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11/29/2011

Why Fat Cannot Make You Unfit to Parent

An eight-year-old Cleveland Heights, Ohio boy has been taken away from his parents by Child Protective Services. An unfortunate, but routine occurrence in the world of CPS–but this time the case has an usual cause—this third grader weighs more than 200 pounds and in the judgement of some Cuyahoga County officials his parents are the cause of his abuse to his health and well-being.

But as the Cleveland Plain Dealer asked this week, “Is Obesity Cause Enough To Take Kids From Parents?” My answer is absolutely no.

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Of course, it is a tragedy that an 8-year old third-grader weighs as much as a major league baseball player and that is is almost certain that he faces a life of serious and life-threatening co-morbities of obesity such as diabetes, heart disease, depression and others. The issue is serious and has consequences that will effect this child throughout his lifetime. On this I agree with Art Caplan who has said, “A 218-pound 8-year-old is a time bomb.” From a health perspective that is true. But will his health status be improved when he is yanked from his family and put into foster care? Almost certainly not, as studies have shown multiple negative mental and physical health consequences from being in foster care including 35% of children increasing their BMI while in foster care. Will the state ensure that his nutrition and physical activity will be better in his foster home than his previous one? They haven’t said they will and it’s impossible to see how they could.

Childhood obesity, no matter how severe, is no reason to take a child away from his family, whom we must assume love and care for him and provide for him well. Why this assumption? No other justification was provided for removing him from his family except for his BMI. But some may argue that his parent(s) are putting him in harms way, allowing him to eat and not to exercise in ways that certainly damage his health. This may be true, or it may be the result of socioeconomic and structural factors that are beyond this family’s control. Perhaps they live in a “food desert” and cannot get easy access to fruits and vegetables and perhaps even more likely they live on a meager income in a society where they are bombarded by commercials and billboards for 99 cent Value Meals.

Moreover, if Child Protective Services is going to get in the business of taking away children from parents who expose them to health risks repeatedly and with serious detriment to their health, the “stereo cops” had better start surveying every house to ensure that the volume knobs on teenage stereos are turned down, lest the parents allow them to get permanent hearing damage from their iPhones or car radios. Or the “tanning police” had better make sure that every child in America never gets a sunburn, because a parent who allows their child to be sunburned exposes that child to a significantly greater chance of malignant melanoma, just from one burn. I could go on and on, but you get the point.

Furthermore, there exist a wide range of details in the case not provided to us via the media: what is the BMI of his mother and/or father? Is obesity a problem throughout the home? Could education, behavior modification, or other interventions far short of taking away a child from his home help ameliorate this problem? Did authorities try these methods and warn the parents prior to taking away the child?

This case, as extreme as it is, does shine a light on an important issue in our society: childhood obesity. There are clearly better and worse strategies to deal with it. The worst would be to traumatize a child by removing them from their home solely because they struggle with their weight. The better strategy would be to have public health and social services unite to help children and their families who live in food deserts and who are the products of a society manipulated by food lobbies find ways to improve their health behaviors and their health outcomes.

Summer Johnson McGee, PhD

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