5 years old, BMI 31... child abuse?

My husband is working a pediatrics rotation right now and he said there was a 5 year old in the clinic with a BMI of 31. To me this is borderline child abuse. Raising obese children sets them up for a lifetime of health problems, and the chances that they’ll ever be a healthy weight are pretty low if they reach adulthood obese.

What do you think? Is it child abuse? Can anything be done about it? How do you feel when you see very fat, very young kids?

I wonder if the parent has been accused of neglect for allowing the child to run around outside without 110 % supervision in the past.

It’s very sad- obesity in kids is tied to all sorts of poor health outcome, as well as worse performance in school, lower education and less earning potential. If the child has no biological cause for its obesity, then it is a form of child abuse. However, I’m not sure what the next step is. I think most people know that their kids should not be obese. Perhaps parenting and nutrition education, cooking lessons and ensuring the family has access to WIC if they meet the poverty requirements could be some good steps.

I don’t really know about child abuse for childhood obesity; we have two nephews aged seven and almost 11, and they’re both overweight. The 11 year old is about 20 pounds overweight, and the seven year old has to be just about doubling his ideal weight. The parents are good parents, and they’re not trashy people or anything, they just don’t seem to know how to feed their kids and keep their kids from overeating and eating garbage. My husband blames his sister (the kids’ mother), because she’s been a garbage-eater all her life, and has raised her kids that way. Is it child abuse to take your kids out for fast food five nights a week instead of cooking at home? I don’t know.

I don’t think it’s abuse. It’s neglectful but not criminal neglect. It’s like not providing books for a child to read or living in a city with high pollution levels. You’re setting up potential for health issues but being overweight does not mean forever and it doesn’t mean definite health problems. It’s not on par with starving your child or making them sleep in a dog crate.

Just my opinion of course. I was average weight as a child. I was still taught incredibly poor eating habits. Taco Bell twice a week, McD’s once. The other days I was fed fried chicken, biscuits, cornbread and mashed potatoes and this was considered healthy because there’s a vegetable. I ate junk food from my Cocoa Pebbles in the morning to my before bed snack of Doritos and onion dip with a can of soda. I didn’t get fat until I was an adult and my lifestyle became more sedentary.

Was my mother abusive? I don’t think so. I think she just had poor eating habits herself and very little time to worry about it.

Sure there are other ways of feeding kids that are not optimal. Unfortunately, for a significant majority of people, childhood obesity means adult obesity; in those cases, overweight does actually become forever. A lot of recent research has focused on how childhood health (going as far back as prenatal health) can be a predictor for adult diseases and adverse health problems.

No. Smoking and a high stress life are also hard on a person’s health. But I wouldn’t put parents in jail for that either. For the most part our attitudes on obesity aren’t even about health, they are social.

Also, what makes anyone think the parents can force the kid to lose weight? The level of control and regulation that would take would be fairly draconian.

Wasn’t there a thread recently that referred to that little girl from a few years ago who made the news, she was three years old or so, and was so fat she couldn’t walk. I think abuse came up in that case, and a diet/nutrition plan was mandated by the court for the girl and her mother. My google-fu isn’t working right now. There were updates later about how the girl was doing, she had lost a bunch of weight and was growing into the rest by getting taller, but still had to undergo a ton of physical therapy because her knees and hips were screwed up. The mom was quite fat, and seemed to still be a bit clueless about healthy diet.

I find it astounding how little people understand about diet and nutrition. Adult parents don’t know what to really raise their children on, and the schools don’t seem to teach nutrition, so some of the reverse education that can sometimes happen when kids teach their parents new information from school doesn’t happen, either.

For a five year old child, parents generally have complete control and regulation over what they eat. Obviously for an older child, the parent’s don’t have that. But at the age in this story, and the three year old girl, the only way a child can get food is if the parent gives it to them or permits someone else to give it to them (school, grandparent, nanny, daycare).

What? :confused:

People throw out the term abuse and other criminal accusations far too liberally. Raising a child this obese is terrible parenting and needs to be corrected and the parents deserve all kinds of derision. However it’s not criminal. Equating this to real, honest to god child abuse marginalizes and insults everyone who actually was abused and would unnecessarily bog down the justice system.

Not everyone treated badly in this world is a victim of a crime.

I found some stuff on that little girl who made the news. Seems a lot of stuff has been deleted and removed regarding her story. This appears to be the least weird page about it. Abuse isn’t brought up, but doctors got involved after that girl landed in the hospital, unable to breathe. Kind of amazing, and as far as I can tell, the latest updates say she had continued to lose weight as of 2010, apparently doing OK.

