Tuesday, November 29, 2011

The Obese Police

Yesterday an eight year old Ohio child was removed from his home and placed in foster care because of his weight. The boy weighs 218 pounds, nearly four times the weight of his “average sized” peers. The county cited “medical neglect” as the reason for removing the boy and indicated that many efforts had been made over the past year to encourage the mother to help her son lose weight. (See details HERE). The mother had apparently not followed through with court mandated services.

The mother (I think she is a single parent) is a substitute teacher and is educated. The family has health insurance. Lack of education or benefits should not have been obstacles as to why this child did not lose weight. The family’s lawyer emphasizes that the county over-stepped bounds by removing this child who “was not in imminent danger, was on his school’s honor roll and participated in school activities.”

Social services contends that the mom was not doing enough to help her child lose weight, thereby putting him at risk for life threatening diseases.  Dr. David Ludwig, an obesity specialist at the Children's Hospital states, “Children with obesity-related conditions like diabetes, breathing difficulties, and liver problems could die by age 30 if no action is taken.”

I have been a social worker for the past 14 and have worked for social services. Fortunately, my job has never been to remove kids from their homes, but I’ve worked in the field of foster care for many years. There is a time and a place for foster care. Effective foster parents can provide a child with the stability they need to get out of crisis mode and to heal while their parents are doing what they need to do. It is unfortunately true, however, that a child is at risk for abuse (physical and sexual) while in a foster home, so this needs to be a consideration as well.

In this instance, I believe a significant risk in removing this child is the trauma associated with the separation from his mother. Yes, having a child who is four times the weight he should be is tragic and unconscionable. However, removing him from the home and placing him in foster care may double the damage. It is not the child’s fault. It is the mother’s fault. Yet, the child is the one being punished the most in this situation. Foster care is not fun. Foster care will not make him thin.

I read somewhere that the mom was court ordered to take him to Children’s Hospital for services and she didn’t. So, clearly, something had to be done. In a perfect SUAR world, the money that would be used to fund his foster care stay should have been spent on paying for a Bob Harper type to be planted in the home 24/7.  This person would monitor meals/snacks, teach healthy cooking and would devise and supervise an exercise program. I doubt this sort of thing exists in the real world, but it should.

My hope is that this child will return home quickly to a mother who now “gets” the urgency of his medical condition - a mother who has been given the wake up call of her life. The child is only eight. His mother has done her son a great injustice. Mentally, physically, emotionally and socially he has already been scarred. Yet, it is not too late. There are many resources for this type of thing. For instance,  Dolvett could whip him into shape!

Do you think children should be removed from their home due to obesity? To me, removal is not the answer.  Let’s face it, we can’t go around removing kids for obesity any more than we can remove them for being exposed to second-hand smoke. Both are life threatening conditions and are, I believe, the fault of the parents. Parents need to be educated and held accountable, even if that involves strict intervention that is uncomfortable and inconvenient. Removing the kid is just punishing the child further. Just my two cents.

I bet that kid is home before the end of the week.



  1. I have thought about this same issue a lot myself. I see kids who are so overweight that they can't even walk. And yet their parents do nothing (or seem to do nothing) to help. Where do we draw the line? I don't know. I would LOVE for their to be a "fat tax" based on average BMI taken 2-3 times per year (at your MD office). Anything over "normal" BMI pays an extra $1000 per point on their federal/state taxes. It will work as an incentive to get people to make real change in their life. Unfortunatly I think punishing people is the only way to go.

  2. I agree that I don't think removal is the best course here. However, I do place blame on parents for having obese children. Not chubby kids. Not big boned kids. 218 pound 8 year olds.

    I'm not sure what should be done in these situations. If the mother wasn't following through with what she was madated to do, do you fine her? Send her to jail? Court ordered counseling for her?

  3. Laura: yeah, I think you could fine her. If you send her to jail, you just punish the kid again b/c he doesn't have a mom around. Tough call.

  4. I should say, the fat tax "punishment" should be levied on the parents, not the kids, obviously. It seems to me, that as a society we don't respond to things unless they hit us in the pocketbook. I hate to make that generalization, but I think it might be true for present-day American society.

