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Paediatrics News South Africa

Childhood obesity - another form of abuse?

With health experts in Australia and in many other developed countries warning that childhood obesity is becoming an increasingly alarming problem, the suggestion has been made that in some cases, child protection authorities should be alerted.

A group of paediatric specialists have carried out a study which says that doctors are duty-bound to report cases of extreme neglect, which includes extreme weight-gain - they say extremely obese children should be taken from parents who allow them to become too fat.

Dr. Shirley Alexander from Westmead Children's Hospital says these are rare cases where the children are extremely obese and over two or three times the expected weight for their age and sex and they are severely affected - she says obesity has a significant adverse effect on a child's wellbeing in terms of both immediate and long-term medical and psychosocial health problems.

Intervention becomes necessary when parents fail

Dr. Alexander says in such extreme cases child protection services ought to be involved but this does not automatically mean that the child is going to be immediately taken away from the family and they are not advocating the involvement of child protection services in every single case where a child that is mildly or moderately overweight.

They say that when the stage is reached where options are diminishing because parents are unable or unwilling to follow the advice from the weight management experts, some other intervention becomes necessary.

As a rule child protection authorities are called in when the child is considered to be at risk from physical or sexual abuse and already authorities are struggling to cope with existing case loads - the suggestion that child protection services ought to be involved in dealing with obesity raises the question of whether this is an appropriate use of the precious time of experienced child care workers.

Dr. Alexander says there are obviously very urgent and immediate interventions often required which are perceived to be more important but childhood obesity can have chronic and complications which can kill children.

Taking a child from the family not the first option

Critics point out that the parents of such children could avoid contact with their GP if they thought there was a danger child protection authorities might be alerted but Dr. Alexander says taking a child from it's family would not be the first option but the last and she says often the parents of overweight and obese children do not realise that their child is overweight or obese.

Dr. Alexander says the number of obese children had doubled or tripled in many countries in recent years and doctors need to act and not do so breaches a doctor's duty of care.

Dr. Michael Carr-Gregg a leading Melbourne child psychologist says he agrees and says parents who allow children to become morbidly obese are guilty of a form of child abuse.

Dr. Carr-Gregg says child protection authorities should be notified in extreme cases because leaving children to become obese is in some instances, condemning them to a life of health problems and an early death.

The study appears in the Medical Journal of Australia.

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