Lose CHICAGO - should parents extremely obese children custody for not controlling their children's weight? A provocative commentary in one of the most prestigious medical journals of the country argues Yes, and the authors close a quiet chorus of advocates, who say that the Government may intervene in extreme cases.
It has happened a few times in the United States, and the guest post in Wednesday's Journal of the American Medical Association says that children temporarily in foster homes in some cases more ethical than obesity surgery.
Dr. David Ludwig, an obesity specialist at Harvard-affiliated of children's Hospital Boston, said the point is not blaming parents, but rather to act in the interests of the children and to enhance help them that their parents can not provide for any reason.
State intervention "ideal is not only the child, but the whole family with the child and family as soon as possible to support goal of reunification." "The Guide, parenting, need", said Ludwig, of the article with Lindsey Murtagh, a lawyer and a researcher at the Harvard School of public health wrote.
"Despite complaints of State intervention is, it may be sometimes necessary to protect a child", said Murtagh.
He said University of Pennsylvania bio Ethikerin art Caplan but, that risks do the debate to much debt to ensure parents. Overweight children are victims of advertising, marketing, peer pressure and bullying - things a parent do not control, he said.
"If you're going to change a child weight, you are going to have to, all of them change," said Caplan.
About 2 million US children are extremely obese. Most not in danger, Ludwig said. But some have obesity conditions such as such as type 2 diabetes, breathing difficulties and liver problems that could kill at the age of 30. These children is for the Government intervention, including education, parent education and temporary "protective custody" in the most extreme cases be taken into account should, Ludwig said.
While some doctors for severely overweight promote teen weight loss surgery, Ludwig said, it has not for a long time been used among young people and can have a serious, sometimes life-threatening complications.
"We the long-term safety and efficacy of these procedures done at an early age know not," he said.
He said Ludwig from thinking about the issue after a 90-pound 3-year-old girl came to his obesity clinic a few years ago. Their parents had physical disabilities, little money and difficulty controlling their weight. Last year at the age of 12, she weighed 400 pounds and had developed diabetes, cholesterol problems, hypertension and sleep apnea.
He said "Of medical concerns placed state this girl in foster homes, where she received just three balanced meals a day and a snack or two and moderate physical activity". After a year, she lost 130 pounds. Although she still obese, their diabetes and apnea disappeared; It remains in foster homes, he said.
In a commentary in the medical journal BMJ last year said pediatrician Dr Russell Viner London and colleagues obesity was a factor in several child protection cases in the United Kingdom. They argued that child protective services weight is, if parents are negligent or actively reject efforts extremely obese child.
A 2009 opinion article in Pediatrics made similar arguments. Its authors said that temporary removal from the home would be displayed "when all reasonable alternative options are exhausted."
This piece discusses a 440-pound 16-year-old girl, developed by overweight problems with breathing and almost died in a hospital of the University of Wisconsin. Doctors debated whether to report their family for neglect. But she didn't because its medical crisis ended "Was a wake up call" for her family and the girl up the lose about 100 pounds, said co-author Dr. Norman Fost, a medical Ethicist at the University of Madison campus.
State intervention in obesity "Relate to new legal requirements not," Ludwig said. Health care providers are required to report children immediately are at risk, and that can be used for a variety of reasons, including neglect, abuse and call doctors "Thrive." That's when children are severely underweight.
Jerri gray, a Greenville, s.c., single mother, the custody of her son 555 pounds 14-year-old lost two years ago, said that authorities do not understand, that the families can face challenges, to control the attempt, the weight of their children.
"I worked two jobs so that we would end up not living in the ghetto," gray said. She said that she have to Cook, often time, so that she would buy their son fast food. She said she asked doctors for help for her son large appetite but neglect was charged with.
Her sister custody of young, now has 16. The sister has the money to help him with a special diet and exercise, and the young has lost more than 200 pounds, gray said.
"If well from this, as far as to remove him has come, he told me just last week ' Mama, I want to be so bad back with you." You have done damage by pulling "Gray told us."
Stormy Bradley, an Atlanta mother of a Georgia interest group "stop childhood obesity" campaign, their being overweight participates in 14-year old daughter, said that it sympathizes with families with a view to legal action in their children's weight.
Healthier food often more expensive, and Mini Club want to monitor weight can be difficult, especially if they reach their teens, and parental-Shun, said Bradley. But young people take the road from their parents "seems definitely too extreme," she said.
Dr Lainie Ross, a medical Ethicist at who University of Chicago, said: "there is a stigma with government intervention." "We need to only do it with caution and humility and make sure that we can really say that our interventions as well will do."
Pediatrics: http://www.pediatrics.org
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