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    Jolie Rouge's Avatar
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    Should parents lose custody of super obese kids?

    By LINDSEY TANNER - AP Medical Writer | AP 1 hr 30 mins ago

    CHICAGO (AP) Should parents of extremely obese children lose custody for not controlling their kids' weight? A provocative commentary in one of the nation's most distinguished medical journals argues yes, and its authors are joining a quiet chorus of advocates who say the government should be allowed to intervene in extreme cases.

    It has happened a few times in the U.S., and the opinion piece in Wednesday's Journal of the American Medical Association says putting children temporarily in foster care is in some cases more ethical than obesity surgery.

    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.

    But University of Pennsylvania bioethicist Art Caplan said he worries that the debate risks putting too much blame on parents. Obese children are victims of advertising, marketing, peer pressure and bullying things a parent can't control, he said.

    "If you're going to change a child's weight, you're going to have to change all of them," Caplan said.

    Roughly 2 million U.S. children are extremely obese. Most are not in imminent danger, Ludwig said. But some have obesity-related conditions such as Type 2 diabetes, breathing difficulties and liver problems that could kill them by age 30. It is these kids for whom state intervention, including education, parent training, and temporary protective custody in the most extreme cases, should be considered, Ludwig said.

    While some doctors promote weight-loss surgery for severely obese teens, Ludwig said it hasn't been used for very long in adolescents and can have serious, sometimes life-threatening complications.

    "We don't know the long-term safety and effectiveness of these procedures done at an early age," he said.

    Ludwig said he starting thinking about the issue after a 90-pound 3-year-old girl came to his obesity clinic several years ago. Her parents had physical disabilities, little money and difficulty controlling her weight. Last year, at age 12, she weighed 400 pounds and had developed diabetes, cholesterol problems, high blood pressure and sleep apnea.

    "Out of medical concern, the state placed this girl in foster care, where she simply received three balanced meals a day and a snack or two and moderate physical activity," he said. After a year, she lost 130 pounds. Though she is still obese, her diabetes and apnea disappeared; she remains in foster care, he said.

    In a commentary in the medical journal BMJ last year, London pediatrician Dr. Russell Viner and colleagues said obesity was a factor in several child protection cases in Britain. They argued that child protection services should be considered if parents are neglectful or actively reject efforts to control an extremely obese child's weight.

    A 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."

    That piece discussed a 440-pound 16-year-old girl who developed breathing problems from excess weight and nearly died at a University of Wisconsin hospital. Doctors discussed whether to report her family for neglect. But they didn't need to, because her medical crisis "was a wake-up call" for her family, and the girl ended up losing about 100 pounds, said co-author Dr. Norman Fost, a medical ethicist at the university's Madison campus.

    State intervention in obesity "doesn't necessarily involve new legal requirements," Ludwig said. Health care providers are required to report children who are at immediate risk, and that can be for a variety of reasons, including neglect, abuse and what doctors call "failure to thrive." That's when children are severely underweight.

    Jerri Gray, a Greenville, S.C., single mother who lost custody of her 555-pound 14-year-old son two years ago, said authorities don't understand the challenges families may face in trying to control their kids' weight.

    "I was always working two jobs so we wouldn't end up living in ghettos," Gray said. She said she often didn't have time to cook, so she would buy her son fast food. She said she asked doctors for help for her son's big appetite but was accused of neglect.

    Her sister has custody of the boy, now 16. The sister has the money to help him with a special diet and exercise, and the boy has lost more than 200 pounds, Gray said.

    "Even though good has come out of this as far as him losing weight, he told me just last week, 'Mommy, I want to be back with you so bad.' They've done damage by pulling us apart," Gray said.

    Stormy Bradley, an Atlanta mother whose overweight 14-year-old daughter is participating in a Georgia advocacy group's "Stop Childhood Obesity" campaign, said she sympathizes with families facing legal action because of their kids' weight.

    Healthier food often costs more, and trying to monitor kids' weight can be difficult, especially when they reach their teens and shun parental control, Bradley said. But taking youngsters away from their parents "definitely seems too extreme," she said.

