Should Childhood Obesity Be a Form of Medical Neglect?

As obesity is plaguing our nation, it is no surprise that it is finding its way into the legal arena as well. In a recent case out of Ohio, a 200 pound 8 year old boy was removed from and placed in foster care, with the social workers citing medical neglect for the removal.[1] A typical 8 year old weighs around 60 pounds. The social workers stated that the boy’s mother was not doing enough to control her son’s weight problems. Children’s services was first notified of this family a year earlier, when the boy was brought into the hospital for sleep apnea problems, which can be weight related. This story, and others like it, begs the question whether childhood obesity can be classified as medical neglect, resulting in the removal of the child from the home?

An article published by the “Child Welfare League of America” confronts this very question, with ambivalent results. “What constitutes abuse or neglect, however, is often a matter of debate. Federal legislation passed in the mid-1990s presented a baseline definition of child abuse and neglect. This legislation was known as the Child Abuse Prevention and Treatment Act of 1996 (CAPTA). Although each state defines child abuse and neglect in a manner that is consistent with CAPTA, because these statutes tend to be written in broad language, courts must often interpret the statutory language to determine whether specific parental acts or failures to act violate the state child abuse and neglect statutes.”[2]

Several states, including California, New Mexico, New York, Texas and Pennsylvania have all confronted the issue of obesity as medical neglect and “all these courts, except the California court, adjudicated the children to be neglected and reached this conclusion by expanding their states’ statutory definition of medical neglect to encompass morbid obesity”.[3]

Should obesity be classified as medical neglect? Isn’t education, poverty and the economy partially to blame for rising obesity rates in this country? On one side of the argument, the home is a private place, and the state should not interfere in the private act of raising of one’s child, even if that includes unhealthy lifestyle choices. Or, perhaps removal from the home is too drastic of an approach, and instead other services should be given to the family before a child is actually removed.  Or, as some states have started interpreting their medical neglect statutes, removal for childhood obesity is warranted. As more cases come to court, each state will ultimately decide how to approach childhood obesity as a form of neglect.