Super sized kids Psychology Paper

Super sized kids Psychology Paper

Super sized kids

Journal Article Critiques
Instructions:

These critiques should be between 1.5 and 2 pages, double-spaced, in Times New Roman (12 point) font, and with 1” margins on all sides. Please include and APA style cover page, page numbers and headers/sub headers, in text citations, and works cited page. Super sized kids Psychology Paper

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Summary: The summary should be between 1 and 2 paragraphs. This should briefly explain the authors’ purpose(s), method, and results (main findings in your own words. No numbers.) Keep the summary informative, but concise (less than a page). Super sized kids Psychology Paper

Critique: You should critique the articles based on the following criteria. Be sure to completely and concisely address each point. Remember this should be a critical assessment or the study (objective). DO NOT INCLUDE YOUR OPINION. Paraphrase , no direct quotes.Super sized kids Psychology Paper

1. Purpose/Research Question: Determine the authors’ purpose of the research and state it in your own words. Comment on how clearly this was presented in the article.
2. Method: Comment on how appropriate the method used was for addressing the purpose. State if the method was employed effectively.
3. Evidence of Support: Examine the method and results of the article and determine if they helped the authors effectively address the purpose presented. Also discuss the strengths and weaknesses of the evidence and the study as a whole.Super sized kids Psychology Paper
4. Real World Application: After reading the discussion section summarize any real world implications the authors suggest. Also give your own suggestions for the real world application of the study and its’ findings.
5. Recommendations: Determine who might benefit from the article, what the benefit may be, and the importance of the benefit. Here you may summarize your subjective judgments of the work and suggestions on how to improve or extend the work.Super sized kids Psychology Paper

FAMILY COURT REVIEW, Vol. 43 No. 1, January 2005 164–177
© 2005 Association of Family and Conciliation Courts
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STUDENT NOTES
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SUPER-SIZED KIDS:
Using the Law to Combat Morbid Obesity in Children
Deena Patel
Morbid obesity is an unfortunate problem that is only becoming worse everyday. The alarming aspect of it is that
it is affecting people at a much earlier age; thus, young children are becoming morbidly obese and are experiencing
the same health problems as middle-aged adults. The first section of this note defines morbid obesity and its
causes and trends. Section two describes child neglect in general and then distinguishes medical neglect. Section
three discusses education and prevention, which are both crucial steps in the struggle with weight-loss and
weight-gain. Section four summarizes the beneficial aspects of removing a morbidly obese child who is in a life threatening.Super sized kids Psychology Paper
position from his or her parents. Section five highlights case-studies from California, Iowa, Indiana,
New Mexico, and Texas, where children have either died or were removed from their families because of morbid
obesity. Section six briefly touches upon similar child neglect scenarios where removal is permissible and compares
those situations with those of morbidly obese children. The seventh section considers some credible counterarguments
to government intervention, and the final section suggests some recommendations on how to prevent the
morbid obesity crisis from becoming worse than it already is. Too many people are dying from weight-related
problems already, yet morbid obesity is preventable! This severe state of obesity is something that can be controlled
and prevented, but only if parents take an active role in their child’s diet and exercise.
Keywords:
morbid obesity
;
child obesity
;
medical neglect
Imagine a three-year-old child so obese that she can barely move. She is almost three
times the size of a normal three-year-old and weighs almost one hundred pounds more than
the average child her age. Her parents have been advised to decrease her caloric consumption
and increase her activity level. Yet, the parents disregard the medical advice, and the
child becomes morbidly obese. Suppose this child dies. Who is responsible? The legal
system’s answer is the parents who consciously ignored the danger their child was in. This
is a case of child medical neglect,Super sized kids Psychology Paper
1
and the above hypothetical situation actually occurred;
only the state intervened before the little girl, Anamarie Martinez-Regino, died.
2
Morbid obesity is an unfortunate problem that is only becoming worse everyday. The
alarming aspect of it is that it is affecting people at a much earlier age; thus, young children
are becoming morbidly obese and are experiencing the same health problems as middleaged
adults.
3
This severe state of obesity is something that can be controlled and prevented,
but only if parents take an active role in their child’s diet and exercise.
“Do little kids steal their parent’s car keys and drive themselves to McDonald’s?”
4
No,
that is why the state should intervene if a child is morbidly obese to the point where it is
life-threatening, and parents disregard or ignore the professional advice of a doctor, because
this is a clear case of child medical neglect and demands education, removal, or criminal
prosecution. This note discusses specific states that have correctly interpreted child neglect
statutes to include morbidly obese children and argues that all states should follow a similar
Patel / SUPER-SIZED KIDS 165
lead. Although this note mentions the problem of obesity in general, the focus remains on
morbidly
obese children.
