Wednesday, July 13, 2011

Run that by me again

Via Megan McArdle, there’s an opinion piece up at MSNBC arguing that the Harvard researchers who want some obese children removed from their parents are wrong. I haven’t thought through the Harvard idea enough to have an opinion on it but I was struck by two statements in the MSNBC piece. First (emphasis mine):

The only basis for compelling medical treatment against a parent’s wishes are if a child is at imminent risk of death — meaning days or hours — and a proven cure exists for what threatens to kill them. Obesity does not pass these requirements.

The risk of death from obesity is real, but it is way down the road for kids. There is no proven cure for obesity.

But then:

But if we don't yank heavy kids from their obesity-encouraging homes, what should we do? [snip]

... might we try to change our food culture? This means doing what we have done for smoking. Demonize the companies that sell and market food that is not nutritious. That means you, candy, soda, fried food and snack food outfits. Tax them too. And get Hollywood and television to make overeating and not exercising uncool just like they did with smoking. Put exercise back on the menu for all school kids.

So which is it? There’s no proven cure for obesity or changing our food culture will cure obesity?


E Hines said...

There was an unsatisfying debate on the noon FoxNews program about this. One lady more or less agreed that child obesity could approach child negligence, or even abuse, but insisted that the only correct answer was to treat the family unit--education, diet instruction, exercise instruction, and so on. It was just too traumatic to take the child out of the family unit. I was left with the impression that with more "classic" child abuse--sexual abuse, beatings, and so on--it still would be too traumatic to take the child out of the family unit: this unit should be treated with anger management, sexual mores, etc. The other lady argued that only as a last resort--and only in cases of extreme obesity--would the child be taken out of the family--indeed, only after the very things the first lady argued for had been tried and had failed.

I agree that child obesity can be child abuse, but I'm hard pressed at where to draw that line. I also am unsure that modern medicine can reliably discriminate between obesity from poor behavior and obesity from a metabolic problem.

Eric Hines

Elise said...

There are a lot of problems with the "remove the child" approach. If nothing else, after a certain age, there's a limit to how much parents can do to control what their children eat.

I also don't think I would classify a child being obese as child abuse. I imagine you could go for child neglect or child endangerment but it's a heck of a slippery slope. Would you take a 12-year-old who smoked away from his parents? A 13-year-old who slept around? I'm going to have to think about this one for a while.

I would certainly say that if taking an obese child away from his or her parents was considered, it should happen only after other interventions were tried and had failed. I can also say that anyone who thinks a child who is being sexually or physically abused should be left with his or her parents is dead wrong.