Obese children to be placed in foster care?

According to a commentary that appears in The Journal of the American Medical Association (JAMA), two Harvard doctors believe that severely obese children should be placed in foster care.1

The writers of this commentary pose the question, is extreme obesity considered medical neglect? Although this proposition will not happen anytime soon, if at all, just the discussion alone has sparked a great deal of controversy and outrage.

While admonishing an overweight child to foster care might seem like an extreme last resort, the writers of the commentary insist that the lack of skilled parenting is one of the key reasons for an obese child. This statement has sparked an intense debate all around the country on the internet and other media outlets.

The authors of the commentary say that many biological, psychosocial, and behavioral factors affect energy balance and therefore, any excessive weight gain by a child is primarily the fault of the parents. That would make it the parents responsibility to help the child ignore ever-present junk food marketing, make sure the child is physically active on regularly and promote other healthy lifestyle choices. The authors blames "parenting deficiencies" which can contribute or cause weight issues with children.

Inadequate or unskilled parenting can leave children vulnerable to obesigenic environmental influences, according to the commentary. The writers say that emotional distress and depression, or other psychological problems arising from abuse or neglect, might exacerbate the situation by leading to disordered eating and withdrawal from sports and other social activities.

The commentary says that foster care is more ethical than obesity surgery because long-term effects of the operation in children are unknown. It goes on to say that in severe instances of childhood obesity, removal from the home might be justifiable from a legal standpoint because of imminent health risks and the parents' chronic failure to address medical problems.

While there are certain cases when children are placed in foster care due to medical neglect, it usually occurs when there are life-threatening consequences.


  1. L Murtagh, D Ludwig. State intervention in life-threatening childhood obesity. JAMA 2011;306:206-207.