The first section of this note defines morbid obesity and its causes and trends. What is
morbid obesity and why is it so prevalent in our society? The second section describes
child neglect in general and then distinguishes medical neglect. The third section discusses
education and prevention, which are both crucial steps in the struggle with weight-loss and
weight-gain. The fourth section summarizes the beneficial aspects of removing a morbidly
obese child who is in a life-threatening position from his or her parents. The fifth section
highlights case studies from California, Iowa, Indiana, New Mexico, and Texas, where
children have either died or were removed from their families because of morbid obesity.
The sixth section briefly touches upon similar child neglect scenarios where removal is
permissible and compares those situations with those of morbidly obese children. The
seventh section considers some credible counterarguments to government intervention,
and the final section suggests some recommendations on how to prevent the morbid obesity
crisis from becoming worse than it already is.Super sized kids Psychology Paper
MORBID OBESITY
According to
Webster’s New World Medical Dictionary
, a person who is “obese” is “well
above one’s normal weight.”
5
A person has traditionally been considered obese if he or she
is more than 20% over his or her ideal weight.
6
A morbidly obese person usually weighs
twice
more than he or she should or
50–100%
over the ideal weight.
7
Health experts use what is called the body mass index (BMI), to categorize levels of obesity,
which is a person’s weight in kilograms divided by his or her height in meters squared.
8
According to the National Institutes of Health (NIH), BMI measures body fat based on height
and weight and applies to both men and women.
9
A BMI between 25 and 29.9 is overweight,
and a BMI greater than 30 is obese.
10
A morbidly obese person has a BMI greater than 39.
11
The higher a person’s BMI, the higher his or her risk of adult onset diabetes, hypertension,
stroke, and other diseases.
12
Lastly, it has been shown that there is a positive correlation between
the risk of mortality and BMI.
13
People who have a BMI of 30
or greater
face a 50–100%
higher mortality rate from all causes compared with individuals of normal weight.
14
Obesity is as dangerous as ever. The Centers for Disease Control link obesity to a range
of illnesses that kill 400,000 Americans a year—more than AIDS and tobacco-related
cancers combined.
15
Today, almost 60% of the American population is overweight,
16
which
means that more than half of the population has a BMI greater than 25. An estimated five
to ten million people have a BMI above 39 and are considered morbidly obese,
17
and about
730,000 people have a BMI greater than 50.
18
A study published in 2003 by Roland Sturm,
a Rand Corporation researcher, found that the number of Americans with obesity (BMI
greater than 30) roughly doubled between 1986 and 2000.
19
During the same period, the
number of Americans with morbid obesity (BMI greater than 40) quadrupled, and those
with a BMI of 50 or more increased over five times.Super sized kids Psychology Paper
20
Looking specifically to children in the United States, it is unclear as to how many
morbidly obese children there actually are, but there are approximately 5.3 million overweight
children,
21
which translates to about 20–30% of children in the United States as
overweight or at risk of becoming so.
22
The existence of overweight children has nearly
tripled for adolescents in the past two decades,
23
and in New York alone, nearly half of
school-age children are either overweight or obese.
24
166 FAMILY COURT REVIEW
So why are children gaining weight? The causes for obesity and morbid obesity are
identical. The most common causes are genetic factors, lack of physical activity, unhealthy
eating patterns, or a combination of these factors. Only one in 100 children eats a balanced
diet as described by the United States Department of Agriculture’s (USDA) Food Guide
Pyramid; 16% of children do not fulfill the serving suggestions for any food group. All children
take in fats and sugar far in excess of recommendations.
25
Gracie Mae, a Los Angeles dietician,
pointed to an increase in the average weekly intake of sugar in processed foods from 24 ounces
to 48 ounces over the past 15 years as one cause of the obesity epidemic; and the growth of
video games, which has helped to ensure that the average American child now spends four
hours a day sitting in front of a television or computer screen and only thirty minutes exercising.
26
Moreover, fast food is more prevalent and portion sizes have increased. For example,
at McDonald’s, today’s Super Size servings are three times the size of 1970 portions.
27
Today,
an order of McDonald’s French fries is 610 calories.
28
For comparison purposes, in 1960,
the number of calories in a regular serving of McDonald’s French fries was a measly 200.
29
Unhealthy diets, the availability of sugar and processed goods, the growth of video games,
and an increase in portion sizes have all contributed to growing waistlines.
Only in rare cases is being overweight caused by a medical condition, such as an
endocrine disorder, but a physical exam and some blood tests can rule out that possibility.
30
Nevertheless, one study on obesity and genetics in adopted children actually showed that
80% of the obesity risk is genetic.Super sized kids Psychology Paper
31
Children who are genetically obese may have a harder
time regulating weight with diet and exercise alone, however, this is an area of obesity that
needs further research. “There are genetic patterns that can predispose people to become
overweight. But there are also patterns of how they eat, snack, exercise, or don’t do exercise
that forms this whole mini-culture in the family, and that is where the child lives,” says Dr.
Murray,
32
who works with children who have weight problems. Further, a recent Surgeon
General
33
report focuses on a recurrent and inveterate theme; while genetics can play a part,
two other factors are equally significant: too much food and too little exercise.
34
So,
although genetics can be to blame, it is still not definitive as the sole contributing factor of
morbid obesity.
