When parents are physically harming their kids, the state can step in and remove them from the home. Should that happen if a child is severely obese? A commentary in the Journal of the American Medical Association says it should be considered, but only “in carefully selected situations.” The two authors, Lindsey Murtagh of the Harvard School of Public Health and David S. Ludwig of Children’s Hospital Boston, say that in most cases, overweight and obese kids will have a chance to improve their health as adults. (About 16% of kids aged 10 to 16 were obese in 2007, according to government stats.) But, they write, the health consequences for the most severely obese children –defined as a body mass index at or above the 99th percentile, which includes about 2 million kids — can be “immediate and potentially irreversible.” Mostly, they’re referring to type 2 diabetes, which can become permanent and set kids up for cardiovascular disease. One obesity treatment option, gastric bypass surgery , carries the risk of serious complications and its long-term effectiveness isn’t known, the authors write. Severely obese kids are often eating more than 1,000 calories a day in excess of what their

body requires, “suggesting profoundly dysfunctional eating and activity habits.” So, the authors write, if counseling, parenting training and other forms of support don’t help parents change their children’s habits, foster care should be on the table — though it’s not “desirable or practical, and probably not legally justifiable, for most” of the severely obese kids in the U.S. They note that foster care wouldn’t guarantee improved health, and that taking kids away from their parents is obviously traumatic. Murtagh and Ludwig suggest using criteria like the ones outlined in this 2009 Pediatrics article ; authors of that piece say that for obese kids with serious health problems that can cause imminent harm, where  all other options have been exhausted, removing the child may be necessary. University of Pennsylvania bioethicist Arthur Caplan tells the Associated Press that so many factors influence obesity in kids and teens that it’s unfair to put all the responsibility on parents. (And here’s his commentary on the topic on MSNBC.com) Readers, what do you think? Should foster care be an option in the most severe cases? Image: iStockphoto

See more here: 
Reader Consult: Should Severely Obese Kids Be Taken From Their Parents?