An editorial in JAMA today by Murtagh and Ludwig proposes that in the case of severe childhood obesity, we should be prepared to consider state intervention. In other words, the state should potentially react to severe "overfeeding" and its consequences as it would to parents starving a child. Protecting the well-being, and life, of the child trumps the sanctity of the family.
But along with the knee-jerk opposition such a proposal evokes (in my opinion, unwarranted in this case, by the way, because Ms. Murtagh and Dr. Ludwig make a very thoughtful, nuanced argument), there is a subtle problem that may go overlooked. Namely, we condemn the outcome, but not the behavior that leads to it.
Adults are criminally liable if they give cigarettes or alcohol or illicit drugs to a child. And they are criminally liable for starving a child as well -- this constitutes abuse. But our society does not view giving a child a donut or fries or soda as abusive -- even if it occurs day after day. How do we sanction state intervention for a bad outcome attached to behaviors we condone every day?
Thinking along these lines led me back to an experience I had a few years ago, when I went to Maui to give a talk at a health conference.
What is relevant to my topic about this is the plane I took to get here. I happened to be sitting in first class, courtesy of those hosting the conference. In my row was a woman who moved to Maui a year prior, her sister and her sister's two-year-old daughter.
I did not get to know her well, but enough to recognize that she was intelligent and warm-hearted. She was thrilled to be bringing her sister and baby niece to visit her new island home for the first time. I liked her.
There was something else I got to know about her, which required no conversation at all. Namely, she was a very large woman. Her sister, just a couple of seats away, was at least as large.
At one point during the flight, my neighbor's sister returned from the airplane lavatory and told her sister, with a chuckle in her voice, "If I get any bigger I'm not going to fit in there!" The two of them had a good laugh and exchanged quips about the need to "extend" those little toilets.
Throughout the entire flight, my neighbor (and her sister) were eating and drinking. This is hard to resist in first class, where you are constantly offered temptations. So my neighbor consumed several glasses of wine. She ate everything that was served. And she ate a box of some kind of glow-in-the-dark cheese puffs she had brought with her.
I watched my very delightful neighbor and her probably equally delightful sister share their eminently destructive behaviors with the two-year-old in their company. I have essentially no doubt that this child -- still lean at age two -- is destined for even more extreme obesity than her mother and aunt, and destined for the chronic diseases that ensue. In other words, I was observing a pattern of familial behavior that would destroy an innocent child's health.
Imagine if two drug addicts joked in public about the health consequences of their drug use, even as they shared their drugs with a small child. Children are removed from their parents for less.
Imagine if smokers joking about their worsening emphysema put their cigarettes into the mouths of their infants. Would anyone observing this feel inclined to mind their own business?
Don't get me wrong; I am not maligning these women. Nor am I am suggesting their harmful behavior was even their fault. Our society has yet to provide any clear guidelines on what is, and is not, acceptable when it comes to second-hand obesity.
That is what has to change, certainly before we sanction the state taking an obese child from a parent. Let's react to the process, not just the outcome. You don't get to decide for yourself if giving drugs or cigarettes or alcohol to small children is appropriate. Society has decided for us: It is not! Good call.
Data from the CDC indicate that children growing up in the United States today will suffer more chronic disease and premature death over their lifetimes from eating badly and lack of physical activity than from exposure to alcohol, tobacco and drugs combined. If the principle we care about is protecting children from harm, the practice should pertain to all threats comparably. At present, it does not. We are feeding our children to death.
Obesity is not the fault of its many victims, but it's no joke either. I like a good laugh as much as the next guy. But unless we start recognizing obesity for the serious threat that it is, the fate of our children will be cause for tears. And unless we take such matters into our own hands, there is the prospect in severe cases- of the state taking our children into theirs.
-fin
Dr. David L. Katz; www.davidkatzmd.com
www.turnthetidefoundation.org
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We'd save tons of money. Because they'll get less than min. wage. Part of their daily pay will be a bowl of gruel, a peanut butter sandwich, & 1 hot meal (mmmm, I'm starting to get hungry myself). Plus we'll provide a canvas roof over the little buggers heads. Assuring us an awesome work force for many years to come.
We'll also arrest their parents for child neglect & abuse. And toss them in a (Privately-Owned) prison & make them work for meals too. If they're big, strong, & healthy, we can make the parents join the military. Never again will we need a Draft. And we'll save big bucks, not having to hire mercenaries anymore.
As for the other little miners, when they grow up, they'll also join the Military. Unless they get real high scores on the entrance exams. Then we can make them Fox News Reporters or hosts.
One last thing's their Health Care. They'll have to find their own drs to take care of 'em if they get ill or hurt. After-all, this is America, by golly. Its not our responsibility to keep 'em healthy. Do you think we're Socialists or something? Humph
Obesity is epidemic--sure we all know that. But the issues that are causing it are multitude. Some genetic, some dietary, some bad civic planning and some medicinal interactions or side effects etc.,
Blaming parents for not raising supermodel children or not being supermodels themselves when all we do is work, when there are few safe places for children to play, when schools cut recess and gym---when the food available to us and our children are deep fried, over processed and laden with crap--
Well there it is. This isn't generally a parenting problem it is a cultural problem. You can try and push it on select targets, but that won't change the truth and it won't solve the problem.
I believe that, first, we have to start teaching nutrition in the schools and supplying healthy lunches. No lunches from home allowed. A small state cost to prevent the cost of chronic disease down the road. Next we have to incorporate PE (physical exercise) as a required course in school all the way up to university.
Rather than taking the children away, I believe the law should require the parents of obese children to take nutrition courses. Some of these parents don't know the difference between protein, fat, and carbohydrates and have no idea what role each plays in human nutrition. They are victims of their parents. If, after that, they don't smarten up, then perhaps take the children away.
NO...but they should be denied medical treatment until they lose the fat.....FAT IS THE MAJOR UNDERLYING CAUSE OF ILLNESSES..
The othe big issue is the lack of arts education and physical education in schools. I'm not saying we need the old-fashioned PE classes where overweight kids are targets in those awful games of dodgeball. But since we're facing an epidemic, (and let's face it, the last thing overweight kids want to do is play a game of shirts and skins) there should be a circuit training, aerobic center for these kids. Arts education and sports keep kids out of the house and off the play station. Provide them with opportunity to move and opportunity to enrich their lives and give them the information to make healthy choices. Not difficult, just costs some money.
On and On this is a big problem ... no pun intended lol the American way of eating is insane
I also think that it is no other person's business. It is mentioned that you don't hand your young child a cigarette BUT people have no problem with smoking while carrying a baby, or have the young ones in the car with smokers. Drinking & smoking is just like the over eating... we know it is bad, you don't have to keep reminding us.
You want kids eating healthier?? Make the cost of fruits and vegetables lower than the cheap junk. People can buy frozen "meals" that heat in the microwave for a minute and poof it's on the table for a lot less than other healthier options. Between the parents having no time to cook because of the multiple jobs and not having the extra money because of the gas prices... what do you expect.