Morbid obesity does not discriminate, but children most likely to gain weight have at
least one obese or overweight parent, live in a small family or are poor, consume a high
proportion of calories from fat, and are avid television watchers.
35
Children who come from
low-income households are at a higher risk of obesity because poor families in wealthy
countries, like people in the lowest income bracket in the United States, can afford to
overeat and are unaware of the related health risks or choose to ignore them.
36
Irrespective of why and which children are becoming heavier is the fact that the extra
weight is directly causing health problems among them. For example, when a three-yearold
child weighs 111 pounds instead of the average 30,
37
he or she will undoubtedly have
health problems that usually occur in adults, such as high cholesterol, high blood pressure,
and type 2 diabetes.
38
Morbidly obese children are also at risk for liver problems, sleep
apnea, and coronary artery disease.
39
Moreover, “childhood obesity is the leading cause
of pediatric hypertension, increase[d] stress on the weight-bearing joints, lower[ed] selfesteem,
and affects [on] relationships with peers.”
40
The most immediate consequence of
being morbidly obese as perceived by children themselves is social discrimination,
41
which
is associated with poor self-esteem and depression,
42
but the most realistic and severe
consequence of being a morbidly obese child is premature death. Representative of this is
Danny Hickey, a morbidly obese seven-year-old boy, who died from heart failure because
he weighed over 155 pounds.Super sized kids Psychology Paper
43
Patel / SUPER-SIZED KIDS 167
Although some researchers think parents should not regulate the diet of young children
because it could be a gateway to eating disorders,
44
they need to take action so that their
children do not literally eat themselves to death. Most overweight children under the age of
three who have parents of normal weight will quickly outgrow their baby fat.
45
The American
Academy of Pediatrics recommends that parents not restrict fat intake for children under
the age of two; but if a child is still overweight after age four, he or she is likely to stay
that way.
46
The most discouraging fact about child obesity is that 80% of obese children
become obese adults.Super sized kids Psychology Paper
47
Even worse, three out of four morbidly obese bariatric surgery
patients have been obese since childhood and nearly one third of these since infancy.
48
In
order to curb morbid obesity overall, it is imperative to start with morbidly obese children.
NEGLECT
In the fight against morbid obesity, the courts must get involved. If parents are found to
have neglected their child by consciously disregarding the medical advice provided by a
doctor and their child continues to eat to the point of morbid obesity, then the courts should
have a variety of options at their disposal to remedy the situation. These options include
mandated enrollment in nutrition education programs, removal of the child and placement
in a temporary foster home or health facility, or in the most severe cases, criminal
prosecution.
First, courts must find the parents neglectful. One can look to the various child neglect
statutes, where morbid child obesity can be considered a form of neglect. “They’ve been
told that the child needs to lose weight or else he is going to die,” states Marion County
Deputy Prosecutor Suzanne O’Malley. “When a parent doesn’t follow that advice, they are
putting that child’s health at risk, and that is neglect.”
49
Child neglect is a type of maltreatment
that refers to the failure of parents to provide needed age-appropriate care, such as
shelter, food, clothing, education, supervision,
medical care
, and other basic necessities
needed for development of physical, intellectual, and emotional capacities.
50
Medical neglect is a specific type of neglect that is defined as “the failure to provide
appropriate health care for a child although financially able to do so,”
51
and that lack of
health care can lead to serious harm and death.Super sized kids Psychology Paper
52
Medical neglect also includes cases in
which the regimens recommended for treatment of chronic illness are not followed.
53
Parents
must ignore or disregard the health of their children, which would occur when they pay
little attention to doctor’s orders,
54
like when children become morbidly obese because their
parents did not administer proper diet or exercise as recommended by their doctors. Parents
have a high duty to recognize symptoms of illness and to seek and follow medical advice,
and failure to do so may constitute medical neglect.
55
Once the doctors and nurses have
informed the parents of potential danger, it is the responsibility of the parents to incorporate
these suggestions into their own lifestyles. For morbidly obese children, lifestyle change
may include parents cutting out junk food and fast food,
56
which may satisfy suspicions of
medical neglect. However, if parents blatantly and repeatedly do not follow lifesaving diet
and nutrition advice provided by their pediatricians, then courts should take action.
The Child Abuse Prevention and Treatment Act of 1996, a federal law which defines
child abuse as “any recent act or failure to act on the part of a parent or caretaker, that
results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act
or failure to act which presents an imminent risk of serious harm”
57
may also cover morbid
obesity. States are allowed to intervene in order to protect a child’s physical or emotional
168 FAMILY COURT REVIEW
health,
58
and intervention usually occurs when parents refuse to acquire adequate medical
treatment.
59
Furthermore, they have the discretion to order medical or surgical care and
treatment for an infant, even over parental objection, if in their judgment the health, safety,
or welfare of the child requires it.
60
Whether under individual state laws or the federal Child
Abuse Prevention and Treatment Act of 1996, the government is allowed to intervene in
morbid child obesity cases where a child is at risk of dying.
