Debate resumes in UK — should fat children be taken from their parents by the state?

Dr. Michael Fitzpatrick, a general practitioner in London and the author of The Tyranny of Health: Doctors and the Regulation of Lifestyle, writes in the current issue of the British Journal of General Practice that child obesity is not a form of child abuse or an issue for child protection authorities. Tam Fry, a spokesperson for the National Obesity Forum, however, is continuing his calls for fat children to be taken into state care.

This debate has been going on for more than a year, but the Local Government Association resumed warnings today that the growing epidemic of childhood obesity necessitates drastic action by the government. Just two months ago, it had issued a similar press statement claiming the child obesity crisis is so dangerous that authorities would have to step in and “deal with the problem…for the welfare of children.” Yet, the government’s own Health Survey for England statistics reveal that there’s been no significant changes in the average weights of children in the UK for nearly a decade.

Yesterday, this was debated on the Jeremy Vine Show on BBC Radio. Mr. Fry said that parents of fat children are just as bad as parents who starve their children or seriously neglect them. He said that the futures of children who are “grossly obese” are in danger in terms of health and quality of life and that what is necessary is to remove these children into the hospital so that their weight “can be dealt with” while their parents have a make-over by child protective services. Then, when the parents have been rehabilitated and the child loses weight, the child can be allowed to return to their parents. He said we may well find that fat children welcome being taken away from their parents to lose weight, because currently they’re “forced to live in homes” where the environment is making them fat and for which “there is no escape.” Parents, too, he said, may welcome social services into their home to teach them how to be good parents.

Rob Lyons, health writer for Spiked, told BBC listeners that this situation illustrates the extent of the hysteria over obesity. Unless a child is in immediate danger, he argued, there is no justification for removing a child from a home. We’ve gotten to the stage where we think obesity is a disease and that children could drop dead at any minute, he said, but that’s overblown far beyond any science. He also argued that a fat child is not the same as one who is being starved. A fat child is likely to be getting all of the nutrients they need and their larger size is genetic; their food intake isn’t to be blamed. In contrast, an extremely malnourished, underweight child who isn’t being fed is in immediate danger.

Jeremy Laurance, the health editor for the Independent, reported that at a meeting of the National Obesity Forum, Mr. Fry’s proposal had been voted down by a vote of 2 to 1. Yet, he continues to make his case to the media. Mr. Fry is claiming that in Tower Hamlets, Lincolnshire and Cumbria, children who were excessively overweight had been removed from their parents, but Laurance went to the Association of Directors of Children’s Services and found that not to be the case. He did report, however, that social workers are currently debating whether a new approach to manage childhood obesity was needed.

Some authorities who object to Mr. Fry’s idea of removing children from their families, he said, support interventions to make children lose weight involving “regular visits from health and social workers to monitor the child’s eating patterns and to help the family with buying and preparing food…Targetes for weight loss could be set and rewards offered.” Laurance added: “In extreme cases, the National Institute for Clinical Excellence has recommended that obese children might be considered for surgery to reduce the size of their stomachs.”

Dr. Fitzpatrick, writing at Spiked today, said he’s received the first request of the school year from child protection authorities for information about a fat 15-year old boy who is a patient in his practice. The family is being threatened with statutory proceedings, he said, adding:

It seems that the Fat Police are already on the rampage. And we can expect more of it: yesterday the LGA published a new report arguing that ‘councils are increasingly having to consider taking action where parents are putting children’s health in real danger…

He also pointed out the inappropriateness of comparing situations of undernourished and neglected babies to an overweight teen whose parents doted on him. There was actual bodily harm due to the direct result of parental abuse with the starved baby and the medical literature provides clear evidence that medical intervention can dramatically restore the growth and health of that baby. In contrast: “A paediatrician told the case conference that there was only weak and contradictory evidence supporting the efficacy of any particular treatment for childhood obesity.” He cautioned that:

Apart from being threatened with legal action, parents will shortly be receiving official warnings [reviewed here] if their children are overweight and instructions from the government about healthy eating and physical activity (despite the abundant evidence that such exhortations are utterly useless). In their crusade against childhood obesity, public health zealots would do well to heed the wise words of paediatric experts in this field, who recently observed that ‘it is also important to remember that obesity remains extremely difficult for professionals to treat, thus criticising parents for what professionals are frequently unable to do smacks of hypocrisy’.

It remains to be seen if the medical evidence will override politics, but we can only hope ... for the welfare of children and their families.