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

In My Humble Opinion
81

I see what you’re saying, but I guess I find it hard to make a judgment call when, for all we know, the parents had been acting as the bad guy. Or it could be a cultural issue. I’m not a fat apologist; however, I do know that many cultures prize large children as exceptionally healthy. My husband is a stellar example. He was always skinny and always being compared to “husky” (read: likely overweight to obese) children. In India, that was perceived as something a kid, especially a little boy, should strive for. In many cultures, it’s the same.

I’m not saying that the parents aren’t to blame for having a kid with a BMI of 31; however, I am saying that, in my opinion anyway, the cause is likely more a matter of ignorance and lack of access to appropriate education instead of either an issue of parental convenience, permissive parenting or some sort of “intent.” Like I said earlier, I have yet to meet a parent who cares nothing for their child’s welfare. Most of us do the best we can. If what I think is best isn’t actually good for my child, does that mean I intend my child to be fat? Does that mean I’m lazy if I’m doing what I do for the health of my child while at the same time I have no idea that what I’m doing is actually unhealthy?

And I’m not sure it’s accurate to assume that the kid was at some point thin. Most babies have a good amount of fat. Most toddlers do, too. I think that, when you have a kid, it’s difficult to pinpoint when that baby fat dissipates. If it just never dissipates, how is the parent to know that’s not the norm?

Keep in mind I am playing devil’s advocate. I do agree with you for the most part, and it drives me absolutely nuts when people on the Dope come up with these weird, unusual scenarios to prove someone else wrong. My point, though, is not to disagree for the sake of disagreeing, but mostly to point out that it’s very possible that these people have absolutely no idea what they’re doing (or not doing) and that it’s not that unusual for someone to have an overweight child and have no idea why.

Even some of the most educated among us have no idea what constitutes healthy eating. My husband’s family boast graduate degrees from some of the most prestigious universities in both India and the U.S., yet many in his family still see butter as virtually a health food. Seriously - it’s considered something that will make you strong. They all do the best they can for their kids without exception.

82

My parents are educated and far from dumb, but when putting together meals, they go overboard with starches because they don’t know of any other way. They’re just doing how they were raised.

I remember as a kid, dinners would often feature two or three carbs. For instance, there’d be macaroni 'n cheese and corn. Or there’d be rice and corn. My dad would sometimes make stroganoff or sphagetti with toast on the side. Sometimes there’d be potatoes, corn, and bread in the same meal. This is not egregious, get CPS on the phone kind of eating, but these little excesses add up over the course of one’s life.

Now that I’m adult, the thought of routinely eating multiple carbs in the same meal is unappealing to me.

83

I think it’s not entirely an issue of having too many carbs on the plate, or too much buttery goodness, but one of portion control. I know that’s my personal problem.

Also, we all really eat quickly now, often in front of the TV or computer. Beyond any “togetherness” the family table gave us, I think it also made us slow down with our eating and listen to our full stomachs.

Also,

84

If you’re doing your best and your kid keeps getting fatter, it’s probably time to consider that you might be doing it wrong. And if that’s the case, it might be wise to ask someone more knowledgeable (i.e. a doctor) about how to do it right.

Aren’t regular pediatrician checkups de rigeur, particularly in a child’s earliest years? A doctor can tell you when the kid’s no longer in the right range on the growth chart. If the doctor doesn’t, that’s a whole other problem, since they should (and “being afraid to” is just not an adequate excuse). And a parent should be asking these things anyway. There are a lot of health issues that can be identified early by paying attention to deviations from normal growth and milestone development. Kid’s nine months old and still can’t lift his head? That’s a problem, and needs to be addressed. Same with growth/weight.

And honestly, if you’re planning to have a kid, for god’s sake at least read a book. Even if the pregnancy was a surprise, you have nine months to educate yourself. As a parent a person needs to know what appropriate developmental milestones are.

If you have a serious problem and don’t know why, do you just throw up your hands, or do you start asking people who might be able to tell you why?

85

I totally agree. I wasn’t saying that it was right or that people shouldn’trecognize these things as issues - I was saying that many people don’t.

Yes, regular checkups are standard. Kids are seen at least annually when they’re school age.

I agree with you here, too. In fact, in almost all instances, we agree. The only area where we don’t agree is everyone knows that this is a problem and understands how to fix it. Even many doctors are unaware of how to address it. Doctors are not required to take nutrition or exercise courses. So while they probably have a general understanding of what keeps a body healthy, many of them are not required to incorporate nutrition as part of their education. Of those who are required to do so, few actually are provided adequate education on nutrition.

