When does obesity become a child protection issue?

July 16, 2010

Childhood obesity alone is not a child protection concern, nor is failure to control weight. But consistent failure to change lifestyle and engage with outside support indicates neglect, particularly in younger children, say experts in a paper published in the British Medical Journal today.

The suggestion that childhood obesity may raise child protection concerns is highly contentious, but there is little published evidence on the issue and no official guidelines for professionals.

So a group of child health experts, led by Dr Russell Viner at the UCL Institute of Child Health in London, set out to review existing evidence and propose a framework for practice.

They found increasing evidence linking adolescent and adult obesity with childhood sexual abuse, violence, and neglect, but found no studies examining the relation between child protection actions and childhood obesity. Data are also lacking on the long term outcomes of child protection strategies in relation to weight control, other metabolic disorders such as diabetes, and .

In the absence of evidence, the authors suggest that child protection actions are not warranted for childhood obesity alone or failure to control weight. "The aetiology of obesity is so complex that we believe it is untenable to institute child protection actions relating parental neglect to the cause of their child's obesity" or "to criticise parents for failing to treat it successfully, if they engage adequately with treatment," they write.

However, they do believe that consistent failure by parents to change lifestyle and engage with professionals or with weight management initiatives would constitute neglect. This is of particular concern if an obese child is at imminent risk of disorders like obstructive , hypertension, or mobility restrictions, they say.

Where child protection concerns are raised, the authors suggest that obesity is likely to be one part of wider set of concerns about the child's welfare. It is therefore essential to evaluate other aspects of the child's health and wellbeing and determine if concerns are shared by other professionals, they say.

Finally, in cases of severe , they recommend a wider assessment of family and environmental factors.

"In all areas of child health, we have a duty to be open to the possibility of child neglect or abuse in any form," they conclude. "Guidelines for professionals are urgently needed, as is further research on the outcomes of child protection actions in obesity and links between early adversity and later obesity."

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not rated yet Jul 16, 2010
You can't call it neglect when the majority is obese...unless we start holding obese adults accountable for their own condition. How about we change the medical system to stop treating conditions that are self inflicted? Might motivate people a bit more.

What, is it going to be like gambling and beer? "Sorry kid, you can't obese till you're 21." Underage obesity? Could you be arrested for it?

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