    Dr. Lainie Ross, a medical ethicist at the University of Chicago, said: "There's a stigma with state intervention. We just have to do it with caution and humility and make sure we really can say that our interventions are going to do more good than harm."

    ___

    Online: JAMA: http://jama.ama-assn.org

    Pediatrics: http://www.pediatrics.org

    http://news.yahoo.com/parents-lose-c...200342454.html
    Laissez les bon temps rouler! Going to church doesn't make you a Christian any more than standing in a garage makes you a car.** a 4 day work week & sex slaves ~ I say Tyt for PRESIDENT! Not to be taken internally, literally or seriously ....Suki ebaynni IS THAT BETTER ?

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    I don't think they should lose custody if they honestly try after being warned but if they dont try then maybe take them till they get the problem under control. Give the parents training on feeding them when they get them back and give them back. And keep an eye on them to make sure they stay healthy.

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    It's not always the parents fault. If both parents (or single parents) work all day or even work two jobs, the kids often will just eat what they want, when they want and how much they want. If the parents think it's cute to see a 125 pound two year old saying "more" or "hungry" and just giving in and feeding them what ever, then maybe so, but only after intervention of some sort is ignored.

    Some people think feeding their kids whatever they want shows them they love them. I don't know, I think each case would be different.

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    Jolie Rouge's Avatar
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    It would need to addressed on a case by case basis ... every situation has it's own problems
    Laissez les bon temps rouler! Going to church doesn't make you a Christian any more than standing in a garage makes you a car.** a 4 day work week & sex slaves ~ I say Tyt for PRESIDENT! Not to be taken internally, literally or seriously ....Suki ebaynni IS THAT BETTER ?

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    I love how the government has no money, can't pay the elderly the SS money back that they collected from them but they can certainly finad all kinds of funds to be Nanny government in people's business. How many trillions are spent on studies about obese kids and why they are obese and how we can now take these kids from their parents, pay foster parents, etc, etc. Let's spend all this money to study that chocolate milk has more calories than "white" milk and spend trillions implementing a plan not to give it out in public schools anymore. While we're at it, let's spend trillions to feed people in other corrupt countries, whose leaders pocket it and live like kings but let's not pay our elderly and make them eat cat food. Makes no sense.

    Oh, and we'll spend trillions in court costs, legal fees and settlements defending all this spending.
    Mrs Pepperpot is a lady who always copes with the tricky situations that she finds herself in....

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    I love how Obama's wife is on a health kick for kids. But she ate a 1700 calorie lunch the other day of a cheeseburger, lots of fries a chocolate shake and a diet drink. Way to set a good example for the kids. They're probably thinking if you can eat it why can't we.

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    So are they going to increase the amount of SNAP benefits so that parents can afford to purchase healthier less processed foods?

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    We don't have the money now for another program. If they did it I would hope they first went into the home to educate the parents on healthy eating for kids to see if they can make it work.

    I was at a fast food place and a women came in with an obese boy about 5. He ate his meal then went to order even more. The counter guy looked at the mom to see if it was ok for the kid to order and she nodded yes. Some parents can't control their kids but who can say who is trying and who is not?

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    Correct me if I'm wrong, but I heard something like if your over weight with a big belly, that it's actually larger and takes more to fill it up/ not be hungry anymore, that's why you see larger people eating so much. That it takes training yourself to eat less at each setting to train your self to eat less, and then it will eventually take less and less to fill you up. I remember trying to do something like that when I was younger, I started only eating "1" plate at dinner time, and withen a week that one plate really filled me up. Now I'm back to seconds LOL.

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    janelle's Avatar
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    My mother always had a big belly. She had no butt though. She carried it all in front. She lived to be 97. Go figure. ???

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    My friend is obese, she feeds her 16 month old food that she eats., french fries, chicken nuggets, pancakes, sweet tea, mac n chez,...I have never seen this kid once be fed anything remotely healthy.
    Rudeness is the weak person's imitation of strength.

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