be clearly thoughtout before kids are removed from their parents for being “fat”
Becca_Masters says:
to point out, I don’t have any children (yet) but have worked and been surrounded by children my entire life.
Also I’ve not read the entire article in full, so some of my points may be moot.
Carrisa says:
Taking them from their families isn’t the answer. It’s too traumatic and could only make things worse. Besides, who gets to take on all the fat kids? It’s not as though there would be some Biggest Loser Foster Home they would go to where treatment, exercise, and healthy food was made available. No, they would probably just go to a foster home where they might be subject to abuse, more malnutrition, or neglect.
I’m an obese person myself. I’ve been overweight since I was 8 years old. Since becoming an adult and moving out of mom and dad’s, I’ve only gotten bigger.
We can say I’m fat and lazy. We can say it’s a food addiction. We can say I’m depressed and eat my feelings. Or all of the above.
I can tell you though, that it’s one of the hardest things to overcome. I don’t know if I’ll ever beat my food addiction. I do know though, that as long as I’m living paycheck to paycheck and bad for you food is half the cost or less of healthy food, it’s highly unlikely that my habits will change.
My biggest fear in life is that I won’t be able to get my body healthy enough to have a child before my child bearing years are over.
Mike says:
Thanks for your brave comment, Carrisa. I was actually coming back to respond to a couple earlier commenters who brought up the issue of inequality of food costs, and how that affects different social classes in a really messed up way. I wanted to put that in my post, but i wasn’t sure how to do it in a relevant, meaningful way, so I’m thankful you and the earlier commentors brought this to people’s attention.
Christine says:
Hi Carissa! I just wanted to say that it’s awesome that you spoke to this as someone who is “obese”. I don’t know anything about you, or why you think you can’t have children, or your health or NADA, but I hope that whatever you’re doing your medical professionals are on your side. A girlfriend of mine was told about two years ago that she was infertile because she was overweight (obese, whatever), but she was pregnant two months later without intervention and went on to have a complication free delivery.
Best wishes to you!
Christine
Christine says:
OH, if I didn’t make it clear, I thought her doctor was a tool, as he had seen my friend once, hadn’t run any tests yet, just saw fat and made a prognosis, which is a bunch of BS. She wasn’t infertile at all. If any of your healthcare professionals makes you feel badly about your size, you let them know that actually they work for you, and then find someone else.
Christina says:
I was the fat kid too and your post brought back those old feelings… I felt sick for you. It truly is a horrible experience for a child. I have experienced meanness that I would not repeat or shed on any other person, ever. I will say this, though… my natural defense mechanisms kicked in and I learned to let things just roll off my back pretty easily AND I learned to love other things about myself. I have more self confidence today than a lot of thinner and more beautiful women do because I learned firsthand that you can be told that you are worthless right to your face and you know what? It doesn’t change the FACT that you are not. The world keeps on spinning and they live their small, ugly little lives and I can choose to make mine something “more.” Some women just boggle my mind… they’re gorgeous but worry about a little cellulite on the back of their thighs and FREAK OUT! I’ve lived through being dismissed because of your looks… it isn’t the end of the world!
Anyway… looking back at my childhood, it is partially my parents fault that I was overweight. My dad was overweight and it was his personal goal that I was just like him so I ate everything he ate (ice cream and candy and fried foods) and hated everything he hated (veggies). He really did take pride in us being alike and kind of forced the issue. It made him feel bonded. I watched him do this many years later with my nephews. My mom ate like crap too and still does but she and my sister and my grandma have some kind of crazy metabolism. They eat horribly, never work out, and weigh 100 pounds. I’m adopted so I didn’t get those genes. My point in sharing this is that it wasn’t necessarily neglect that led to me being overweight. It was the way my parents showed they loved me. It was the way they bonded with me. And my mother will tell you to this day that she didn’t want to pressure me to lose weight because she figured it would just make matters worse. MAYBE she could have done something that would have been the perfect mix between staying out of it and pressuring me… but what parent always knows the perfect thing to do?
In relating that to the parents of the seriously morbidly obese children with life-threatening conditions (I was not in that category, thank goodness) I tend to believe that this is not abuse and neglect in the same way that physical, psychological or even malnourishment abuse is. You have to take intent into account. These parents are likely trying to provide for one aspect of their childrens’ well-being such as their happiness (candy brings smiles) or even preserving childhood in some sort of Willy Wonka fantasy way where you get everything you want because “that’s the way childhood should be” (my parents think this… my 40-something sister can do nothing for herself as a result). I think that this type of “neglect” can be related to the parent who showers his/her child with too much of anything… so much safety that the child ends up incapacitated with fear and has no common sense whatsoever, so much cleanliness that the kid becomes a germ-o-phobe and has no immune system. However, this does remind me of parents who smoke even though their children have crippling asthma (I know of 2 people in this situation). Is that abuse? Maybe. I have trouble coming to the conclusion that these children should be taken away, though. I work in education so I tend to see how all roads can lead back to that. If most parents knew better, they would do better. Some parents are seriously damaged, mentally ill, or otherwise unable to raise a child. I just don’t think that is most of these cases we’re talking about. I think the education system has failed to teach these parents about nutrition when they were in school. And why don’t we pair family planning and child rearing in with sex ed in high school? I’m not talking about indoctrination, just sharing some best practices… cover it for a week. I’m sure some parents would go nuts over that but there isn’t anything some parents won’t go nuts over anymore.