If you check out this article from September 2010, you’ll see that a scant 26% of medical professionals have what is considered the bare minimum requirements of nutrition education.

It’s hard to imagine how a parent relying on their doctor for medical advice on their kid’s weight can obtain an actionable understanding of how to improve their child’s health over and above the most basic.

Of course not. However, if you genuinely don’t see that there’s a problem, why would you address it? And if those medical professionals who are supposed to provide you with information on how to fix it can’t do so, it can be difficult to make the leap to, “Hey, this doctor doesn’t know everything. Maybe I should look this up instead.” Lots of people don’t get that doctors aren’t the end-all, be-all of medical advice, and I’m guessing that not many doctors think to refer a kid to a dietician, even when it might be necessary. And many parents may not know to ask.

86

That’s why everybody around the child needs to have some input. I’m not saying a stranger in Walmart but every member of the extended family (school, doctor, close friends and relatives).

People outside of the parental units need to feel obligated if they see a child that may be headed down the wrong path to speak up and talk to the parents. It is simply not an excuse for people on this board to say “well maybe the parents simply don’t know better”. A) Ignorance is not an excuse and B) It takes a big ass caring village that doesn’t mind having the uncomfortable conversations to raise a child.

I’m not calling obesity child abuse but we have to realize that these obese kids may grow into obese adults and obesity has all kinds of physical and mental (depression, self esteem, etc) issues associated with it that will effect our quality of life down the road.

If you see a child that you love going down the wrong path (no matter if it’s drugs, alcohol, sex or obesity), make a point to talk to the parents. It’s hard but as a member of the human community, it’s something that you have to do.

87

Just out of curiosity, diggerwam, have you ever told a friend or family member that their kid is fat? How’d that go? I’m trying to imagine a scenario in which this information is welcomed and helpful, and I’m not coming up with much.

88

Well, this brings us full circle to where neglect comes in. One, the information, even if just the most basic information, is widely available at this point; people know at least enough to know that being too fat is bad for you, and that children are becoming too fat too. Two, as a parent it’s your job to be aware of these things, to deal with them, and to hunt down more information if you need it. Sure, it’s tough. Absolutely it means being held to a higher standard than someone not responsible for a kid. I have no problem with that; raising a kid is a serious, huge responsibility that not everyone is cut out for. If a parent can’t or won’t do it on their own, then the village, in the form of CPS if necessary, can step in and keep an eye on things; in addition to being able to point parents to necessary resources, if that’s really all it would take.

It’s not about the parent. It’s about the kid.

Yes, the system often falls down. For any doctor, giving a referral should be the very next step after saying “I don’t know.” Does it happen often that they don’t? No idea, but I have to think that it happens less and less, given the prominent placement of the obesity epidemic headlines. And having an additional course of action/safety net for kids who really need help but aren’t getting it through the usual channels is a good thing.

89

Perhaps it is the BULLYERS who are responsible for the bullying?

That some people feel justified in calling fat people derogatory names (as displayed in this thread), and pass this on to their children, is not the fat person’s fault. Is teaching your children to be mean to other people child abuse?

90

You’re ignoring the very real health problems associated with being obese.

91

“It’s at least on the level of criminal neglect. If CPS (rightfully) gets involved if someone feeds their kid so little as to cause serious health problems, why shouldn’t they get involved when someone feeds so MUCH as to cause serious health problems?”

The health risks of overfeeding are also nothing compared to those of underfeeding where immediate organ damage or death may be involved, vs health problems when they get older.

Basically as health risks go, obesity doesnt fit well with other forms of child abuse that qualify for legal intervention. To qualify as child abuse, generally the risk has to be fairly immediate rather than being the longer term health risks involved with obesity. And I agree that ‘risk of being bullied’ probably wouldnt qualify.

Otara

92

Is it your opinion that immediate harm should be required? Not educating your child in many states is considered neglect. There is no immediate harm of not educating your child, and arguably there is much greater immediate harm of obesity to a child.

93

Dunno about ‘should’, more that thats generally been the precedent and legal systems tend to struggle with less direct risks. ‘Cumulative harm’ is the new buzzword here, where things like obesity fit very well in theory, but its tended to struggle in the courts vs more direct ‘classic’ abuse.

“Educational neglect can pose a serious threat to the child’s emotional well-being, physical health or normal psychological growth and development”

Ie the argument is that the risks/harm will occur while still a child, rather than later in life. But I agree its a better parallel than using starvation as a comparison.

Otara

94

Renee:

No, thankfully I have never had to have that conversation.

Just because a conversation is difficult to have or may risk a relationship does not mean the conversation is not worthwhile having.

95

But I think Renee’s point isn’t trivial.