  5. K: yeah I agree except I think it's a short term solution. Plus, a lot of people are already struggling so much financially. Wish there was another way to get the point across.

  6. I think it's wrong to remove the child.

    I was a heavy child, my mother tried her best to help me. She restricted food (which lead me to shamefully steal and sneak food) she tried to help me to be more physical, she cooked (relatively) healthfully.

    I was depressed and always just felt fat.

    My parents did the best they could and if I were removed from my home I really might've not been able to bare it. I would've internalized it and blamed myself -- no matter what anyone told me.

    Which leads to - what becomes the thresh hold? What's 'too fat'? who deems that being 175 pounds and the kids stays but 200 and the kid goes?

    Something has to be done -- without a doubt but, like you, I believe that child removal will lead to more harm than good.

  7. The BMI is a load of shit. My BMI was at a little over 25 (before I got pregnant). When I told people my weight they practically fell over. They could not believe I weighed in the low 140's. I looked closer to low 130's. It was all muscle. Should I be "punished" and have to pay an extra 1,000 in taxes because I am more muscular?

    What should be done? I am not really sure how to answer this one. SUAR brings up good points.

  8. I actually think a reward system should be in place for cases like this, and for dealing with obesity in general. If you had people pay LESS for their health insurance if they exercise, or allow them to take 1 hour off from their work schedule to exercise we would decrease health care costs tremendously.

    It seems to me that this woman needs help herself. She may be an overwhelmed mom, with too little money and time. I think it is atrocious that she is about to lose her son bc of this issue. What is next, taking your kid away if you take them to mcdonalds? I mean, we know that if you eat at mcdonalds daily for a while you increase your risk for many diseases.

    We have a bad system in place. Things are rarely simple and black and white.

  9. first, can I just say that Fat Tax comment my back up?? I am technically in an "unhealthy" BMI. I am technically obese. I also run 12ish miles a week and am training for a half marathon. I'm more healthy and fit than a LOT of skinny people. I have a large build and YES, extra weight I still have to lose. But we eat organic foods, we don't eat processed items, we exercise like crazy. And we are hardly ever sick. BMI is NOT an accurate way to judge fitness or health, sorry. ((Steps off emotional soap box))

    Back to the original post--That whole situation just makes my heart hurt. I was overweight growing up (and statistically still am, but whatever-I've been healthy and active for 5 years). I blame my mom for not teaching me how to eat right to start with. But she couldn't help herself. She STILL can't help herself. There are deep emotional issues there that she solved with food, and she has never really addressed. Like SO many people on BL, its totally a protective shell. I struggle very hard to teach my kids positive body image and healthy habits so they won't ever have to deal with overeating and self esteem issues.

    There is no good answer. I definitely blame the parents. How can you NOT move heaven and earth to make sure your kids are healthy? But we also live in a society where our food supply is basically poisoned with genetically modified food and people regularly put nasty stuff in their bodies without thinking about it. We (myself, my family, and a few friends of similar mindsets) simply try hard to educate people in our little corner of the world, encourage families to be active, and try to spread the word about healthy eating. As Gandhi said, "Be the change you want to see in the World"

  10. By the way... click my picture. Do I look fat to you? Because "according to the BMI " I am "overweight"

  11. That story came from my neck of the woods.

    I think they should have sent him to fat camp before taking him away from his parent.

    But in any case this initial news report does not give enough details to explain what is probably a complicated situation.

  12. Maybe a question is, who should pay? The parent, the child, society? I agree I AM the change I want to see in the world. I just don't know if there will ever be a real world solution to this problem. There are just "What if" scenarios to ponder

  13. I have no idea how you would deal with this. I would say a hefty fine, but that would only further limit the parents ability to properly feed their kids.

    But also, how do you expect parents to really know how to feed their kids when tomato paste is a vegetable? Government sets the example.

  14. I got nothing to add but have my popcorn ready for the rest of the comments!

  15. I have been a Special Education Teacher, quasi social worker in the military and worked at a Group Home for several years where kids went after many failed foster placements. Taking children out of the home is not something that is done or should be done lightly.

    There has to be more to this story than just a child who is fat/obese. If this is the case, it is opening up a can of worms that needs to be shut immediately. It seems that there are some axes being ground here.

