While childhood obesity and failure to control weight are not childhood protection issues, failure to change lifestyle and receive support may be seen as neglect, especially in younger children, according to experts in an article published by BMJ (British Medical Journal).
It is highly controversial to propose that childhood obesity can raise child protection concerns, there are no official guidelines for professionals on the topic and not much published evidence, the authors wrote.
This drove Dr Russell VIner at the UCL Institute of Child Health, London, England, and a team of child health experts to evaluate any evidence and put forward a framework for practice.
The group found that there is evidence to link adult and teenage obesity with sexual abuse, violence, and neglect, but didn’t find anything examining the link between child obesity and child protection actions. Data are also lacking on the long-term outcomes of child protection strategies when concerning weight control, metabolic disorders and psychological health.
Without significant evidence the authors propose that child protection actions are not reasonable for childhood obesity alone or failure to control weight.
The authors wrote:
The aetiology of obesity is so complex that we believe it is untenable to institute child protection actions relating parental neglect to the cause of their child’s obesity” or “to criticise parents for failing to treat it successfully, if they engage adequately with treatment.
However, the authors believe that it does constitute neglect if parents constantly fail to change lifestyle or accept help from professionals and weight management initiatives – especially if an obese child is at imminent risk of disorders, such as obstructive sleep apnea, hypertension (high blood pressure), type 2 diabetes or mobility restrictions.
The authors say that where child protections concerns are raised, obesity is likely to be one part of wider set of concerns about the child’s welfare. Therefore, it is necessary to assess other aspects of the child’s health and wellbeing and determine if concerns are shared by other professionals, they say.
A wider assessment of family and environmental factors should be carried out in cases of severe childhood obesity, say the researchers.
The researchers conclude:
In all areas of child health, we have a duty to be open to the possibility of child neglect or abuse in any form. Guidelines for professionals are urgently needed, as is further research on the outcomes of child protection actions in obesity and links between early adversity and later obesity.
“Childhood protection and obesity: framework for practice”
Russell M Viner, Edna Roche, Sabine A Maguire, Dasha E Nicholls
Published 15 July 2010, doi:10.1136/bmj.c3074
Written by Joseph Nordqvist