Kate says:
I’ve read a lot of the comments and agree with about 99% of what others have already said: removal from homes being a last-ditch response, the broken nature of the foster care system, the problem with using BMI as a standard, et cetera. I just would like to add two points.
The first is anecdotal, admittedly, but is this: I’ve always been a big girl. Not purely fat, but big. I’m five-nine and built like a linebacker. My skeleton probably weighs more than my petite mother. When I was a child, though, I got a lot of comments, not just from other children but from teachers and school administrators. In fifth grade, my gym teacher sat me and my parents down and informed us all that I was “morbidly obese”, would have diabetes before I was out of high school, that my body couldn’t support my weight, and that she wanted me to start walking two miles every day in order to combat this. I was 12 years old.
My parents stressed and fretted and called doctors and nutritionists. They worried and started coming up with “plans”. They denied me desserts that my siblings got, dragged me away from having ice cream with my softball team, made scenes at restaurants when I ordered soda instead of water. In short, my life became a living hell for the year where my parents really tried to take her advice (short of making me walk two miles a day, since they weren’t comfortable with me going out and wandering the neighborhood for that long). But guess what? I never developed any of the illnesses she’d promised. When I saw the teacher again five years later, she complimented me on how good I looked – even though I’d done nothing to change my habits! And while I’m still a big girl, I also don’t get nearly as winded on stairs as my mother – who is a totally “normal” weight.
Being heavy is already stigmatized in this society – at all ages – without adding to it. To stigmatize the parents as well as the young people and make it even a more harrowing for everyone involved isn’t going to help the problem of weight in this country. More likely, it’s going to encourage parents to put a lot of pressure on their children and lay the foundation for even worse habits (such as my sister, who hoarded food in her youth and to this day is a compulsive overeater – all in response to how big of a deal food became in our house thanks to my jerk gym teacher). That’s not really a good solution to the problem.
And the other thing, and one that wasn’t really talked about too much above, is this: a program like this is most likely to effect lower-income families. Healthy food is expensive. Home-cooked meals take time and effort to prepare. It’s often cheaper and easier to run out to McDonald’s or buy a bunch of pre-packaged food than it is to cook chicken with veggies and rice. This is especially true when you have parents working two jobs, or graveyard shift, or just struggling to make ends meet. Even with government aid, you can’t buy nearly enough to feed a family in a healthy way, and which would you rather do: feed all your kids regularly but unhealthily, or feed them well for two weeks and then not at all for the other two? It’s incredibly difficult to balance the two and fresh, healthy foods are almost cost-prohibitive in their expense. Parents who don’t have the money for healthy food will be punished – even though they’d never do that to their child on purpose.
irene says:
“Home-cooked meals take time and effort to prepare.” are you kidding?! If you are too busy to prepare a meal, go to the grocery store and get an already cooked chicken for under $6.00, add a head of lettuce for a salad and a vegetable and it comes to under $10.00, still cheaper than takeout. You can make your meals ahead of time and freeze them if you are too “stressed” to cook.. Rachel Ray has a tv show on making an inexpensive healthy meals in 30 minutes, don’t we all have that much time to give our family. I think we all need to sit down and evaluate what is important here, we have a responsibility as parents to give our kids good healthy meals and not something cheap, convenient and full of crap every single day.
Mom again says:
Considering how poorly the county/state manages to care for kids separated from their parents because of the parents’ addictions/cruelty/criminality/neglect, I doubt actual useful sevices would be provided to these kids or their families. Besides, if health and weight improving assistance is to be offered or required, wouldn’t it be better to assist the whole family at once?
VDog says:
Love you, Mike. You have such a good soul.
Sarah the Bear says:
There are totally cases where kids need to be taken away. Not to be crass, but people who think that it’s worse to be malnourished than overfed as a kid can wrap that notion in sandpaper and stick it someplace uncomfortable. It’s sadder to see a skeletal five year old being taken out of a crack den than to see a round, red-faced one pushing spaghetti-o’s into her pie hole, but that doesn’t mean that the second scenario is any less awful. Aside from the myriad health risks that accompany super obesity, there are the social risks. Say what you will, but primates are social animals and our need to be a part of the group is important. We can’t do that if we’re ostracized because our fat rolls are growing stinky mold (look it up dude, it freaking happens). If a parent can’t be trusted to raise a healthy, socially acceptable, potentially successful child, then SOMEBODY ought to get in there and do something about it. I don’t care if it hurts a parent’s feelings, I don’t care that nobody’s supposed to judge anybody else’s parenting style, I don’t care that moms are supposed to know best: sometimes parents screw it up, and there is no reason that the kid should have to bear that burden. Remove her, get her healthy, teach her that bike rides and soccer are most awesome, that cookies should be enjoyed only once-in-a-while, and that she is fantastic. In the meantime, get a social worker into the house to train and monitor the parents. It’s nothing short of negligence, and I would argue for abuse, for a parent to allow a child to become obese. If they can’t make life work, then value that child enough to make life work for her.
