Should Obese Children Be Placed in Foster Care?

A piece in the Journal of the American Medical Association argues that children with health-threatening obesity should be placed into foster care. There really no dispute that obesity, particularly in children, is a major public health problem. Obesity (being severely overweight) is a major risk factor for heart disease, diabetes, stroke, and some forms of cancer. Worldwide, it is one of the leading preventable causes of death. It is also a common source of social stigma, especially in children, which can cause lifelong psychological problems such as depression and social anxiety.

However, Western (particularly American) society has a strange view towards obesity: the public largely considers it a moral failing rather than a health problem. So, any acknowledgment of the fact that obesity is not entirely an individual’s fault, without denying that lifestyle choices play a huge role, is seen as a retreat from personal responsibility, and people who are overweight should just suck it up and have a salad.

On the flip side, any government policy meant to promote healthy eating, exercise, and health education in children, with an eye toward reducing childhood obesity rates, is seen as an unnecessary government interference in the parent-child relationship.

Paradoxically, most Americans (really, most people) recognize that the state has an interest in protecting children from abuse and neglect at the hands of their parents. After all, children are, for the most part, legally unable to make their own decisions, and it’s often impossible for them to defend themselves against abusive or neglectful parents.

Given that severe obesity in children, especially young children, can be extremely threatening to their health and well-being, I think it should follow that children in such situations should be removed from their homes, applying the same standards that would apply in cases of abuse or neglect. Obviously, removing a child from the custody of their legal parents should be considered only as a last resort, when all other efforts to mitigate the problem have failed. After all, we would remove a child from a home in which he’s being starved to death. Why the reluctance to rescue a child who’s being fed to death?

We’ve all heard horror stories about very young children who have reached astounding weights – 10-year-olds who weigh over 200 pounds, for example. Those stories are tragic, and it’s clear that the parents bear some responsibility. With a child that young, the parent has a great deal of control over the types of food that they have access to, and whether they have an extremely sedentary or active lifestyle.

Obviously, a child being slightly overweight is not enough to justify much, if any, intervention by social services, let alone removing the child from custody.

I’m referring to the most extreme situations, where a child is so overweight that their health is already suffering, and they risk getting illnesses and injuries that could negatively affect them for the rest of their lives, even if they eventually get down to a healthier weight.

An obvious solution is to enact policies that reduce childhood obesity in the first place. This strategy should include, as a small part of a much larger agenda, the knowledge that parents who endanger their children’s health through obesity will be treated no differently from parents who endanger their children’s health by any other means. Obviously, this does not meant that every instance of sub-par parenting would result in the loss of custody. Our policy should be geared towards improving parenting, and the well-being of children. Removal of a child from their parents’ custody should only be considered when it’s clear that doing so would be in the child’s best interests. It should not be a means of punishing what we view as lousy parenting.

There are many other government policies that could probably reduce childhood obesity. Hopefully, as the Affordable Care Act takes effect, more low-income families will have access to preventative healthcare services, including counseling and education on childhood obesity. For relatively little money, the federal government could provide additional funding for healthier lunches in school cafeterias, as well. Perhaps the biggest thing the government could do to combat childhood obesity, and therefore make this whole issue moot (or closer to being moot, anyway) is to cut or eliminate corn and soy subsidies.

The agricultural industry is heavily subsidized by the federal government, and a large percentage of these subsidies go to corn and soy growers. It just so happens that these two crops are practically ubiquitous in unhealthy processed foods.

Obviously, how we should deal with childhood obesity is a complex legal and public policy issue, and there are no simple solutions.

However, a good start would be to remember that the state does have a role in protecting children. To argue otherwise would effectively be an argument for legalizing child abuse and neglect. When parents negligently expose their children to severe illness and injury, regardless of the exact means, the state has a right and a duty to intervene.