No

by Dr. Deborah Bauers

Created on: October 25, 2010

The question of whether childhood obesity is due to abuse is difficult to answer because of a number of variables that can impact weight gain in children. In all fairness to those parents who struggle with good intentions and concern about this issue, a case for neglect cannot be made without first considering the extenuating circumstances that can make weight gain in children difficult to control.

While it may be true that a majority of overweight children simply need better nutritional oversight and adequate exercise, not every child’s obesity can be “fixed” so easily with just these solutions. If society begins to label every parent of an obese child as negligent or abusive, it will do a great disservice to a small cross section of parents who need its help, not its condemnation.

There can be some serious reasons why children become overweight that are complicated and require the help of, not just parents, but specialists who can diagnose and treat medical and mental health issues that can be causal to the problem of overeating.  Parents of children who suffer with health issues are often more focused on identifying the underlying problem of which overeating may be just a symptom.

Children who are victims of bullying, have low self-esteem, suffer anxiety disorders, have attachment issues or struggle with learning disabilities may all have the propensity to be either overweight or underweight.  When a child with mental health issues is overweight, food is often an unfortunate coping mechanism that provides a source of comfort, stimulation, and reward.  For this child, the notion of solving a problem of obesity by making behavioral changes is an oversimplified, naive approach to getting the child the help he/she needs.

There are also overweight children who suffer with hormonal imbalances and rare diseases such as Cushing Syndrome.  These children are heavy because of hormonal imbalances like toxic levels of cortisol in the body that result in unnatural weight gain. In cases like these, obesity is secondary to identifying and treating the primary problem, a problem that parents cannot address on their own.

If you are to assume that every overweight child is a victim of gross neglect, then you must automatically rule out the additional potential for genetics as a determinant of a child’s size and weight. And though it’s easy to see an overweight child with obese parents and assume that the parents are negligent in providing healthy and balanced nutrition, there is much not understood about the significance of the battle is that is waged between nature and nurture.

Is it accurate to say that childhood obesity is always the result of parental abuse?  In light of the roles that mental and physical illness as well as genetics can play, the answer is far from cut and dried. And even if conclusive evidence supported a case for neglect in some families with obese children, what is the answer?

Social Services are already taxed far beyond its capability in dealing with overt cases of child abuse, abandonment, gross mistreatment, and sexually molestation.  According to Dr. Russell Viner and his colleagues of the UCL Institute of Child Health in London, a recent study shows that 37% of overweight children residing in foster care have gained additional weight after placement.  Viner argues that weight alone, without consideration of other factors, should not be used to determine cases of negligence or neglect (The Guardian, July 16, 2010).

The jury is still out and likely to remain so for the foreseeable future on the issue of whether childhood obesity constitutes abuse.  There is no way to sort out the complexities of childhood obesity on a case by case basis without infringing on basic human rights.   Removing a child from its home because of weight issues is likely to have even greater negative impact upon the child, and in this case as in most, the end rarely justifies the means.

The answer to addressing obesity in children lies in education, not government control.  Those parents who have children with secondary medical and mental health issues need help and support, not condemnation.  Let’s be vocal about encouraging those agencies that are intended to protect to focus on intervention where they can make a positive difference; let’s tell them to leave the issue of obesity to parents as well as healthcare professionals.

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