Posted by: ezzakazhall | July 23, 2012

Out of the frying pan…into the foster care fire

  Most days, I enjoy keeping this blog- weight is a touchy subject and one close to my probably coronary-prone heart, but blogging about it keeps me on my tip-toes and out of trouble. On other days, however, it’s just depressing. A couple of Fridays ago, when an article from the Australian news site The Herald Sun appeared as one of my Google alerts.

Said the article:

“At least two children in Victoria have been removed from their parents because of their weight.

And it is predicted there will be more cases to come.

Associate Professor John Dixon from the Baker IDI Heart and Diabetes Institute told the ABC that sometimes taking children away from their parents is the best option.

“(Obesity can be the result of a) whole range of environmental issues, the food, the lack of transport, all sorts of things.

“But it also can be symptomatic of dysfunctional circumstances … where there’s problems; mental illness, siblings with disabilities, that really make family life for some of these children very complex indeed, and produce that rare circumstance where they may be better off out of home for a while.”

The rest is here. ABC news in Australia ran this radio broadcast featuring comment from various agencies, including Prof Dixon (quoted in the article above), the Chief Executive of the Australian Association of Children’s Welfare Agencies and a Professor of Medicine at the University of Melbourne. The latter two interviewees stated they did not believe obese children should be separated from their families, and (as the Professor of Medicine stated) obesity in children is often a result of genetics, not parental neglect. In spite of this, Victoria’s Department of Human Services doesn’t appear to be backing down- though it did assure us that “child protection workers are only called in as a last resort and only when the child is at risk of significant harm or abuse“.

As it turns out, the removal of obese children from their families is not new, nor is it confined to Australia. Last year, a couple in Dundee, Scotland, were threatened by social workers with the removal of four of their seven children, if the children’s weight was not brought under control- as is reported in this Daily Mail article. The couple were warned that their children will be placed in state care if they did not slim down- and the family spent two years living “in a council-funded ‘Big Brother’ house in which they were constantly supervised and the food they ate monitored.”  According to the article, despite their parents’ best efforts to ensure the kids ate healthier, it didn’t appear to make a difference where their weight was concerned. On the flipside, the family court in Ottawa, Canada, is now (based on hospital assessment) using obesity as in factor when deciding if a parent is fit to raise a child. As was the case concerning this gentleman, who eventually lost custody of his two children- with his body weight cited as one of the primary reasons (never mind that he had lost a large amount of weight before the decision was made). As it turned out, the gentleman in question also had issued with cannabis abuse and anger management…but it’s interesting that his body size appeared to be given more consideration than those other factors (reminds me a bit of this story, in fact).

I digress. As it would appear, there has recently been much dialogue in the US about the issue of removing obese children from their families. As this Huffington Post piece reports, an article in the Journal of the American Medical Association (JAMA) supported the removal of “extremely obese children” from their parents in “extreme cases”. This move is endorsed by both an obesity specialist at Boston’s Children’s Hospital and a lawyer at Harvard’s school of public health. Says the Huff Post article:

“Dr. David Ludwig, an obesity specialist at Harvard-affiliated Children’s Hospital Boston, said the point isn’t to blame parents, but rather to act in children’s best interest and get them help that for whatever reason their parents can’t provide.

State intervention “ideally will support not just the child but the whole family, with the goal of reuniting child and family as soon as possible. That may require instruction on parenting,” said Ludwig, who wrote the article with Lindsey Murtagh, a lawyer and a researcher at Harvard’s School of Public Health.

“Despite the discomfort posed by state intervention, it may sometimes be necessary to protect a child,” Murtagh said.”

And the JAMA article (which can be found here) isn’t the first time this issue was explored. Says the Huff Post:

“In a commentary in the medical journal BMJ last year, London pediatrician Dr. Russell Viner and colleagues…argued that child protection services should be considered if parents are neglectful or actively reject efforts to control an extremely obese child’s weightA 2009 opinion article in Pediatrics made similar arguments. Its authors said temporary removal from the home would be warranted “when all reasonable alternative options have been exhausted.”