If I have a daughter who’s fat, chances are I’m going to know it. Because I have eyes and have the ability to compare her against other kids her age. Plus, I take her to the doctor on a regular basis, and he’s always telling me that she needs to drop a few lbs.

So I decide to do something about it. Something so subtle that changes won’t be instant, but hopefully by the time my kid reaches 10, she’ll be within the “normal” range.

How am I going to react if someone–whether it be a friend, a neighbor, or a family member–says to me, “Hey, you know little monstro could stand to lose a few pounds. Just sayin’.” I’m going to react defensively, most likely. “How dare you!” will probably come out of my mouth.

So…like I said above, I don’t know how the hell a parent is supposed to deal with this situation. Or a concerned relative, for that matter. It would be great if a Doper who had experience with getting a kid to lose weight would chime in.

96

I believe it’s child abuse and it’s the main reason my last relationship ended.

When we first met, his kids’ ages were 4,6, and 13. All three of the kids were overweight/obese then. I was shocked but then when we had dinner together, they ate “healthy” food for the most part. There were no sugary cereals, it was all raisin bran and a glass of pulpy orange juice. Dinner would be broccoli and skinless rotisserie chicken. The kids didn’t drink soda pop and rarely had treats or dessert or fast food (maybe once or twice a week). He knew they were obese and that was his solution.

It took me a while to pick up on it, I’m not stupid but I’ve also usually had a high metabolism and was skinny when growing up. In the years of the relationship, even my weight started to creep up too. Once I started to see the problem, I tried to do something about it. It turned out to be the one big thing we disagreed about. His ideology around parenting revolved around a simple statement: Food=Love. His family ran a local restaurant and all events revolved around food.

I started to notice ugly patterns. The kids were bored and while they couldn’t explain that they just wanted to hang out and do stuff with their dad, they would just say they were hungry. The relationship they ha was that whenever they were bored and wanted attention from their father, they would say they wanted a snack. They left school and walked to the family restaurant and while they waited about 30 minutes for their father to finish up his shift, they would have a large bowl of matzo ball soup. Then they’d come home and want a snack so they’d have a yogurt and a hand fruit. After that, dinner, and then another fruit.

After asking him if he should cut back on the snacks, he said that they were healthy snacks so it shouldn’t be so bad. Then I started noticing the portion sizes. Spaghetti and meatballs would have about 1/2 a pound of meat per kid and noodles with about 4 portion sizes. Yes, the food was generally healthy but the portions and amounts of food were HUGE.

I started counting my calories as well as theirs. When I saw my calorie count I was shocked, when I noticed that the kids were eating way more than mine, the fights started. The kids were healthy though, except for their weight and the fact that they’d get out of breath when they ran. Finding clothes that fit them was very difficult, by the time the girl was 8 years old, she was wearing size 16 dresses that rarely fit as they were made for women far taller. The ten year old boy had never worn jeans as he was stuck in sweat pants that bunched at the bottom because the legs were too long. The eldest, who was 17, was 5’2" and 265 pounds. Her arms were thicker than my legs.

When I had the kids to myself which was Monday and Tuesday nights, we’d cook together. Really healthy but tasty food. We’d make pita pizzas and I’d not only teach them to count calories but what that meant. The 17 year old was very resistant to change and would cry in her room if her portions were cut to what would be normally too high for her. So my ex would bring home a high calorie Reuben from the restaurant and sneak it up to her.

In this case, the only case I personally know the details, it’s definitely fucking child abuse.

97

Restricting food in kids often leads to food anxiety, disordered eating, and over the long term, weight gain.

We go to the doctor. We follow the advice of a nutritionist (in short, we choose which foods we serve when, and our kids choose how much they eat). We restrict calorie dense foods. We counsel our kids on eating slowly, not jumping into a second serving. We enjoy exercise as a family. We are very well read on the subject of childhood obesity and how best to approach it.

98

Yeah this seems to be more a debate about how to address the issue rather than a fundamental disagreement over whether it needs to be addressed.

Otara

99

I would say it’s abuse, but i would also start with emotional and nutritional counseling…

101

Sorry, but when my borderline overweight daughter asks for thirds (and she has to ask) I am not going to say yes.

I also restrict food by making just enough for all of us for dinner. If there are no seconds, no one can have them.

I also send them with a lunch to school. While they might be able to trade with their peers, at this age, they don’t have access to buy extra food.

Food is also restricted to meal times and snack times.

She has proven that if left to her own devices, she will eat until she throws up. Right now, she has to be restricted. We are working on getting her to monitor herself but she isn’t really mature enough to do that on her own yet.