EDUCATION AND PREVENTION
As mentioned previously, once a judge finds medical neglect, he or she should have the
option of mandating enrollment in nutrition education programs. If more people knew the
causes and dangers of morbid obesity, then the number of weight-related deaths could
decrease, but do people know enough about diet and exercise to maintain healthy lifestyles?
One may think so, but when it comes to families, even simple awareness seems to be
lacking, which is apparent from a recent survey.Super sized kids Psychology Paper
61
In
Prevention
magazine’s comprehensive
2003 Childhood Health Survey
, they announced findings on the awareness level and
prevailing perceptions about obesity among obese children and their parents.
62
The
following findings indicate that parents have skewed viewpoints of their children and
weight: almost half of the parents surveyed have obese children but do not believe that
their children are obese,
63
a third of the parents feel that their obese children have a
“healthy enough or as healthy as it could possibly be,” diet,
64
half of these obese children
think likewise
65
and almost half of the parents are likely to agree that good health is
mostly determined by people’s genes and not by things like diet, exercise, and drinking
habits.
66
Evidently, lack of awareness is yet another contributing factor to the morbid
obesity crisis.
While the government needs to implement education for children and parents of
all
weights and ages, there is an imminent need to educate morbidly obese children and
their parents today. Although it would be beneficial to implement a general education
program for everyone, that should be considered a long-term goal, whereas a short-term
goal would use the court system to target morbidly obese children and their parents
now. This might single out morbidly obese children and their parents, but the children are
at risk of dying and require immediate attention. In these programs, parents would learn
how to provide healthy food options for their children and encourage more active lifestyles,
while children would learn how to make smart food choices and how to engage in more
physical activity. A working example of a health clinic where parents and children learn
about obesity is the University of Miami’s Mailman Center for Child Development’s
Better Eating and Activity for Children’s Health (BEACH) clinic, where overweight
teens have access to nutritional counseling sessions taught by dieticians and psychologists.
The nutritionists encourage the children to work with their parents to develop
healthy eating and exercise habits. The doctors insist that one way to reverse the trend of
obesity is to “start teaching kids early about healthier food choices, smaller portion sizes,
and exercise.”Super sized kids Psychology Paper
67
Another health clinic is called Bright Bodies and is located at Yale University in New
Haven, Connecticut.
68
Children attend the first two meetings with their parents but continue
the program alone and gradually learn about behavior modification, food journals, and
common triggers of hunger and how to avoid them.
69
The program is designed for children
from the ages of nine to sixteen
70
and has helped many of them learn about healthy eating
Patel / SUPER-SIZED KIDS 169
habits and weight-loss techniques. The benefits of education programs are numerous. Both
the BEACH and Bright Bodies clinics have helped children to lose weight. Courts could
either mandate the parents and the morbidly obese child to attend the education programs
before
actual removal of the child or simultaneously require parents to attend education
programs while their children are removed and placed in foster care
71
or health facilities,
but this should be determined on a case-by-case basis.
THE BENEFITS OF REMOVAL
Removal is another option for courts. A statute, providing for the temporary removal of
a child from his or her parent’s custody, pending the disposition of a child protective
proceeding, where such removal is necessary to avoid imminent risk to the child’s life or
health, is constitutional.
72
Most states have such statutes providing for temporary removal
of children if they are in danger, so, in emergency situations in which the welfare, health,
or life of a minor child is threatened, the state may remove the child from the custody of
his or her parents for a reasonable time.
73
For example, in Texas, a four-year-old who
weighed over 136 pounds was temporarily removed from his home and placed in foster care
because he was dangerously obese.
74
When a court temporarily removes a morbidly obese child and puts him or her in foster
care or a health facility, such as a hospital, the result is commonly favorable. Prior to
removal, if the child is at a critical weight where his or her parents are not taking the
appropriate measures, then courts can bypass the education program and immediately
order removal. It has been found that children that are removed from their households lose
weight that they would not have lost had they been kept in their normal households.
75
In
Pennsylvania, a boy named D.K. was just over five feet tall but weighed over 451 pounds.
76
D.K.’s mother was also morbidly obese and would not attend medical appointments with
him; and although he had problems with his weight since infancy, his parents never took
him to a dietician.
77
His school finally took action and diagnosed his morbid obesity as
“life-threatening.”Super sized kids Psychology Paper
78
Northumberland County Children and Youth Services removed the boy
from his family and placed him in foster care, where he lost over fifty pounds in less than
three months.
79
The temporary foster care helped him lose weight and learn a new lifestyle,
which he was incapable of learning with his parents. He learned to exercise 30 minutes
daily,
80
which is a habit he plans to continue with his family. He now feels that he is ready
to return home and lose more weight.
81
In the case of Anamarie, the Children, Youth and Families Department took her away
from her parents on August 25, 2000, and placed her in a foster home.
82
Three months later,
she was returned to her family, and today, her parents are extremely strict about her daily
fifty-minute exercise routine and 800 calorie per day diet.
