Foster care for obese kids: Drastic measure,  preventable problem
Jennifer Shu says there are multiple factors contributing to the choices and habits that lead to obesity in children.
July 14th, 2011
01:54 PM ET

Foster care for obese kids: Drastic measure, preventable problem

In addition to being CNNHealth’s Living Well expert, Dr. Jennifer Shu is a practicing pediatrician. She also blogs regularly for The Chart on kids’ health.

Poor prenatal care, child abuse and neglect can get a child taken out of the care of his or her parent(s), but what about extreme obesity?

A commentary by two Harvard health researchers in the Journal of the American Medical Association suggests just that - that in certain situations it may be in a very obese child’s best interests to be removed from the home.

Should parents lose custody of obese children?

The heart of the debate involves the concern that children at or above the 99th percentile for BMI (body mass index) are at risk for complications from diseases such as type 2 diabetes.

In order to prevent these life-threatening problems, placing a child in foster care while intensively reducing weight has been proposed as a way to help avoid surgical procedures such as gastric bypass surgery and its related risks.

Obesity does not happen overnight and in most cases can be prevented. As a pediatrician, my hope is that regular doctor visits (or contact with a school nurse or health department) would identify children at risk for becoming obese before they reach the 99th percentile mark.

To put things into perspective, a 10-year-old child with a BMI around the 99 percentile with an average height of 4 ½ feet tall would weigh about 110 pounds. Since children grow for several years, it’s entirely possible through changes in health habits for the height to eventually “catch up” with the weight so that they are more in proportion in the future.

In rare instances where a medical condition is part of the child’s weight issue - such as a genetic disorder or hormonal problem - it’s important first to address the underlying problem.

There are multiple factors contributing to the choices and habits that lead to obesity in children, and many of these are completely unrelated to poor parenting.

Low-income families may have difficulty accessing healthy foods or lack the knowledge to make proper food choices. The solution should therefore focus on education and support for families rather than state intervention and transferring responsibility to foster parents. The average stay in foster care is almost three years, and even the authors acknowledge in their commentary the emotional impact of disrupting homes.

While I don’t have all the answers for combating this growing problem of childhood obesity, the best strategies are often not simple nor inexpensive.

Unfortunately, most of the recent attention to this article has dealt simply with the removal of obese children from their families, which the authors point out would only be an option in rare cases. This approach of course would not be relevant to the vast majority of children and oversimplifies the issue.

While thought-provoking and highlighting the important topic of childhood obesity, the proposed drastic method of treating obesity using foster care runs the risk of doing more harm than good to a child’s well-being, and efforts could be better directed toward getting help for the child in the home rather than outside of it.

soundoff (31 Responses)
  1. Cathy

    Where are you going to find enough foster homes to handle the influx with obesity rising in the US? And then we can start fostering kids from families that smoke or eat too much red meat, etc... The problem is serious and real – this solution is ridiculous.

    July 14, 2011 at 14:32 | Report abuse | Reply
    • Rachel

      Your comment implying that eating too much red meat is a similar health hazard to smoking highlights just one aspect of the complexity of this issue. No one will debate that smoking is bad for your health, but "too much" red meat? There are cultures that have almost exclusively eaten red meat and fat (Eskimos, for one) and have been extremely healthy, until they started consuming pizza, soda, chips, and other junk food. Then they began developing the same diabetes, heart disease, and obesity problems we have here. So who determines healthy eating? Clearly eating fast food every day is not healthy, of course you're not even getting much actual meat in your McDonald's burger or Taco Bell taco. But who decides what is healthy? Our government's dietary recommendations which lean heavy on the grains has done nothing to improve our health. Who then is to decide?

      July 15, 2011 at 09:03 | Report abuse |
  2. Dori

    OMG have you seen some of the foster parents? What makes people think that foster parents have it all together – better take a closer look! There is no requirement for foster parents to be in top shape or eat the right kinds of foods why would anyone think that that would be a solution obviously whoever came up with this bright idea lives in a bubble.

    July 14, 2011 at 15:49 | Report abuse | Reply
    • unhappygrammy

      CPS probably came up with the idea. I can see the $$$$$$$ in their eyes now. Gastric surgery would be better than placing a child in foster care. The gastric surgery scar's will fade. The psychological scar's will remain for the rest of the child's life. What's wrong with even sending the children to Dietician's? Hasn't CPS ruined and destroyed enough lives already? Why throw more children to the wolves?