    Yes the parents are negligent to a certain extent if a child is that morbidly obese, however, we don't know from the information given what the parents look like, what their background is.

    There are too many variable in this case that we are not privvy to and sweeping generalizations and fat taxing people, sending them to jail, hitting them in the pocket book or removing their children seem to me to defeat an already difficult situation.

    Yes there is an obesity problem in this story and in many more of our children who are not taken away from their parents. School meals need to be more healthy, the foods we eat need to not be filled junk, chemicals, drugs or genetically modified -- we don't know the long-term affects on our children or other people's children, who can't or don't know healthy food from unhealthy food.

    There are no easy answers to this question and if the States are going to start taking away obese children from their parents in otherwise stable homes, then are we going in the wrong direction.

    Enough already Harold, this is one of those soapboxes where no one has won, lots of money wasted and the only ones that win are the lawyers, who will get their legal fees one way or the other.


  16. Such a tough one - but I totally think that removing the child is really damaging to the child...Is he going to remember "They took me away from my Mom because I am fat" like his self-esteem is probably not the highest anyway...

    I feel like somehow the PARENT should be made to suffer the consequences - not the kid..BUT how do you do that? I really don't know...Fine the parent?

    218 lb 8 year old is just scary...

  17. @ Anna Maria There was a bill that came through that would give you a discount on health insurance if you maintained a healthy lifestyle but it was squashed my lobbyist's. The sad thing is that it was the American Heart Association and the American Cancer Society that squashed it.


  18. @Jeff...that made me LOL.

    I have nothing to add either, other than I wish so badly I could give obese out-of-shape people the gift of fitness. It is so great, I wish I could share it with them!

  19. to me it is not a tough call..removing the kid from his home is not the way to fix this. they are punishing this boy instead of the person who is responsible for this situation. I agree it will not make him thin..if anything he will get depressed and turn to food even more. His mother needs HELP and a serious WAKE UP CALL. The court should order her to take a class and she should have someone who is following her case and visits their home every week. Mandatory Dr visits for physical and supervision of that boy's health. If she does not oblige she pays. She is killing her son...probably not on purpose but she still is.

  20. Being a teacher in a low income school, this seems like a no-brainer to me. Taking him out of the home is not the answer or even their right. There are so many abusive behaviors from parents that AREN'T visible and so much more damaging. It is proven that parenting classes are MUCH more effective than disrupting a "stable" family. Shame on the courts.

  21. Not sure either how to resolve this, but I think somehow putting the parent/child into some sort of counseling, and getting them up w/ a nutritionist should somehow come into play. Who pays for this?? I don't really know. I think like you said, having someone like Dolvett or Bob to come and hold them accountable would be ideal. Taking the child from his home will only cause him to harbor more feelings of self-doubt and ill-will towards himself and his Mom. NOT the solution, however, something major had to be done to wake her up. This hits a nerve w/ me!!

  22. Wow. That is really heavy for an eight year old. I agree that something has to happen to help that kid, but as someone with family members both on the supply and demand sides of the foster care system- that is not the answer. First, do no harm. I just don't have an answer for that one, and I think the problem is that neither did the authorities in question. They wanted to do something, and they chose an imperfect solution over nothing at all.

    As to the BMI discussion, the trainers at my gym were even astonished at mine. They do bioelectrical impedence testing and then do it again. My BMI at the weight they refuse to coach me under because I'd be losing too much muscle mass puts me squarely overweight, veering towards obese, and at a size 6. So put me in the BMI sucks camp.

  23. Mom should have blamed school lunches. Everyone else seems to!

  24. Such a tricky issue! I have experience working in the child welfare system - and I WAS a "baby snatcher". I didn't work in Cleveland, but rather Cincinnati, so I was under the same state policies that this agency was presumably following.

    Based on my experience, I'm guessing there were a variety of factors that led to this child being removed from this home:
    - Inexperienced/undertrained workers (I was one)
    - Overworked, undersupervised workers (I was one)
    - Other issues in the home leading to DCS continued involvement - such as Mom's non-compliance. Whether we agree with the court orders or not - they're court orders.