83
This is yet another example of
how intervention has succeeded.
84
From these cases, collectively, it is apparent that removal
has certain beneficiary effects that can lead to weight loss. Sometimes a drastic measure
like removal is necessary to save a child’s life.Super sized kids Psychology Paper
CASE STUDIES
Following are more case studies highlighting morbidly obese children and their individual
situations. In one scenario, removal may have been beneficial but since the child was not
170 FAMILY COURT REVIEW
removed, she died, and under other circumstances, removal did in fact prove advantageous.
Already in California, Iowa, Indiana, New Mexico, Pennsylvania, and Texas, child neglect
statutes are interpreted to include morbid child obesity. In California, if a child is suffering
from health-related problems due to his or her obesity, then the government can intervene.
A thirteen-year-old girl, Christina Ann Corrigan, weighed over 680 pounds.
85
With the consent
of her mother, she dropped out of school and sat around wearing muumuus and watching
television.
86
Christina’s mother found her dead in the living room.
87
Her mother did not
have any excuses other than the fact that being morbidly obese herself made it hard to take
care of her daughter.
88
Additionally, the mother claimed that her daughter was “increasingly
shy and ashamed” and would not show her body.
89
Therefore, the mother maintained she
never noticed the numerous, massive bed sores or evidence of “uncleanliness” (feces in the
folds of her skin) on her daughter.
90
The mother must have been unmistakably aware of her
daughter’s size, so she could have tried limiting her daughter’s diet or encouraging her to
exercise instead of letting her watch television. The mother was accused of child abuse and
is defending allegations of “inaction.”
91
Superior Court Judge Richard Arnason found her
guilty of misdemeanor child abuse.
92
In Indiana, “failure to provide a proper diet can be considered a form of abuse or
neglect.”
93
In the case of Cory Andis, he weighed 111 pounds at the age of four,
94
where the average weight of a four-year-old is approximately 35 pounds,
95
and only
one in 20 children at age four exceeds 45 pounds.96 The doctors provided a personalized
diet (for Cory) to his parents; however, his parents thought it was “too hard to follow”97
and even fed the child fast food while he was hospitalized.98 The parents had also
“complained to a nurse about being instructed on how to properly feed Cory.”99 In this case,
the parents were aware of Cory’s obesity problem, but they deliberately disregarded the
doctor’s orders.100 His parents were repeatedly warned that Cory needed to lose weight or
he would eventually die due to his morbid obesity.101 The prosecutor’s office argued that
Cory’s parents were guilty of neglecting their child by repeatedly ignoring the medical
advice and, therefore, temporarily removed him.102 Consequently, Judge Tanya Walton Pratt
accepted Andis’ guilty plea to a child neglect charge and ordered her to serve one and a
half years probation and perform 100 hours of community service for endangering her
son’s health.103Super sized kids Psychology Paper

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In Iowa, the state removed ten-year-old Liza from her mother, because her record
revealed that the child’s obesity was a potentially life-threatening condition and that it
interfered with the child’s socialization.104 Liza was taken away from her mother because,
at five feet three inches, she was over 270 pounds.105 The mother failed to help her daughter
lose weight and also failed to attend the dietary classes.106 The state also suggested that she
rewarded her daughter with food and refused to place her in the recommended residential
treatment.107 She also did not schedule appointments with the Skiff dietary program as
instructed by the doctors.108 Therefore, the court affirmed the juvenile court referee’s
adjudication of Liza as a child in need of assistance,109 removed her, and placed her in residential
treatment foster care. The court found that removal was in the child’s best interest.110
In New Mexico, the child neglect statute states that a “neglected child” is one “without
proper . . . medical . . . care . . . necessary for the child’s well-being because of the faults
and habits of the child’s parent . . . or refusal of the parent to provide them.”111 In 2000 the
State of New Mexico took Anamarie Martinez-Regino, a three-year-old who weighed over
131 pounds, away from her parents because her obesity was at a life-threatening level.112
Obesity must be of a severe nature reaching the life-threatening or morbid state, which has
also manifested itself in physical problems or mental problems.113
Patel / SUPER-SIZED KIDS 171
Some parents argue that they follow doctor’s orders as much as possible, but sometimes
it is unrealistic and impractical to do so.114 Additionally, it is hard for parents to deprive
their children of food and administer healthy workout routines, like in the case of Anamarie.
Every time she was admitted to the hospital, she lost weight, but when she returned
home, she would regain the weight.115 Her parents blamed the weight gain on “uneven sidewalks,”
116 which prevented Anamarie from exercising at home. As a result, the Children’s
Court Presiding Judge Tommy Jewell in New Mexico ordered the overweight toddler to
remain in state care.117 One might hypothesize another reason Anamarie regained the
weight is poor diet.Super sized kids Psychology Paper
Lastly, as mentioned previously, a young boy in Texas was removed from his parents, and
during the time he was placed with a foster mother, his weight “began to drop.”118 From
these case studies, it is evident that some states have already interpreted state statutes to
include morbid child obesity. By mandating education programs, removing children from
dangerous situations, and by prosecuting medically neglectful parents, most of these case
studies have ended happily.