      July 14, 2011 at 20:28 | Report abuse |
  3. formerfosteryouth

    To the comment above, most foster parents are low income also. What is the cheapest types of foods to buy? Junk. If a family has an issue with obesity, we need to look at other areas of safety before deciding to remove a youth. Do they have shelter? Is there abuse? Are their basic needs being met? The answer should not be displacing more children, its preventive actions, education, and a democratic President, House, and Senate who will give support to low income families. Oh, and a better economy.

    July 14, 2011 at 16:22 | Report abuse | Reply
    • HAL 2011

      Dori- I agree with your comment concerning no requirement for foster parents to be in shape, but my question to you is what are the actual requirements and where did you find these?
      Former Foster Youth- Are most foster families low income? I feel you would provide a stronger argument if you were able to back this claim some proof.

      – I feel that both of you raise interesting points. But have you considered possible counterarguments? Will the added support you speak of (education and funding) actually promote weight loss, is there proof of this? I don't have the "correct" answer, but im interested in hearing you thoughts.

      July 20, 2011 at 10:17 | Report abuse |
  4. jackal & jester

    Well if tv stations would do a three hour shutdown like between 5 to 8 pm that would give time to do a few activities while making it easier to provide much better prime time tv. Tv is always nice after a long walk around. Just a suggestion.

    July 14, 2011 at 17:00 | Report abuse | Reply
  5. Susan

    All those who think an obese child should be taken away from a good home, has never been a foster child. IT'S HELL, SCARS YOU FOR LIFE! Lord knows when it comes to the illegals all we hear is how awful it is that families are broken up because we want to send illegals back to their own country, but somehow because a kid is overweight it's ok to take them away from their home, thereby breaking up their homes, and they haven't even broken a law!

    July 14, 2011 at 19:29 | Report abuse | Reply
  6. Nicole

    i dont think this is such a good idea. they already probually get mad fun of for being heavier now its basiclaly like your fat you have to go live with some other family. Why cant they stay with their own family so they have support from them. My mom used to do fostor care the stories i heard from of the fostor kids werent so pretty. So why put them in an enviroment like that. Maybe just make them go to the gym everyday an re do there diet. DONT take them from their familly.

    July 14, 2011 at 19:58 | Report abuse | Reply
  7. Carol,APRN

    As researcher, a Assoc Professor at Yale and a practicing clinician I find their editorial deeply flawed. There is absolutely no
    Proof that foster care reduces BMI. To the contrary, as pointed out the majority of foster families are low income and
    Foster care is highly stressful, likely promoting weight gain. This is simply a case of ignorant ivory tower elites trying
    To get published at all costs.

    July 14, 2011 at 22:46 | Report abuse | Reply
  8. Quincey9

    I would think that all this would do is to pile a lot of deep emotional issues on top of an existing problem.

    July 15, 2011 at 06:35 | Report abuse | Reply
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    July 15, 2011 at 07:06 | Report abuse | Reply
  10. JPX

    What if parents were giving young children alcohol or cigarettes? It's no different that feeding them into obesity. I completely agree that the kids should be removed from the home.

    July 15, 2011 at 08:35 | Report abuse | Reply
    • HAL 2011

      JPX- I see that you stand behind the idea of removing obese children from their homes... but my question to you (with all due respect) is what makes you say this? In this particular case, the alternative is to place these obese children in foster care- but has proof shown that foster care can actually reduce body mass index? Or, will the transition of moving the child from home to foster care create much more stress, leading the child to comfort him/herself with food? Foster care already has its issues, who will regulate and fund this and furthermore, what will we do if foster care doesn't promote weight loss? Where is the line drawn. I am interested to hear your thought on this.

      July 20, 2011 at 10:06 | Report abuse |
  11. JD

    This is outrageous and discriminatory! Obesity is frequently the result of addiction, whereas simply being overweight is the result of insufficient exercise and poor eating habits. What about those addictions that aren't shown outwardly? How far are we going to go? Is it a cry for help? Probably. Abuse? NO!

    July 15, 2011 at 09:04 | Report abuse | Reply
    • skarrlette

      Lets take them all to the arid plains of Africa to live in a village collecting water at 5 miles a pop I guarantee they will all be stick thin when they get back to the US!