    Somebody, somewhere, sometime, was concerned about this child and made a phone call and things went too far. I currently work in a juvenile detention center and make lots of phone calls - sometimes on medical related issues such as parents who refuse to bring their child's medication in. This sometimes leads to a case being opened, and other issues being uncovered.

    If mother had been fined instead, that money would have come away from the child. If she had been sent to jail, the child likely would have been placed in the system then, too. Ohio requires workers to investigate kinship placements, so there are likely to be no appropriate family members to step in and support.

    It's a messy situation.

    And it's situations like this that made me apply to graduate school to get my MSW so I can go back to Ohio and work on policy writing and worker training programs!

  25. Damn it Jeff...what kind or response is that?

    Anyway, as you know I have a true passion about this subject matter and for me it is not about removing the child from the home but educating both parent and child.

    Some people learn through reading, others through listening right? So why not develop programs that address these issues this way so that the parents and the child benefit.

    Let's also talk about the fact that obesity seems to be such a sensitive topic that we don't want to talk to the obese person about it. That a load of horse shit. People are quick to say to the drug addict or drunk that an intervention is needed so why not for obese people?

    I don't get it. It's the tip-toeing around the subject that has probably led them to continue down the path of eating as a shelter from something else. They turned to food for a reason and now stay there because nobody wants to say to that person that they are fat and slowly killing themselves. BUT nobody has a problem telling that to the smoker......what's the difference?

    So for me you have to educate. You have to shed light on the good and bad of healthy eating and unhealthy eating and some days you just have to use tough love.

    No easy answers but there are answers and we can't keep saying I DON'T KNOW. That doesn't help either.

  26. I don't think the child should have been removed. I totally agree with having someone come into the home- it would have been a better option. More needs to be done to help reduce obesity in this country. Having pizza count as a vegetable for school lunches is not the way- the ones at our school are bad enough.

  27. i think it's wrong to remove the child. I also wonder how much weight will he lose (in a healthy way) in foster care? My thinking is a kid who is 4x the average weight of his peers probably has a physical reason (ie NO ONE's fault) for gaining so much weight. Sure, things could be done to make sure he's healthy (exercie, healthy foods) but some people are just bigger people. I hope there isn't so much pressure on the foster family to get results that the boy suffers - they do need a professional making sure he gets the right no. of calories. (and not too few either!) Can't you just see this kid feeling like it's all his fault for being heavy and he's so upset from being away from his mom and home that he does something drastic, like ends his life, heaven forbid. I hope there's a happy ending to this story.

  28. Re: Caroline - based on my experience as a caseworker in Ohio, someone WAS visiting the home every week, and Mom WAS mandated to take him to the doctor. It's a long, steep road to removing a child from the home without extreme, imminent danger present. The lowest level of required visits for an open case is 2x/month, and they increase in frequency based on the level of risk/history.

  29. Fine the mother and get her some sort of mandate to take the kid to a trainer (the trainer would then report to the state...) but removing the child is not the solution.

    Still, I hope she gets a clue now and does something about it.

    This sort of reminds me of when my twins were 11....I'll have to tell you the story sometime when we're on a run or a bike ride together!! :)

  30. I'm not sure what to think about this. There are so many things we don't know about the situation. It certainly seems wrong to leave a child in a situation of such ill health. But obesity isn't a disease that we can cure, in the sense that we can cure broken bones or provide a drug to cure or control many diseases.

    And this is just one kid! Depending on who's stats you read, there are many more, and even more adults. I'm pretty sure there aren't enough people to provide a surrogate parent for all these kids.

    And short of taking them to a camp in a remote area where the only food is under lock and key, and putting them through a tough scholastic and exercise regimen till they get back down to a "normal" weight, there isn't much that can be done.

    Hmmm, now there's an idea. I wonder how much you could charge people for such a camp? Hmmm.

  31. make her take the train in with me ... she'll smarten up!

  32. I think situations like these should be look at on a case by case basis. For me, there too many variables to give and up or down answer.

    We fostered a 14 month old baby boy. He eventually became our son. I feel very blessed.

