Dr. David Ludwig, Harvard Pediatrics professor, proclaimed in a JAMA article this week that children with life-threatening obesity might be best served by some type of state intervention. Ludwig is suggesting this radical involvement for children with BMI in the 99th percentile. He believes that initially child protective services should offer "intermediate options such as in-home social support, parenting training, counseling, and financial assistance, that may address underlying problems.” But ultimately if the child’s health does not improve the state would force the child into foster care. Ludwig told the Associated Press that he started thinking about the idea of state intervention nearly a decade ago, after a 3-year-old girl showed up at his obesity clinic weighing 90 lbs. By last year, at age 12, she had reached 400 lbs. and had developed diabetes, cholesterol problems, high blood pressure and sleep apnea.
Her parents had physical disabilities, little money and difficulty controlling her weight. "Out of medical concern, the state placed this girl in foster care, where she simply received three balanced meals a day and a snack or two and moderate physical activity," [Ludwig] said. After a year, she lost 130 pounds. Though she is still obese, her diabetes and apnea disappeared; she remains in foster care, he said.
An even less ethical solution is exhibited by the recent spike in children undergoing weight loss surgeries which carries physical risks and can be irreversible. Ludwig argues that “at first glance, bariatric surgery might seem an obvious solution, but the procedures don't have a lengthy safety record in teens, and they're not recommended for children.”
“Given that situations involving the undernourishment of children have frequently been defined as child abuse or neglect and warranted state intervention, it may be likely that overnourishment may be addressed similarly,” Ludwig argues.
The article has proved to be the most controversial health commentary of the year and is presented by one of the most well respected journals in the country. It has come at a time when the rates for obesity have worsened in 16 states and not a single one has showed improvement. Not to mention, Colorado, the slimmest state, with 19% obesity in 2010 would have been the heaviest state in 1995. Currently, about 1 in every 400 children has diabetes and it’s predicted that of children born after the year 2000, 1 in every 3 at some point in their life will have type II.
It would be extremely short-sided to imply that it is solely the parents that are to blame. The entire food culture has to start taking responsibility. The manufactures need to start taking a more ethical approach, the media must exemplify healthy living, the government has to adopt more aggressive stance and the school system has to reinstate physical education. There has got to be a better way than tearing children away from their parents. But, in these extreme cases some form of external mediation seems necessary.
However, I fear that this argument will become socioeconomic in nature. That the “99th percentile” tends to come from the poorest of families and they won’t be able to afford healthy food choices and are limited by expensive after school activities. But, there are two sides to every coin. We know that that you can live a healthy lifestyle on a tight budget. It just takes the proper education. I’d love to hear your thoughts in the comments section!
I was shocked when I saw this on the news a few nights ago. It's a fine line. As you said, there is much more to this than poor parenting choices. There definitely needs to be a focus on affordable health/nutritional education for families, everyone in the family...not just the parents, not just the children...EVERYONE. Physical education classes should be mandatory for the entire time children are in school. Taking at least one year of health class should be mandatory to graduate from high school. I think family health/wellness therapy would be a great beginning...education is the key! Taking a child away from a loving home could be so emotionally devastating, that it could have the opposite effect.
ReplyDeleteThis is outrageous. What about adolescent girls who are too skinny? What about some high school kid smoking cigarettes behind the gym? It's not even as if we have a decent foster care system. A child put into foster care runs the risk of abuse, neglect, sexual abuse and being bounced from home to home. Keep the d___ government out of our homes!
ReplyDeleteI totally agree with Stacia. Such a fine line. I truly believe education is key.
ReplyDeleteLike Bob says, "We are an all or nothing society." We need to stop thinking in terms of extremes and more in terms of the middle ground which as others have suggested is education and change over time. Don't take the kids away, work with the parents. They will probably use public assistance either way, so include dietician services that will assist with shopping and educate on the entire process.
ReplyDeleteThanks for the comments everyone. I respect everyone's opinion and agree that taking a child from their family would be devastating. But, like the children described in the story, they are on the brink of death. As I said in a post on facebook, my perception of government is that they are there to protect the people. As for preventative medicine, they are doing a shotty job. I hope that the current health reform talks will help provide affordable help to families such as these and will start regulating they corrupt insurance system. Thanks for taking part in such an important debate.
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