      July 15, 2011 at 13:23 | Report abuse |
  12. BR

    I have issues with this! I used to work with foster kiddos for several years, and pulling them out of their home and away from their family will not solve anything. First of all we already have a major shortage of foster homes in the US. We don't have enough homes for the children who are being abused and neglected, so how are we going to find homes for all the children who have been diagnosed as obese? Secondly, who is going to regulate the foster homes? Are you trying to tell me that the foster homes are onyl going to serve well-balanced, healthy meals? Ha!! Is the goverment also going to create jobs so these foster homes can follow the regulations and "special diets" of these children? There are so many children that are in the system already that lack the monitoring they truly need because their case workers are so busy with the rest of their case load. It is impossible for case workers to keep up with the demands of the already existing case loads. Third, it is a known fact that stress and depression effect eating habits. Some people eat more, some people eat less. Children who are removed from their home, do suffer from stress and depression, so this can have the exact opposite effect then they think... I eat when I'm depressed and I can tell you that stress does not encourage weight loss.
    Is it horrible that there are children that are 10 years old and morbidly obese? Absolutely!! But services into the homes to help families learn healthy choices. Assist families with finding a dietician. Assit famililes in affording healthier foods. There are plenty other options out there than removing more children from their home and disrupting the bonds that they have with their families.

    July 15, 2011 at 11:00 | Report abuse | Reply
  13. April

    It seems to me that we just talk about BMI as determining obesity. What about other factors? My children are both in the 95%+ percentile according to their BMI's, but neither are considered "fat." My girls are athletic, they play outside, they eat fruits and vegetables and rarely drink soda. They are just stout, strong and very tall for their ages. My husband's side of the family are built like Vikings and my girls are built like that, too. Even their pediatrician is amazed about their size: "Your girls are so big, I don't mean fat, they're just big everywhere!" Even my child who doesn't have a little belly has to wear plus size clothing because she's often too broad for the regular little girl section.

    July 15, 2011 at 12:43 | Report abuse | Reply
  14. skarrlette

    I am tired of hearing about fat people and I am tired of looking at them!

    July 15, 2011 at 13:22 | Report abuse | Reply
  15. Heather

    As an adoptive mother, this story and the media attention it has garnered infuriates me. Foster care and adoption are not light choices to be made and only made when it is absolutely in the child's best interest. As it is, there is not enough foster care for the children who have been abandoned and horribly abused. Many children are living in group homes (what used to be termed orphanages but we don't like to use that word anymore). This was an irresponsible attention grabbing antic and those responsible should be ashamed.

    July 15, 2011 at 15:00 | Report abuse | Reply
  16. seriously?

    Brillant. Really. Let's just let the government controll our lives a little bit more...

    Not to mention...WHO GOING TO PAY FOR THIS? OH, that's right! The taxpayers! Maybe our government officials can sneak this into the debt plans too! Free healthcare and foster homes to all! Hurrah!

    July 16, 2011 at 03:23 | Report abuse | Reply
  17. Pankaj Manocha

    As a researcher myself I do not see this as a very good idea. I donot see foster care can help rescue obesity. I feel otherwise,we should educate parents and increase the awareness and the consequences of obesity. They should be educated to have a structured life which includes dietary habit modification and ofcourse more importantly exercise for half an hour or so over a prolonged period if time. Intensively exercising and reducing weight without life style modification is not going to work for long term. I feel foster care or adoption should only be helpful in special cases when child needs it.
    I Understand the logical idea behind the concept of foster care but I am afraid it will not be helpful in a long run as there will be many more challenges involved in foster care.

    July 16, 2011 at 10:39 | Report abuse | Reply
  18. summer1974

    This is the funniest thing I have ever read. Don't get me wrong, diabetes runs in my family and so does obesity. However, my son who is eight is border line overweight, as was I at his age. No one suggested that I be removed from the home and placed in foster care until I lost the weight. To be honest, I don't know when I lost the weight, but I did. Just like me, my son is very active, he rides his bike, runs, plays basket and even has a healthy heart to prove it (suprised the doctors, since they think he sits and plays video games all day). I come home and cook dinner, non smoker, etc. Did it ever occur to these so called specialist that every one is not suppose to be super model thin.

    July 16, 2011 at 16:39 | Report abuse | Reply
  19. Sugar Poo

    Every parent who has an obese child says that it is genetics.That way it is not their responsibility.Do you ever hear one say," Damn! My kids are huge because I am giving them too much of the wrong kind of food? I thinketh not.Instead you will see the obese parent clutching the hand of a toddler that can barely walk and leading it into an all you can eat buffet.If you breed em and overfeed em then YOU deal with the health costs.

    July 18, 2011 at 11:18 | Report abuse | Reply
  20. Zachary Musick

    Children are not FAT/OBESE because they over eat ect!!! It is becase of genetics!! If two "obese" people/parents have kids then the children are going to be "obese!!" If two skinny parents have kids then the kids are going to be skinny!! Its all about genetics! And yes you can over eat and get a little more fatter wether you skinny or "obese!!"

    July 19, 2011 at 20:00 | Report abuse | Reply
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