  33. Suar, you cite Foster Care as a really negative thing, but it isnt the foster care so much as the process of being removed from amhomemand parent that isnso traumatic. There are many foster homes that are positive nurturing environments and these foster parents go through a rigorous screening process that 'regular' parents neveqr have to go through. I think Im reading your point, but just to be clear, foster placement may be the most positive thing to ever happen to some children. And Halloween.

  34. Wow, this is a tough one. I have written a lot about childhood obesity myself—not to mention, the state of public school lunch programs.

    Whenever I see an overweight kid, I have a desire to go up to their parents and just say, "...excuse me, do you realize that you are killing your child?" I think it is the worst in cases where the parents are fit and the child is obese. I may be over-generalizing here, but that speaks of selfishness to me. I see parents at my Y that compete in triathlons and spend hours working out, pick their children up from child care, and feed them a bag of junk and a bottle of juice.

    There is not enough money or resources—in my opinion— to adequately intervene in this case. It sounds to me like the mother needs a lobotomy, and the child needs some positive role models.

    Okay, but to really answer the issue... I think the kid should be removed from their parent. As difficult as it is for the child, this IS child abuse. You would remove a child if they were suffering more traditional forms of abuse, right? This woman is killing her kid, slowly.

  35. Why everytime my home state makes the news, its always goes national?!?!?!

    So how do you punish the mother, to where she is actually punished, that is not jail, to make her responsible for her actions or lack of?

  36. RTP: As I said, foster care has its time and place. Foster care has saved lives and there are many wonderful FPs out there. I don't think it was appropriate in this case.

  37. There is so much oversight in every other area of our lives - cameras that catch us speeding and running red lights, library cards revoked for late books.....yet parents get to be shitty parents without much consequence. I don't know what the solution is, I agree removal is not the answer, the kid will just turn to the only comfort he knows (food). I just don't know why people can't make the decision to make health a priority. Our nanny, who loved our kids dearly, was overweight. She knew she was unhealthy, would start workout programs, diet programs, only to fail. Yet she would order pizza almost every day, bring over pop and chips. I just couldn't have that example around for my kids. And in her family's case, they ate so poorly and didn't exercise at all.....it would take just a few small changes to start seeing results.

  38. The whole thing just makes me sad on so many levels. I am sure you are right, that the trauma to this boy is more than what needs to be doled out. I hope we get to find out what happens from here and that things take a turn for the better for the family.

  39. Yikes! While I agree that allowing the child to become so unhealthy IS abuse, like you said - the child is suffering even more by being removed from his home. Placing a specialist in the home would have been a great alternative.

    I truly hope the mother has gotten the wake up call she needed to take this seriously and hopefully get her son home soon - with the proper care he needs to get healthy!

  40. I do think the parents have a huge responsibility in this case. However, I don't think this was the way to fix it. I read about all the resources offered to the foster parents to help the kid and I wonder why those same resources weren't given to the parents. Great discussion.

  41. You know, I think you make a very good point in your post. My thoughts were that something had to be done, because obviously the measures already taken (the warnings, the hospital visits that were supposed to happen, etc) were not working. But, the child is the one that is ultimately affected the most by the foster care decision.

    My view on it would be kind of a variation on what you said... Mandate a "wellness appointment" for the boy and mother both at the hospital three times a week to learn fitness exercises, proper cooking, health and nutrition maintenance, etc. Make it court-mandated just like community service or defensive driving. I think that situation is a win-win for everyone involved. Then again, I'm probably living in a utopian society in my philosophy, who knows...

  42. Obviously childhood obesity is a big deal. I get it. But, um, aren't there other kids who are in greater need of being removed from parents who are physically/mentally/sexually abusing them? To me, removing an obese child from a parent is crossing a line. Surely there are other options (although, I guess if she ignored a court order to get him medical care, maybe not? she obviously has got some issues...).

  43. This comment has been removed by the author.

  44. Also, I see a lot of people commenting "instead of removing the child, they should have court-mandated education" -- it seems likely to me from SUAR's original post that they DID mandate some type of action, and the mother did not comply, therefore leading to the removal. What is the next step if they refuse to comply with court orders?

  45. I read a different article about this case yesterday and it stated the child had been under the care of the Children's Hospital obesity clinic for 20 months prior to removal. He had some brief weight loss early on and then proceded to gain it back and then some.