SIMILAR CHILD NEGLECT SCENARIOS
Parents can be criminally prosecuted for starving their children. Morbid obesity is the
opposite of starvation but should be held in the same regard because food is a necessity.
Starving a child to death is a direct result of too little food, and dying from morbid obesity
is a result of too much food. If parents or guardians starve a child to death, they can be
criminally prosecuted.119 For example, in Commonwealth v. Cottam, Larry and Leona
Cottam were found liable for murder in the third degree, recklessly endangering another
person (two counts), and endangering the welfare of children (two counts), all charges
stemming from the starvation death of their fourteen-year-old son and the malnutrition of
their twelve-year-old daughter.120 The Cottam parents were held liable for starving their
children.121 If a child does not receive necessary medical care for a health problem, there
is usually no difficulty for a court to make a finding of dependency, especially in a situation
where a child was malnourished to the point of near starvation.122
In a similar case, defendants were found neglectful and sentenced to seven years in
prison for failing to feed their young sons.123 Raymond and Vanessa Jackson allegedly
starved their four boys and are being charged with child abuse and neglect. They are also
charged with aggravated assault and endangering the welfare of children.124 Since parents
can be criminally prosecuted if they starve their children to death, they should also be at
risk for prosecution if their children die from morbid obesity, and they neglected to take
steps to prevent or counteract it.Super sized kids Psychology Paper
COUNTERARGUMENTS TO MANDATED EDUCATION, REMOVAL,
OR CRIMINAL PROSECUTION
Although mandating education programs, removing morbidly obese children who are in
life-threatening situations, or criminally prosecuting parents who have allowed their
morbidly obese children to die might curb premature deaths of young children, there are
some counterarguments to consider. It is possible that morbid obesity is genetic and out of
the hands of parents. Arguably, morbid obesity could be a side effect of a condition called
172 FAMILY COURT REVIEW
leptin receptor deficiency,125 in which people constantly feel hungry and no matter how
much food they eat, they never feel satiated. Environment, however, is still a key factor and
can help one control or reduce his or her weight.126 Diet and exercise can help one to reduce
weight despite genetics.
Psychologists argue that removing a child from his or her parents may be helpful but can
be temporarily detrimental as well.127 Experts contend that “the attachment between a
parent and child forms the basis of who we are as human beings, and the continuity of that
attachment is essential to a child’s natural development.”128 Moreover, disruptions in the
parent–child relationship may provoke fear and anxiety in a child and diminish his or her
sense of stability and self.129 While this theory is plausible, if a child remains with his or
her parents in order to affirm the “attachment,” we may be overlooking the looming morbid
obesity problem, which can be circumvented with the proper attention. Morbid obesity
presents fatal risks to the child’s physical health and those risks need to be addressed before
emotional health concerns in order to prevent irreparable damage that might be caused
from the excess weight.Super sized kids Psychology Paper
There is also growing concern about the power of the state. Who is to determine what
is best for the child—the state or the parents? By allowing the state to intervene in cases
of morbidly obese children, are we allotting too much power to the government in the realm
of our private affairs? Perhaps we are encountering a slippery slope, because if the government
can remove morbidly obese children today, then maybe tomorrow it will be permissible to
weigh each and every individual in the country, including fathers, mothers, grandparents,
etc. And if we allow child neglect cases here, then perhaps it will be acceptable to allow
them every time an expert says that a particular lifestyle is not acceptable. The flaw with
the slippery slope argument is that by following the leads of California, Iowa, Indiana, New
Mexico, Pennsylvania, and Texas in interpreting child neglect statutes to include morbid
obesity, government intervention will not be based upon arbitrary weight analysis but
rather on already established standards like BMI that define morbid obesity and doctoradministered
medical treatment and advice. Therefore, the chance of actually reaching that
slippery slope is greatly diminished.
