
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.