    I'm not familiar with this particular obesity clinic but the ones I do know are centered around education of the families. Some even have kitchens in which parents can learn to cook healthy meals and gyms where children can learn about exercise. As a pediatrician, I am often very frustrated when I have parents who have these educational resources and still do not learn the tools they need to succeed. In a perfect world, we could give them all someone to come into their homes and give them very personalized treatment but there just aren't resources out there for that.

    Obviously, I do not have all the details of this case and was not involved personally to know what truly went on so I'm still not sure what the best answer is. But, it does sound like some steps were taken to educate the mother and many chances were given before resorting to such drastic action.

  46. That's tough. Maybe they could fine her and see if that lights a fire under her butt to get her child help. I also think it depends on whether is condition gets worse or better. If they fine her and he continually gets worse it might be necessary to take a more drastic step. I do agree the money that is being used to foster the child could better be used to pay for a health/fitness professional to meet with him once a day or a few times a week. Maybe I'm ignorant to the costs of such programs, but I still think its a great idea!

  47. In my former life, I was the law clerk to a Family Court judge who handled, among other things, abuse and neglect cases in NYC. So, you can imagine what came through our doors on a daily basis. You nailed it - where's the imminent risk?

    Foster care has its place, but this is not it. Even in the most horrific situations I saw, kids WANTED to be with their parents. I know it doesn't make sense, but their parents are all they have ever known. Removing a child from them should only be done when there is imminent risk of harm to the child. The standard varies by state, but that's pretty much the basic litmus test.

    I hate that the kid is obese. I'm sure caseworkers thought they had done everything they could to encourage the mother to get help for the kid, but removing a child from his home should only be in cases where they are at risk of immediate harm. Foster care, unfortunately can be brutal, humiliating, and sometimes even more dangerous for a kid than being at risk for health issues due to being overweight.

    I read this story and I just ached for this kid. If this case wandered into our part in NYC, you can bet he'd be home the same day. In NY we were mandated to hold what we called 1028 hearings, when requested, to ensure that the removal was justified by imminent risk. There's no way this would have flown by.


  48. My oldest son is seeing an endocrinologist because he has fallen off in growth (probably just a late bloomer), but while were at Children's Hospital for his appointment I noticed that there were kids there being treated for "not being able to stop eating." (Can't remember the name of the disorder, but it has something to do with a hormonal imbalance). The parents bringing these kids in were desperate for help. If this kid has this particular affliction, he needs medical attention more than a broken home.

  49. This is not a reason to remove a child from the home. It is unfortunate though. I have no easy answers. Right now I am dealing with an overweight spouse whom I love more than life but I feel absolutely powerless over his eating habits. The fact is, it's up to him to take ahold of his situation.

    I certainly have more power with my kids but again, it's hard to forbid sugary cereal when their dad eats it. It's hard enough to drag my bones outta bed to get a few miles in without having to motivate a household that is not at all interested in health and fitness.

    Both my kids are at a healthy weight and I am determined to keep them that way but I understand this moms frustration. It's tough.

  50. There are no easy answers to this case. However we need to remember a couple of things. Foster Care is not just for imminent danger. If this family has been working with Child Services in their home for a while and no changes were made, long term risk to the child must be considered. Also, remember that more than likely child services cannot comment on specific cases publicly to protect the child. So in most of these cases that hit the press, you only hear one side, the parents', which is not necessarily unbiased.

  51. I can't even comprehend what the state was thinking here...yes, there's an injustice in ignoring your child's health, especially to this extent - but you're spot on with "the kid is being punished", and will be so traumatized by this. I can't even imagine what's going through his little 8-year-old brain. I have no idea what the 'fix' is for this, but I hope someone figures it out soon. God forbid that Ohio's actions set a precedent...

  52. Something that I don't recall seeing mentioned here is the huge difference in the cost of eating healthy vs being able to have food every day. It's expensive to eat well.
    I won't judge in either direction because the media here in Columbus (and everywhere else, I imagine) often focuses on getting increasing readers/watchers and rarely do we ever get the whole story.
    My heart aches for this mom and son.