Although the counterarguments have valid points, this should not deter child protection
authorities from intervening on behalf of morbidly obese children; it is important to
remember that the United States is only getting fatter. Tommy G. Thompson, the Secretary
of Health and Human Services, has already declared to the country that “We’re just too
darned fat.”130 If people continue to eat what they want, when they want, and as much as
they want, then there will be an increased number of morbid obesity-related deaths. Annual
overweight- and obesity-attributable medical spending is estimated to be approximately
$78.5 billion per year. These figures now rival spending attributable to smoking.131 Removing
morbidly obese children will reduce overall public health costs for everyone. Since obesity
is preventable, we should be working to educate parents and children in order to prevent
obesity-related fatalities. The combined impact of education programs along with removal
and criminal prosecution could drastically lower or at least slow down the number of
morbid obesity-related deaths.Super sized kids Psychology Paper
FINAL RECOMMENDATIONS
A general education program should be the first step in creating awareness for the morbid
obesity epidemic. In line with a general education program is contact with families and
Patel / SUPER-SIZED KIDS 173
schools, which are the two most critical links in providing the foundation for physical activity
and nutrition.132 Parents can control diet and exercise in the home, but if children are at
school for nearly seven hours of the day, then it is infeasible for parents to be held 100%
accountable. The government should also combine its efforts with parents and schools to
combat morbid obesity. One federally assisted meal program helping children eat nutritionally
balanced meals is the National School Lunch Program, which provides low-cost or free
lunches to children each school day.133 Recent studies have shown the children who
participate in the National School Lunch Program consume twice the servings of fruits and
vegetables and eat greater amounts of grains and dairy products.134 In an effort to revolutionize
obesity prevention, schools are restructuring physical education class and limiting
food options in the cafeteria and vending machines. Paradigmatic of this so-called revolution
is a school in South Dakota that replaced a soda machine with a milk machine as part
of an attempt to improve students’ awareness of nutritious choices.135
An alternative example of schools and parents working together is embodied in the East
Penn school system in Pennsylvania and in Florida’s Citrus County district, where the school
systems have developed a system of writing letters home to parents of children in order to alert
them of a weight problem.136 The letter mailed to parents in Citrus County was intended to
assist parents in appraising, protecting, and promoting the health status of their children.
It is intended to encourage good nutritional habits and healthy physical activity.137 The
school administration writes home when children have vision or hearing problems, so they
have decided to write home about weight problems as well.138 The schools are waiting to
see if there will be a causal link between a potential decrease in weight and the letters.
The worst case scenario for a morbidly obese child would be death. Under these circumstances
or others just as severe, if parents have deliberately ignored medical advice, then
they could be criminally prosecuted.139 If morbid child obesity is taken seriously, and there
are severe consequences, such as education, removal, or prosecution, then parents will be
more likely to proactively help their children lose weight. Parents should monitor their children
from an early age so that they will know whether they need to take additional steps to
reduce their child’s weight or seek guidance and assistance from a doctor. It is essential
that parents and children alike are educated about the imminent perils of morbid obesity,Super sized kids Psychology Paper
whether via general education programs or state-mandated nutrition education programs. In
an ideal world, education and prevention should be the focus of health experts. When these
fail or even before they are viable options, every state should follow the pioneering efforts
of California, Iowa, Indiana, New Mexico, Pennsylvania, and Texas in interpreting the child
neglect statutes to remove morbidly obese children from their homes or criminally prosecute
them when the obesity is life-threatening and parents have failed to follow medical advice.
So, is it right or wrong to remove morbidly obese children from their families? Last year,
when three-year-old Anamarie was taken into custody by officials who believed she was so
overweight that her health was at risk, Glamour magazine conducted a survey.140 500
men and women were asked the question, “Should overweight kids be taken from their
parents?”141 and 38% answered, “Yes.”142 One researcher claims that morbid child obesity
is not a question about neglect and whether parents should be held responsible or not; rather
he posits that obesity is a “social and cultural issue.”143 Too many people are dying from
weight-related problems already, yet morbid obesity is preventable!144 Government
researchers predict that almost every American will be overweight or obese by 2040.145
Dr. William Klish, a child obesity expert, provides a sobering thought;146 “If an answer
to this obesity epidemic is not found, for the first time in at least a century, the present
generation of children will not live as long as their parents.”147
174 FAMILY COURT REVIEW
NOTES
1. Shireen Arani, Note, State Intervention in Cases of Obesity-Related Medical Neglect, 82 B.U. L. Rev.
875 (2002) (The case of Anamarie Martinez-Regino remains unpublished).Super sized kids Psychology Paper
2. Id.
3. Carma Haley Shoemaker, Carrying the Weight, available at http://recipestoday.com/resources/articles/
overweight.htm (last visited July 20, 2004).
4. Craig Tanner, Avoiding Evil, at http://www.avoidingevil.com/blog/archives/cat_the_duh_files.htm (last
visited Dec. 4, 2002).
5. Webster’s New World Medical Dictionary (2d ed. 2001).
6. Id. (Ideal weight encompasses a person’s height, age, sex, and build).
7. MedLine Plus, Morbid Obesity, available at http://www.nlm.nih.gov/medlineplus/ency/article/
003102.htm (last visited Aug. 21, 2004).
8. Webster’s New World Medical Dictionary, supra note 5.
9. National Heart, Lung, and Blood Institute, Calculate Your Body Mass Index, at http://nhlbisupport.com/
bmi/bmicalc.htm (last visited Feb. 16, 2004) (BMI may be a reliable indicator of body fat; however, it can also
overestimate body fat in athletes and others that have a muscular build or underestimate body fat in older persons
who have lost muscle mass).Super sized kids Psychology Paper
10. Id.
11. MedLine Plus, supra note 7.
12. A publication of the USDA Center for Nutrition Policy and Promotion, Insight Profile of Overweight
Children (May 13, 1999), available at http://www.usda.gov/cnpp/Insights/ins13a.PDF.