Amy says:
While I don’t believe a ‘fat kid’ should be taken from the home I do think the child(and family) should be privy to some therapy. Why is child so obese and if the family is willing to do the work and support the child then so be it. If not?
I would really have to question the family and seek out more therapy.
Kim says:
BMI is a dangerous tool sometimes and definitely doesn’t tell the whole story.
I was skinny-ish as a child. Perfectly normal weight for my height. But I’ve always weighed more than I looked. I’m 5′ 8″ and solidly built, even at a normal, healthy weight. I have to work hard at treading water. But BMI has always said I was overweight.
Doctors have to stop depending on the BMI as the be all, end all.
Amanda says:
BMI isn’t necessarily reliable for adults because of muscle mass and other factors. But BMI for kids are pretty accurate.
99th percentile is deadly. Literally. I’m an Exercise Biology/Human Development double major (5th year so I’ve been around the subject for awhile now). Obesity is a big topic in EXB and obesity in childhood is a big topic in HDE. It is SO sad that parents allow or even help set their kids on a path to disease and debilitation that is very difficult to get off. Taking them out of the situation is the best for the kids and may help their parents move towards better health.
Angelique says:
My 4 year old son has a muscular build, so I would disagree with your statement above. He rides a 2 wheeler w/o training wheels 1 mile to the beach up hills andyou can see his calf muscles bulging. Why wouldn’t some children have more muscle than others?
Amanda says:
That’s true. I should have said “more reliable” because the difference of musculature is less pronounced between children as opposed to adults. Though there is a difference! My sister is skinny as a stick, but built from swimming & water polo since middle school. Her BMI isn’t indicative of health. Granted the kids they are talking about are 99th percentile and obviously obese. A BMI isn’t going to take a healthy, muscular child away from their parents.
Angelique says:
Nutritionist Ellyn Satter has some great insight into this topic. Her book “Your Child’s Weight: Helping without Harming” is a must-read for anyone with kids.
edenland says:
Want to stab the douche in the eye who wrote “Fat kid” on that bit of paper.
Well, as far as my friend Woogs and I are concerned, you’re goddamn hot now.
Tabitha says:
I am the parent of a three year old who is in the 79th percentile for height and 95th for weight, I could not disagree more with the idea of taking children away from their parents. We had a doctor’s visit where one nurse said my son is overweight and needs to be more active and another nurse said he’s too active and we need to have him tested for ADHD. Yes, his weight is up there in the percentile, but he eats healthily and never stops moving. He’s not a fat kid, he’s a solid, strong child with a great deal of muscle mass. I was looked down upon by one nurse for his “lack” of activity and the other for him being too active. Give me a break. If the child is riddled with health problems due to weight, the parents need to be educated, but if the parent is trying, the child is still overweight, but is otherwise healthy, leave them alone. I realize people are advocating taking the children away only in extreme situations, but who gets to decide that? My son may be overweight on paper, but anyone who spends more than the 5 minutes the doctors spend with him knows that it’s not an eating or an activity problem. The whole idea frustrates the heck out of me. There are parents who don’t care about their children’s health, but it would not be those people who would suffer from something like having their children taken away, it would be the parents who do their best, but cannot make the doctors happy.
Julia Janzen says:
As a former therapist I can tell you that taking a child away from their parents is a devastating thing and better be a last resort. Children in the foster care system are twice as likely to suffer from PTSD as combat veterans and most foster homes aren’t treatment based. They could NOT possibly deal with a child with eating disorder issues. In fact I can confidently say that the damage from removing these children places their health at greater risk than allowing them to remain in most cases. Now if they were hospitalized and treated maybe that would be helpful. There truly is no easy answer.
I wonder though…. if you equate food to crack then shouldn’t unhealthy food be illegal too? Are McDonalds, Carls Jr., Baskin Robbins, Wendys, Taco Bell, etc. legal crack houses? Is Frito Lay a food cartel?
Maybe we should also remove children with parents that smoke?
Is obesity an issue in our society ABSOLUTELY but are parents exclusively responsible? I say no. We all are. Including the FDA that says that genetically modifying our food is acceptable and that high fructose corn syrup is ok, and partially hydrogenated foods are safe. Look at the foods that are served in school lunchrooms that the USDA says are healthful meals for our kids. This issue is far more complicated and removing kids from their parents is not the only solution. It’s just the easiest for a researcher to come up with.
Ray says:
Former chubby kid/over-weight adult now:
I agree that taking an extremely obese child away from their family can be highly traumatic. And, I think it would do more bad than good. Rather, I think, the parents should be taught healthy-eating habits (like you suggested), and a weight-loss progam should be started immediately. There should also be a social worker involved. Making sure that there is weight-less, and not more dangerous weight-gain. If this does not work…? Then and only then should the child be taken away. Only the worst case scenario.
Taking away a child from their home is not a joke. And it should be taken seriously.