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Morbidly Obese Children - Should Community Services Intervene?

By Yvette Vignando - 14th July 2011

Dr. David Ludwig, an obesity specialist at Harvard-affiliated Children's Hospital Boston, contributed to an article in the American Medical Association Journal calling for consideration of protecting morbidly obese children in extreme cases by temporarily removing them from their parents. One of the arguments is that temporary removal to foster care together with treatment, would be better than the risks associated with bariatric surgery for example. View the discussion above on Sunrise on Channel 7 with Yvette Vignando about the Australian situation.

Some doctors who specialise in obesity,diet and nutrition have called for morbidly obese children to be removed from their families in the past, both in Australia and other countries. And there are instances, rare ones, of children being temporarily removed from their families for important medical reasons. However, as far as I understand it in Australia, a child would not be removed from their family by Community Services for obesity alone. Authorities in Australia must first find there is a risk of significant harm to the child before considering placing a child in foster care - and in most cases, I believe, Community Services would attempt intensive interventions if they felt a child's health and nutrition was at risk.

Certain categories of professionals such as doctors, teachers and police are obliged to report cases of "neglect" or concern to Community Services if they believe that a child is at risk of, or has serious medical problems and if they believe the parents are unwilling or unable to have the child evaluated and treated. But even then, reporting to Community Services does not mean a child will be removed from their family - often it will mean the family receives support such as financial assistance to get to medical appointments and education about nutrition.

But this issue is an emotive one - we've all heard of cases where children were not removed from a family and things went terribly wrong. We don't hear so often about children being removed and how they feel about that process themselves. My personal view, and I think (correct me if I'm wrong) the philosophy of Community Services and similar departments, is that children are almost always better off emotionally if they can stay with their parents. In the case of a child being morbidly obese, this could be a good reason to be concerned about a child's health, and maybe even their parenting, so I understand why government authorities should (and do) get involved. But I think I would only support removal to out-of-home care if a parent refused or was for some reason unable to have their child's medical conditions treated and cared for by the appropriate experts.

There's even more complexity here - what about the influence of the community? What role can or should schools play? Do you support the call by the Australian Medical Association for a ban on junk food advertising during children's viewing times? The AMA has said that the junk food industry has failed to self regulate in this area. How should we deal with this issue as a community and at the same time avoid the stigmatisation of children who may be overweight?

To give you some perspective, it appears that the number of children who can be called obese in Australia lies somewhere around the 5-8% mark, with perhaps up to 25% of Australian children classified as overweight. There are many sources for this kind of information - here is one: Australian Bureau of Statistics

I would welcome your thoughts on this.

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