Foster Care: A Slimming Strategy?

July 19th, 2011 by Andrea Bennett

Harvard researchers suggest parents lose custody of obese children.

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The Responsibility Project

There has been plenty debate over the causes of the so-called obesity epidemic among America’s kids, but few would suggest a solution this controversial: In a recent opinion piece in the Journal of the American Medical Association, Harvard researchers Dr. David Ludwig and Lindsey Murtagh proposed that since the epidemic is caused, in part, by “inadequate or unskilled parental supervision,” taking obese kids out of their homes and placing them in temporary foster care could present the answer.

Let the fracas begin.

Dr. Ludwig told the Associated Press that the point is not to blame parents but rather to act in children’s best interest by giving them help that their parents cannot provide. State intervention, he said, “ideally will support not just the child but the whole family, with the goal of reuniting child and family as soon as possible.” Murtagh added, “Despite the discomfort posed by state intervention, it may sometimes be necessary to protect a child.”

But in an opinion piece for MSNBC, University of Pennsylvania bioethicist Art Caplan said he worries this solution places too much blame on parents. “Our laws give enormous authority to parents and rightly so. The only basis for compelling medical treatment against a parent’s wishes are if a child is at imminent risk of death — meaning days or hours — and a proven cure exists for what threatens to kill them. Obesity does not pass these requirements.”

Ludwig, however, would argue otherwise. As the AP piece reported, he had started thinking about the issue after a 3-year-old girl weighing 90 pounds came to his obesity clinic several years ago. Her parents had physical disabilities, little money and difficulty controlling her weight. By age 12, she weighed 400 pounds and had developed diabetes, cholesterol problems, high blood pressure and sleep apnea. The state placed the girl in foster care, where she lost 130 pounds after a year, shedding both her diabetes and sleep apnea.

In the JAMA opinion piece, the scientists noted that roughly two million American children are extremely obese. Most are not in imminent danger, but some have obesity-related conditions such as type 2 diabetes, breathing difficulties and liver problems that could kill them by age 30. Ludwig believes state intervention – including education, parent training and, in the most extreme cases, temporary protective custody – should be considered for these children.

“Before we start grabbing porky youths out of their homes and sending them off to government fat camps, might we try to change our food culture?” Caplan reasoned in his MSNBC article. He suggests demonizing unhealthy foods much as we’ve done for tobacco industry. “That means you, candy, soda, fried food and snack food outfits,” he wrote.  “Tax them too. And get Hollywood and television to make overeating and not exercising uncool just like they did with smoking. Put exercise back on the menu for all school kids.”

What’s your take? Do you see the benefit in placing at-risk kids in foster situations, or do you see that solution as causing more damage to families in the long run?