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What Parents of Obese Children Must Do to Keep Them Home

It happened in Ohio to a nine-year-old boy. He weighed 218 pounds; his mother was offered help, he didn’t lose weight and he was removed from his home.

Is a mother who allows her son to become morbidly obese guilty of a form of abuse? That’s for the legal eagles to decide, but I’d say it’s more a case of medical neglect. Either way, it never should have reached that point.

The dangers of childhood obesity

The boy went to live with an uncle, lost 42 pounds, and has been returned to his mother’s home—for now. My concern is that not enough work has been done by his mother to ensure that he’s not being returned to the same dysfunctional eating environment from which he was removed.

What bothers me most is this statement from the mother: “It’s a lifestyle change and they are trying to make it seem like I’m not embracing that. It’s very hard, but I’m trying.”

She needs to try harder. This is her son. The boy’s uncle made the situation work well, proving that her son could certainly lose weight and be healthier if given the right environment and some commonsense parenting. Now she needs to step up and provide him with an equally healthful environment. If she doesn’t, she could lose her son again.

As a clinician and a practitioner who often advocates for parents, it’s still hard for me to defend this parent. Her son did not reach 218 pounds overnight. The eating environment in his home had to have been downright toxic for some time to enable this level of obesity by age nine. I hope she’s serious, but she should have been serious at least 75 pounds ago.

Removing a child from a home should be only a last resort. In this boy’s case, there were imminent health risks that were not being addressed by his mother. He had sleep apnea and he was at huge risk for diabetes and a host of other serious health problems that come with morbid obesity, which is usually defined as being either double one’s ideal weight or at least 100 pounds above one’s ideal weight.

This mother needs help, and not just with buying and preparing healthy food. Most parents would feel that absolutely nothing is worth having their children removed from their care. In this case, even the threat of her child being removed wasn’t enough for her to make necessary dietary and lifestyle changes. That’s a red flag that she—and probably her son—needs ongoing counseling, in addition to sessions with a registered dietitian. She and the boy both need to reestablish a positive relationship with food and activity, and she needs to understand the barriers she set up that blocked her motivation to make changes. This kind of intervention probably should have begun as soon as the child was removed, but it’s never too late to start living a healthier life.

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Keith-Thomas Ayoob, ED.D.

Keith-Thomas Ayoob, ED.D.

Dr. Ayoob is director, Nutrition Clinic, Children’s Evaluation and Rehabilitation Center at Montefiore and associate clinical professor, pediatrics at Albert Einstein College of Medicine.

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Comments on this entry are closed.

  • Lisa Fields June 10, 2012, 7:05 PM

    Dr. Ayoob,

    Thank you for writing about this very challenging case. We know obesity often runs in families. I have worked with families in their home who had both chronic mental and physical health problems. What if there was a program that could work with both the mother and her child? This would be an excellent choice for the family, our community, health care providers and the medical institutions charged with the care of this family.

    I suspect the mother is suffering from some type of addiction. Compulsive use, loss of control and continued use dispite adverse conditions~ certainly makes sense that these factors were in place and they were so severe she was not able to take care of her child in a manner that ensured his health and safety.

    In the past we had a wonderful program called Weight to Go in Greensboro, North Carolina. The program focused on exercise, behavior management techniques, basic nutrition, etc and provided all this information in a way that was fun and easy for both the children and their parents to understand and embrace. What happened to the program? The program is no longer in place due to the budget cuts. The pediatricians in our community were very disappointed it is no longer in place. As a means of transparency I had no affiliation with the Weight to go program.

    I agree that both the mother and her child need supportive services as soon as possible. Families are systems and if we are serious about the health of our children we must also assist their parents. A peer- to -peer program for both the mother and child would also be a recommendation I would request if money or some other challenge was not in our way.

    Thank you for your passion for children and their health. I highly respect Albert Einstein College of Medicine and appreciate being able to learn and discuss medical issues with the help of this blog.

    Sincerely,
    Lisa Fields, M.S.
    AKA Twitter @practicalwisdom