Tuesday, December 6, 2011

Working with an obese child

While childhood obesity is a serious crisis across the nation, I was truly stunned by an action that removed an 8-year-old child from his home and into foster care simply because he was obese.

ABC News out of Cleveland, Ohio reported that this boy was removed from his mother after officials claimed she “did not do enough” to help him lose weight. According to the news report, the family had been working with the child, including enrolling him in healthy children’s programs, but the weight hadn’t come off. Instead of working with the family on interventions, the state opted to pull the child from the family.

While the state strongly believed it could do better in assisting the child with the weight problem, removing a child from his or her rightful parents can often create other problems such as emotional and mental distress. In the same ABC News report, another parent had come forward with news that her child had once been taken away because of obesity, but the state’s plan failed to help the child lose weight.  Not only did the child return to the family still in an obese state, he likely suffered emotional and mental problems thanks to the state’s removal process. In this case, the state’s action seemingly created more grief for the entire family.

Child removal is generally performed when there is suspected or known abuse of a child. The fourth amendment states that citizens have the right to be secure in their persons, houses … but upon probable cause, the persons or things could be seized. In the case of the Cleveland child, I don’t see that enough probable cause warranted removal. I just don’t understand why the state or local children’s health agencies couldn’t have stepped in with interventions and suggestions rather than pull the child from their rightful parents.

Research has shown that numerous interventions can be helpful for obese children and teens, but almost all of them involve family and community assistance while the child remains with their family. One of the key ingredients to understanding obesity is to educate the parents. Parents often struggle from obesity themselves which affects their ability to talk with their child in a non-judgmental way regarding losing weight. This is where agencies and health professionals could step in.

In Meadville, there are several resources available to help you and your family learn about healthy weight. These include the Meadville Family YMCA and various fitness centers with qualified trainers, the WIC Program, your personal care physician, your child’s pediatrician, Weight Watchers programs that include educational components, and independent dietitians such as Rust Nutrition. You can find these places listed in the phone book. In addition, the internet can provide a plethora of information on dealing with obesity in your family. Working with an obese child is an emotionally and physically taxing experience. You need to be prepared yourself in order to be successful.

Exercise Prescription on the Net is a resource set up mainly for exercise professionals, yet it provides a basic checklist to help you engage your children in healthy habits.

1.       Educate yourself on obesity, and consider working with professionals who may better connect with your child on the issue.
2.       Choose a private place to speak with your child about obesity and weight concerns.
3.       Never associate the child’s weight with acceptance or approval. You do not want your child thinking that you will love them more if they lose weight.
4.       Discuss feelings and body image, being sensitive that their weight may be creating low self-esteem. A professional may be your best solution in helping your child with this issue.
5.       Emphasize healthy habits rather than weight loss, such as increasing activities or eating more vegetables at dinnertime.
6.       Work with a healthcare provider or dietitian on meal plans and snacks. You should not approach this as a diet, but should consider it a lifelong habit in which the entire family participates.
7.       Monitor eating and activity and stock up on healthy foods. Consider removing poor nutritional choices such as sodas, chips and candy from the home.
8.       Eat meals together as a family. The child needs to see you consume healthy foods as a positive influence and role model.
9.       Do not reward positive behaviors with food; and likewise, do not punish with lack of food. Food is a nutrient, not a reward or punishment system. Children will associate food with good or bad behaviors and eventually treat them likewise, which will promote eating disorders. Use stickers, praise or other favorite activities for rewards and try withholding favorite activities such as internet use as punishments.
10.   Do not “make” your child exercise. You should adopt language like “Let’s play” or “Let’s go …” At least 60 minutes of daily play is recommended for children, and the best way to motivate is by doing it with them.

Interventions that promote healthy behaviors should start early, even if you or your child doesn’t seem to have any signs of being overweight.


References
Exercise Prescription on the Net. (2011). Childhood and teenage obesity. Intervention strategies. Retrieved November 30, 2011 from http://www.exrx.net/FatLoss/ChildObesityIntervention.html.

Newcomb, A. (2011). Obese third grader taken from mom, placed in foster care. Retrieved November 30, 2011 from http://news.yahoo.com/obese-third-grader-taken-mom-placed-foster-care-201731761.html.

The Rutherford Institute. (2001). Social services investigations: the removal of children from the home. Retrieved November 30, 2011 from http://familyrightsassociation.com/bin/white_papers-articles/investigations.html.


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