Should morbidly obese children be taken from their parents? That's the question an increasing number of countries are grappling with amid the Western world's obesity epidemic.
The latest case to make headlines concerns a Scottish couple who lost custody of two of their six children on the basis of what was, their lawyer claims, a failure to reduce the kids' weight following warnings from Scottish social services. The couple lost their Oct. 14 appeal in a case that is far from clear-cut representatives of Dundee City say they would never remove children "just because of a weight issue." But obesity appears to be the primary reason South Carolina mom Jerri Gray lost custody of her 14-year-old, 555-lb. son in May. She was arrested after missing a court date to examine whether she should retain custody after doctors had expressed concern about her son's weight to social services. The boy is currently living with his aunt, and his mother is facing criminal child-neglect charges.
Several other cases in recent years in California, New Mexico, Texas and New York, as well as Canada have garnered attention because a child's obesity resulted in loss of custody. "It's happening more than the public is aware of, but because these cases are usually kept quiet [as a result of child-privacy laws], we have no record," says Dr. Matt Capehorn, who sits on the board of the U.K.'s National Obesity Forum. The issue of whether parents should lose custody of their obese children took center stage two years ago with a British television documentary about Connor McCreaddie, an 8-year-old who weighed more than 200 lbs. and was at risk of being taken from his mother by authorities. She eventually weaned him off processed foods and retained custody.
Removing children from their parents remains a last resort, but obesity experts are increasingly debating whether doing so can boost a child's chances for a healthier life. Childhood obesity can lead to a host of health problems, including Type 2 diabetes, which until recently was primarily a problem seen in adults. Overweight children can also develop insulin resistance, hypertension, high cholesterol, sleep apnea and orthopedic problems and go into early puberty. "Children are vulnerable. If they're given food and told to finish what's on the plate, they'll eat it, and without exercise get bigger and bigger," says Tam Fry, chairman of Britain's Child Growth Foundation, who is lobbying obesity experts to consider overnutrition a form of child abuse.
Yet the parents' share of responsibility in weight gain isn't always easy to judge. "It's unfair to blame solely the parents, when there's a myriad of other factors influencing a child's weight," says Dr. Dana Rofey of the University of Pittsburgh, whose weight-management clinic is regularly called on during custody battles in which one divorced parent blames the other for making a child obese. She says contributing factors include not just genetic predisposition and socioeconomic status but also environmental factors, like whether children have access to parks and playgrounds. Rofey also sees children of all ages sneaking extra food behind their parents' backs.
And then there's the issue of parents, sometimes obese themselves, who can be in denial of their children's weight problems. When parents refuse to address the issue, Fry wants kids to be put in the care of professionals with the provision that parents may visit and that steps are taken to alter the family's diet so the child may eventually return to a healthier home. Last year, Fry introduced a motion to that effect at the U.K.'s National Obesity Forum conference but could convince just one-third of the delegates to support it. "I knew that I was running against the tide, but I'm seeing others slowly but surely coming around," he says.
During the 20 years Dr. Melinda Sothern has been working with obese children, the Louisiana-based exercise physiologist and author of Trim Kids has seen only about a dozen removed from their homes. But in recent years, she's noticed a real change in attitude. "I've seen less and less willingness on the professional side to understand how hard it is on the parents' side, especially from younger professionals," she says. "[Child protection] laws have changed, so a lot of times they worry that if they don't report parents, they'll get in trouble."
Dr. Sothern also notes how difficult it is for many of her patients to shed weight, including one boy whom social workers recently considered removing from his home. "They were saying, 'This mother must be feeding him to death. We need to remove him.' I said, 'Guys, before you do that, we need to look at more options he's obese, but he's fit, enrolled in sports. He can run. His breathing has improved.' "
This child, like Gray's son, had difficulty finding a weight-loss program for which he wasn't over the cutoff weight. Gray's lawyer, Grant Varner, says she had been unable to find any programs in South Carolina that could handle her son. Even programs dealing with morbidly obese kids reportedly told her that he was beyond their maximum weight.
According to Varner, Gray was worried that her son had an undiagnosed medical problem but that as a single mother with limited means and no health insurance, she was at a loss and couldn't monitor his eating 24/7.
"If she's found guilty, it could open a Pandora's box," says Varner. "Where does it stop? Who tells you how big is too big? Will parents of 16-year-old girls who are obsessed with being skinny be next in line?"
Dr. David Ludwig, who directs the Optimal Weight for Life program at Children's Hospital Boston, says there's plenty of blame to go around. "Parents have a responsibility, but it's also society's responsibility the national government spending billions of dollars on farm subsidies for poor-quality foods, communities placing their priorities on development revenue rather than parks, cutbacks to school nutrition," he says. "All this is unfair to the kids."