Controversy- Obesity is Child-Abuse?
Controversy- Obesity: A Form of Child Abuse?
The definition of overweight is individual weighing 10% or more of what is considered his or her recommended healthy weight. More recent guidelines for obesity use a measurement called BMI (body mass index) which is the individual’s weight multiplied by 703 and then divided by twice the height in inches. BMI of 25.9-29 is considered overweight.
The definition of obese is an abnormal accumulation of body fat, usually 20% or more over an individual’s ideal body weight. More recent guidelines for obesity use a measurement called BMI (body mass index) which is the individual’s weight multiplied by 703 and then divided by twice the height in inches. BMI over 30 is considered obese.
The definition of overweight for children is defined as a BMI at or above the 85th percentile and lowers than the 95th percentile for children of the same age and sex. A child’s weight status is determined using an age- and sex-specific percentile for BMI rather than the BMI categories used for adults because children’s body composition varies as they age and varies between boys and girls.
The definition of obese for children is defined as a BMI at or above the 95th percentile for children of the same age and sex.
Obesity now affects 17% of all children and adolescents in the United States – triple the rate from just one generation ago.
With childhood obesity increasing in the United States, courts and child welfare systems are facing many issues. One of these issues is whether to prosecute parents for neglect of their children, when parents disobey doctor’s medical advice. Secondly, if the state does consider this to be an offence, what should they do in regards to these cases? Should the state and Child Protective Service remove the child from their home and place them in foster care; should the parent be charged with an offense and penalized, or should they take less drastic matters such as teaching the parent and child about nutrition, exercise, and healthy food choices?
Over the past few years, there have been several states that had to wrestle with this notion of charging and prosecuting parents with abuse or neglect due to their child being morbidly obese; because they were unwilling or unable to control their child’s weight against medical orders.
In 1998, the California case, involved a 13 year old girl who weighed more than 680 pounds; the New Mexico case, decided in 2000, involved a 3 year old girl weighing 131 pounds; the Pennsylvania case, decided in 2002, involved a 16 year old boy who was a little over 5 feet tall but weighed over 450 pounds; the New York case, decided in 2007, involved a young adolescent girl weighing 261 pounds. All of these courts, except for California court, decided the children were neglected and decided to change their state’s statutory definition to include morbid obesity in the definition of medical neglect. The child in California had died before the case was heard, so the mother was charged with a misdemeanor child abuse through inaction (Darwin, A., 2008).
Definition of neglect:
According to Child Welfare Information Gateway, “Neglect is frequently defined as the failure of a parent or other person with responsibility for the child to provide needed food, clothing, shelter, medical care, or supervision such that the child’s health, safety, and well-being are threatened with harm” (Child Welfare Information Gateway, State Statutes, 2011). You can look at this website to find the definition by state: http://www.childwelfare.gov/systemwide/laws_policies/state.
In the cases listed above, do you think the parents are responsible for their child’s obesity? Yes, the parent does provide food for their child at home, but what about the times when the child is away from home? Who do we hold responsible, for the choices that child makes? What about the schools? Children spend about a third of their day at school. Cafeterias are providing children with unhealthy food choices such as pizza, hamburgers, and french fries, plus children have access to vending machines which doesn’t offer a wide selection of healthy foods. Schools are also reducing physical education to promote better performance in math and reading.
Research shows that genetic factors do make some children more susceptible to gaining weight. Some of the genetic disorders are Turner Syndrome and Prader-Willi Syndrome, which prevents a child from feeling full after eating. Children with these disorders will always be severely obese as a consequence. There are some medical disorders that aren’t genetic, such as hypothyroidism and central nervous disorders, which can cause obesity.
Steps to Help Families
Child welfare systems and states should provide families with intensive services before getting the courts involved, such as: family counseling, menu planning, education on nutrition and exercise, classes on cooking for parents and children, and a nurse/social worker to visit the family.
This ensures that all members of the family are mentally healthy. It helps the child voice their feeling and helps the family address any mental health problems, such as situational depression. For more serious mental illnesses, the counselor can refer the parent or child to a certified mental health professional. Family counseling can assist the family in building and maintaining strong bonds and enhance trust.
This component will provide parent and child with information on proper nutrition and exercise. Some of the parents in the cases above stated that they didn’t understand proper nutrition and dieting.
Research shows that 80% of children are obese when at least on of their parent are obese, while only 10% of children are obese when neither parent is obese. When parents are aware of the importance of proper diet and exercise, they are more likely to be able to their child engage in a healthier lifestyle.
This would be beneficial for impoverished families. Many of the cases involved impoverished families. Studies show that people in the lower social economic bracket have higher rates of obesity than people in the higher social economic bracket. Healthier food cost more than fast food, and if a parent has to choose feeding their child fast food or nothing, fast food will prevail.
Menu Planning and Visiting Nurse and Visiting Homemaker
The menu planning component helps the parent prepare more nutritional meal that have the proper caloric content for their child. For better results, a treating physician or dietician should plan the child’s menus. The visiting nurse/homemaker will help ensure the family complies with the dietary compliance. The visiting nurse can provide treatment for any minor health ailments afflicting the child due to their obesity. Finally, the visiting homemaker benefits the family be modeling healthy cooking; by showing alternative ways of cooking and assist with portion size at meal times.
Bowdoin JJ. A response to the Expert Committee’s recommendations on the assessment, prevention, and treatment of child and adolescent overweight and obesity. Pediatrics.2008;121 (4):833– 834