And…now we see that Australia catching on quite nicely, if the removal of children in Victoria is anything to go by. My questions on the issue are as follows:

1) Prof Dixon of the Baker IDI Heart and Diabetes Institute, quoted in the Herald Sun article above talks about removing obese children from families where there’s incidences of mental illness, or where other siblings may have disabilities…which makes me wonder if Australian authorities actually plan to assist those family members struggling with said mental illnesses or disabilities. Or…is removing the obese child from these families the ultimate solution? While I can see how removing an obese child from that kind of situation may be in the best interests of the child…I would hope the Australian Government would provide some assistance and support to the vulnerable family members left behind.

2) Both the ABC radio broadcast and the Huff Post article stated that obese children would only be removed in “extreme circumstances”, or if they were at risk of serious harm, or if all other options had been exhausted.  My concern is what will happen if government intervention stretches beyond these so-called “extreme circumstances”- and extended to removing overweight children from loving and stable family units (such as the couple in Scotland mentioned above claimed to be) out of concern for their health. As this article on American news outlet PolicyMic points out, in most cases, obese children are not in any immediate danger. So, I would hope that a strict set of criteria would be imposed as to when it is appropriate to remove an obese child from their home…so that the Government is not separating otherwise healthy, confident kids from their families willy nilly.

3) What does the Australian Government plan to do in cases where obesity in children is not the result of parental neglect, or difficult family circumstances? For example, the ABC broadcast quoted Joseph Proietta, Professor of Medicine, who cited genetic factors as a leading cause of childhood obesity. He mentioned a deficiency in lepton, passed on to the child by their parents, which can lead to uncontrolled eating. So…what happens in these cases, where obesity is not the result of poor parenting?

Conversely, what happens to children in extremely poor health due to diet and other environmental factors…who are not actually obese? Such as Stacey Irvine, a 17-year-old from Birmingham, England, who lived on nothing but chicken nuggets and the occasional french fry since the age of two (more information in this article: http://www.dailymail.co.uk/health/article-2092071/Stacey-Irvine-17-collapses-eating-McDonalds-chicken-nuggets-age-2.html). You certainly couldn’t call this young woman fat- yet she has been told by doctors she will die if she doesn’t eat a more varied diet. Would young people like her be removed from their homes? Or is body fat the benchmark?

4) Finally…has the Australian Government given any consideration to the effect on the mental and emotional health of obese children removed from their families? The PolicyMic article states that even if these obese children did lose weight, their health may still suffer in other ways if they were placed in foster care. Says the author of the article (with links to various studies): “Research shows that children who enter foster care have higher rates of emotional and behavioral disorders, earn less money, and are more likely to become delinquents. According to one study, children in foster homes were worse off than troubled children who stayed with their families. In others words, we’d be swapping overweight kids for thin kids with serious psychological disorders. That hardly sounds like a sensible solution to obesity.”

I can’t say I disagree, to be honest. I can  only imagine how disruptive (and, in some cases, extremely traumatic it would be for a child to be removed from their parents, and placed in a entirely new family. Also, has the Government considered the possibility of abuse in foster homes? Or how obese children will cope with the pressure to lose weight so they can be reunited with their families- and if this will lead to disordered eating later in life? Or, as the PolicyMic article mentions, how time in foster care will effect these children’s mental health in the long-run and into their adulthood, and affect their relationships with others? Clearly, the apparents dangers posed by body weight outrun all of this as far as Victoria Authorities and the AMA Journal are concerned,

As usual, thoughts are welcome.

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Responses

  1. […] Last time, we talked about the Victoria State Government removing obese children from their families. Now, it appears that the Western Australia Government has invited itself to the anti-obesity party, with the launch of this advertising campaign, supported by the Heart Foundation and the Cancer Council. […]


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