Is Severe Obesity in Kids a Sign of Child Abuse?

Are parents of an extremely — morbidly — obese child committing child abuse?

A Journal of the American Medical Association op-ed by Lindsey Murtagh, JD, MPH, of the Harvard School of Public Health and David S. Ludwig, MD, PhD, of the Children’s Hospital of Boston, considers whether the state in the form of Child Protective Services should intervene when a child is so severely obese that he or she is at risk of developing a life-threatening condition such as type 2 diabetes.

That is, according to the op-ed’s authors, having a severely obese child is a sign of parental neglect. At a time when, the authors write, “ubiquitous junk food marketing, lack of opportunities for physically active recreation, and other aspects of modern society promote unhealthful lifestyles in children,” overnourishment and severe obesity need to be thought of as endangering children’s lives just as “improper feeding practices, causing undernourishment and failure to thrive have long been addressed through the child abuse and neglect framework.”

Murtagh’s and Ludwig’s suggestion sounds and is, they acknowledge, drastic and should be applied only when obesity is life-threatening. It’s a last resort after “intermediate options such as in-home social supports, parenting training, counseling, and financial assistance” have been tried. They also discuss gastric bypass surgery — while noting the risk of health complications — as an option to removing a child and placing her or him in foster care when “support services may be insufficient to prevent severe harm.” As they write,

In severe instances of childhood obesity, removal from the home may be justifiable from a legal standpoint because of imminent health risks and the parents’ chronic failure to address medical problems. Indeed, it may be unethical to subject such children to an invasive and irreversible procedure without first considering foster care. Nevertheless, state intervention would clearly not be desirable or practical, and probably not be legally justifiable, for most of the approximately 2 million children in the United States with a BMI at or beyond the 99th percentile.9 Moreover, the quality of foster care varies greatly; removal from the home does not guarantee improved physical health, and substantial psychosocial morbidity may ensue. Thus, the decision to pursue this option must be guided by carefully defined criteria such as those proposed by Varness et al, with less intrusive methods used whenever possible.

What stands out in Murtagh’s and Ludwig’s argument is their equation of overnourishment — causing a child to become severely obese — as tantamount to child abuse and malnourishing a child. GOOD magazine points out that

Whether you agree with it or not, kids have already started being taken from their homes for being too overweight. Ludwig says the idea for state intervention in obesity cases came to him when he met a 90-pound 3-year-old whose parents were poor, disabled, and unable to control her weight. By the time she was 12, she weighed 400 pounds and had developed diabetes, at which point the Massachusetts Department of Protective and Family Services intervened and removed her from her home. Within a year of government care, she’d lost 130 pounds and her diabetes was gone. She’s still obese, says Ludwig, but she’s getting better all the time, which is why she remains in government care.

There’s already enough of an outcry about First Lady Michelle Obama’s efforts to stop the epidemic of obesity among children. Having state agencies step in and remove a child is certainly a much more intrusive act into people’s private lives. What we do need to keep pushing (though it’s an uphill battle) is education of parents and children about healthy eating practices and exercise; is making sure that healthy food options are available — though, of course, there’s no guarantee that just because there’s fresh fruits and vegetables that people will buy them.

Currently only a few states (California, Indiana, Iowa, New Mexico, New York, Pennsylvania, and Texas) have, say Murtagh and Ludwig, “legal precedent for applying this framework to overnourishment and severe obesity”: What if more states also chose to apply this framework? Could there be a day when overnourishment — when not getting a child to eat healthily (always a challenge for any parent) — is as much a crime as malnourishment?

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Photo by TheeErin

Disclaimer: The views expressed above are solely those of the author and may not reflect those of
Care2, Inc., its employees or advertisers.

George B.

10:50AM PDT on May 1, 2012

It is abuse and neglect. My heart goes out to the children of parents that just don't want to be bothered. I see them every day. Mothers, Fathers that will not cook for the family, because fast food is easier. Or will not take children outside to play because there is no air conditioning. There should be some way to make parents do the right thing. Doctors, Hospitals and Schools should be required to report all over weight children that they treat and Teach, parents should have to go to parenting classes, and if they are on any kind of assistance programs their assistance should be in jeopardy. Some parents should not be allowed to have children. I know this sounds drastic but some parents can,t even be bothered to get out of bed and get their children off to school. Their should be punishment for them.

send a green star

Robert V.

9:39AM PDT on May 1, 2012

The dietary pedophiles who make soft drinks available and normal for children should be punished for their part of the problem, but their public relations technicians are so powerful that they could make what Errol Bradley did legal and even acceptable if there was as much profit involved. Their Nuremberg defense "I was just following the orders of the market place" under capitalism is no excuse.

Anton K.

2:31PM PST on Feb 17, 2012

It certainly can be a sign of abuse or neglect.

Anne G.

12:28PM PST on Dec 31, 2011

I do think it is a form of child abuse, but the parents should be educated on how to help their children and most likely themselves, taking the children away is not the answer.

Kim M.

7:08AM PDT on Oct 13, 2011

It's the responsibility of parents to teach children good eating habits. Wouldn't go so far as to call it abuse, but it's definitely negligence.

glenda b.

5:43AM PDT on Oct 13, 2011

We're so use to see obesity that know we think its normal but at one time it was not....And we think or blame all kinds of excuses to why this is happening. You can't be to skinning because it can damage your health just like obesity..There is a middle ground but people thinks its to hard to do...I just don't want to pay extra in my health care because they don't care or want to care. I take care of myself and it's not that hard to do. I hoping it will give me a longer life with its ups and down and happiness to top it off.

Doug A.

2:45AM PDT on Oct 13, 2011

There are too many factors involved here to blame a parent for his or her child's obesity. Any judge hearing a case like that would have to go beyond the wisdom of Solomon to make a just decision on the matter. Most parents don't have a degree in nutrition and are just trying to do what is best for their kids. To keep kids from getting overweight now days you would have to keep them in abusive confinement given the amount of junk food that is available to them in school and in most communities.

f. w.

9:14PM PDT on Oct 12, 2011

I believe it IS child abuse. So many parents are too lazy to make healthy, balanced meals for their families. They let their children eat whatever they want, whenever they want and they let them have a sedentary lifestyle. Parents need to take control of their households and their children. If parents control the food and the type of play their children get the children will enjoy a healthy lifestyle and a healthy body.

Yow F.

8:05PM PDT on Oct 12, 2011

they onLy love to eat ... obesity is not a part of abusing a child .. it's a problem related to the community .

Kaye W.

7:34PM PDT on Oct 12, 2011

Sure, punish the poor. Make sure the only food they can afford is GMO, loaded with HFCS and sodium, and then tell them they're abusing their children by feeding them in the first place. I thought I had a simple answer to the question, but it really is more complicated than yes or no. There are too many variables.