Should Parents Lose Custody of Obese Kids?
As I was preparing my new syllabus, I came across a case that forced me to think about the extent to which parents should bear responsibility for their children’s obesity. It is well-known that obesity places children at greater risk of Type 2 diabetes, heart disease, kidney failure, and possibly cancer later in life. Sixteen percent of American children and adolescents are obese; another sixteen percent are overweight. The medical profession has warned that, as a result of the rise in childhood obesity, the current generation of American children may have shorter life expectancies than their parents.
I believe that parents should make efforts to provide their children with healthy foods and regular exercise. However, I question whether parents who do not control their children’s weight problem should lose custody of their children to the state? Are we willing to hold that a parent who does little to address his child’s obesity has neglected his child in the same way as if he had failed to provide him with adequate nourishment or supervision? Courts and child welfare agencies are grappling wth this issue. In a recent case, In re Brittany T., a New York Family Court ordered the removal of a morbidly obese child from her parents’ home based on the parents’ consistent failure to comply with the court’s order that they take her to the gym 2-3 times a week and attend a nutrition and education program, among other things. Although the case was reversed on appeal, the New York Appellate Division did not hold that child obesity can never be grounds for neglect, but rather that, in this particular case, the Department of Social Services had not shown that the parents had willfully violated the terms of the court’s order. In fact, although Brittany had gained 25 pounds in five months, the evidence showed that her parents had taken her to the gym at least once a week, had met with a nutritionist, and had kept a food log for her. Yes, the food log reflected that Brittany ate “lots of chicken nuggets, lots of pop tarts, hot dogs, and pizza,” but the parents had maintained the log, as ordered.
Courts in California, Iowa, New Mexico, Pennsylvania, and Texas have recognized childhood morbid obesity as a legal issue. However, removing an obese child from an otherwise adequate home inaccurately suggests that parents have complete control over their children’s diet and exercise. This is not the case. For example, Brittany’s parents testified that Brittany (who was 12 years old) was known to have snacks after school and to “sneak food” at home. Anyone who has spent any time around older children (or who recalls their own childhood) knows that children do not always do as they are told. A finding of neglect in these cases also fails to consider the extent of schools’ responsibility for the rise in childhood obesity. Many schools have cut their physical education programs from five days a week (when I was in public school) to only once a week in some districts. In addition, schools serve high-caloric meals and provide vending machines stocked with junk food. In fact, the New York Appellate Division found that Brittany’s food consumption at school, rather than her parents’ allowance of inappropriate foods, may have been the cause of her 25 pound weight gain. Many parents serve their children only one meal—dinner. It is unlikely that parents are solely or even primarily responsible for the rise in childhood obesity.
I also worry that a determination that failure to address a child’s obesity may constitute neglect would disproportionately affect minority families who are more likely than whites to have obese children. For example, 14.5% of white adolescent girls are obese, as compared to 20% and 28% of Mexican-American and African-American adolescent girls, respectively. Minority children are already disproportionately represented in the foster care system. Do we really want to place more children in foster care? On the other hand, when a morbidly obese child develops, as Brittany did, “gallstones, excessive fat in her liver . . . which could eventually develop into nonalcoholic cirrhosis of the liver), sleep apnea, intermittent high blood pressure, pain in her knee joints, insulin resistance (indicating an increased risk of developing diabetes)” and the “significant social and psychological impact such morbidity has,” including depression, what is a court to do? I do understand the frustration of Brittany’s doctor who spent a long session explaining to Brittany’s mother the adverse effects of childhood obesity and what foods she should eat, only to see Brittany, minutes later, eating burgers and French fries in front of her mother. However, I am not sure that removal from the home (and placement in foster care) is the solution.