Of course, this is a very extreme case. While I’m not sure abuse should be brought into the range of terms that should be used in the case of a small child being so huge, I wonder how involved pediatricians should get as far as recommending or requiring these children and their parents to see a nutritionist? I wonder how compliant parents would be about it if the pediatrician was able to require it/prescribe the consultations somehow? If health insurance would help pick it up, as it really would be the least expensive treatment health-care wise?

That’s what we see with our nephews - they’re at an age (well, at least the seven year old) where all his food comes from his parents. He’s basically a little shit, and he makes it extremely difficult for his parents to control his food, but that’s how they’ve raised him, not anticipating that his getting his way on everything would lead to this kind of obesity. They’ve created the situation, and the kid’s going to pay for it (and it won’t be very long until he’s going to want to do things and be too fat to be able to).

I agree. Abuse is about intentional harm. Intentional harm that the abuser thinks is justified, but still intentional harm. Not all bad parenting is abuse.

For me 30 (ie ‘Obese’) is a pretty low cutoff to start talking child abuse.

Its not like most people will even know the difference between a child with a BMI of 28 and one of 31.


Whoops, OK I didnt know BMI levels change for children that young, 18 gets you into 95th percentile, and 31 would be wayyyy up there.

Kind of makes my point though, most people dont know the ‘right’ BMI for a childs age Id bet.

I don’t think it’s that hard to control what food your kids eat: simply don’t keep anything unhealthy in the house. Yes, you can’t control what they eat with their friends, but this would go a long way towards a healthy weight.

I was a bit confused about the BMI thing, too, glad **Otara **clarified that. 31 BMI for adults isn’t really that fat (my husband is higher than that and he’s very fit). Still, abuse? I think we need a different category–ignorant neglect or something. Even then, I’m not sure I’m comfortable with the government intervening. I don’t know, it’s a difficult problem.

I’m surprised so many parents are allowing their children to become so fat; everyone knows how difficult it is to lose weight once you’re obese. I don’t understand why these parents are OK with setting their kids up for that lifelong struggle so young, when they wouldn’t be OK with sending those same kids to a dangerous or otherwise terrible school. Can anyone shed some light on this? What are the parents thinking here?

People who struggle with life-long morbid obesity are often compulsive eaters from childhood, and stealing/hording/hiding food can start very young. Simply having only “healthy” food in the house isn’t really simple: I know people that smuggled sticks of butter out of the fridge and ate them in secret when they were six. “Healthy” food like bread, fruit, peanut butter, table sugar, can all be over eaten. Candy can be stolen from grocery stores. Lunches can be raided at school. It’s a lot like keeping alcohol away from an alcoholic: they will find the damnedest ways to get what they need. You can–and absolutely should–take steps to limit these kids’ access to food, but it’s not simple, and it takes a huge amount of effort and emotional strain. I mean, parenting has a whole lot of unpleasant crap associated with it, but for parents of kids like that, they have all the normal crap plus a constant struggle over every bite of food. It’s hard.

Now, certainly not all obese children are compulsive eaters, but I’d be willing to bet that a fair number of the ones above the 99% are.

Again, compulsive over-eating is kind of it’s own thing, and really very rare, but I’d be willing to bet a three year old with a BMI of 31 has some sort of disordered eating thing going on. For the vast majority of obese kids, I think it’s probably a matter of not knowing much about nutrition and not liking to say no. It’s my own completely out of my ass theory that this is why we see so much more obesity among the poor: when you have to say no to vacations, lessons, toys, clothes, cable, video games, movies, and even spending much time with your kids, well, junk food becomes the only thing your kids ask you for that you have the power to give them. I can imagine it’s pretty tempting to finally say yes and see them smile at you.

I guess I’m thinking of all the generic obese kids that I see a lot of lately. Those 400-pounders are a special case, I think, and the parents should recognize this problem like any other mental problem and get the kids help. I doubt that the majority of fat kids are that way because they’re eating sticks of butter, though; more likely it’s because the parents keep chips and cookies in the pantry, and that they exposed the kids to crap “food” when they were very young. I just don’t really understand why people are letting their young kids eat crap that’s making them obese, when it’s obvious that this will set them up for a lifetime of struggle. These same parents wouldn’t do something that would retard their kids’ mental development; I don’t really get why they’re willing to set them up for a lifetime of food issues.

Just as a talking point: If you see there is an obvious problem with your child’s health, be it weight, physical development or cognitive abilities, and you did not know how to solve the problem yourself, wouldn’t you seek advice from a someone who DOES know how to deal with the issue? If I failed to find a healthy diet for my kids, I’d get professional help. I say that in full appreciation of the healthcare system where I reside that includes access to a nutritionist at no cost to me.