13. Eugenia E. Calle et al., Body-Mass Index and Mortality in a Prospective Cohort of US Adults, 341 New
Eng. J. Med. 1097 (1999).
14. Hope Cristol, Trends in Global Obesity: Developing Nations are Gaining on U.S. in a Weighty Matter,
Futurist, May 1, 2002, at 10.
15. John Harlow, Obese Young America has its Coronaries Early, Times (London), Mar. 24, 2002; Joyce
Howard Price, Chronic Overeating Called an Addiction, The Wash. Times, Aug. 15, 2004.
16. Jill Smolowe, Everything to Lose; Too Much Food and Too Little Exercise Have Left Millions of American
Youths Overweight and at Risk for Devastating Illnesses. What Can be Done? Plenty, People, Nov. 4, 2002, at 58.
17. Strong Health Bariatric Surgery at Highland Hospital, Is Bariatric Surgery Right For You? What Is Morbid
Obesity?, at http://www.stronghealth.com/services/surgical/bariatric/morbidobesity.cfm (last visited Aug. 18, 2004).
18. Obesity in the Extreme, available at http://www.hmiworld.org/past_issues/May_June_2004/
around_obesity.html (last visited Aug. 21, 2004).Super sized kids Psychology Paper
19. Id.
20. Id.
21. Smolowe, supra note 16.
22. See Nanci Hellmich, It’s Tough Being an Obese Kid, U.S.A. Today, Apr. 9, 2003, at 8D.
23. U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Prevent and
Decrease Overweight and Obesity, available at http://www.surgeongeneral.gov/topics/obesity/calltoaction/
fact_adolescents.htm (last visited Feb. 16, 2004).
24. Sarah Bernard, Alarmed by the Surge in Childhood Obesity, New York’s Carb-Obsessed Parents are
Fixating on How to Keep Their Children Healthy and—Perhaps More Important—Thin, available at http://
www.newyorkmetro.com/nymetro/news/features/n_9887 (last visited on Feb. 16, 2004).
25. Statement, American Academy of Pediatrics, Ohio Chapter, Ohio AAP Statement on Soft Drink Contracts
in Schools, available at http://www.ohioaap.org/softdrinks.htm (last visited Feb. 11, 2004).
26. Harlow, supra note 15.Super sized kids Psychology Paper
27. Smolowe, supra note 16, at 58.
28. Id.
29. C. Gopinath, The Fat Crisis, Bus. Line, Feb. 10, 2003.
30. The Cleveland Clinic Information Center, at http://www.clevelandclinic.org/health/health-info/docs/
2400/2434.asp?index=9467 (last visited Aug. 12, 2003).
31. Randall J. Thirlby, A Genetic “Obesity Risk Index” for Patients with Morbid Obesity, 12 Obes. Surg.
25 (Feb. 2002), at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=
11868292&dopt=Abstract.
32. Jennifer Warner, Parents Not Alone in Child Obesity Fight, at http://my.webmd.com/content/article/52/
50294.htm (last visited Feb. 16, 2004).
Patel / SUPER-SIZED KIDS 175
33. David Satcher was the Surgeon General at the time.
34. Smolowe, supra note 16, at 58.
35. U.S. Department of Health and Human Services, supra note 23.
36. Cristol, supra note 14, at 10.
37. The Obesity Struggle, at http://www.weightlossurgery.com/the_obesity_struggle.htm (last visited Nov.
30, 2003).
38. Health Risks of Obesity, at http://www.weight-loss-i.com/obesity-health-risks.htm (last visited Nov. 30,
2003).
39. Laura A. Kelley, Note, What Should be the Standards for Intervening Between Parent and Child?: The
Parental Prosecution for a Young Boy’s Obesity, 9 Buff. Women’s L.J. 7 (2001).
40. Childhood Obesity, at http://www.kidsource.com/kidsource/content2/obesity.html (last visited Nov. 30,
2003).
41. U.S. Department of Health and Human Services, supra note 23.
42. Id.
43. Harlow, supra note 15 (The case referring to Danny Hickey is not published).
44. Shari Roan, Eat Right and Exercise . . . You Talkin’ To Me? Yeah!; We Followed the Rules and We’re Still
Overweight. Now, Health Professionals Say We Should Just Say No to Dieting, L.A. Times, Sept. 22, 1997, at S1.
45. Daphne Miller, Is Your Child Overweight? at http://edition.cnn.com/HEALTH/diet.fitness/9909/03/
kids.weight (last visited Feb. 15, 2004).
46. Id.
47. The Obesity Struggle, supra note 37.
48. Cynthia Buffington, Why Obese Children Become Obese Adults, at http://www.beyondchange-obesity.com/
obResearch/obeseChildrenAdults.html (last visited Aug. 21, 2004).
49. Mike Ellis, Parents Being Prosecuted for Young Son’s Obesity; Indianapolis Couple Lost Custody and
Were Charged with Neglect When Boy Grew to 138 Pounds at Age 4, The Indianapolis Star, Nov. 29, 2000, at
1A.
50. National Exchange Club Foundation, at http://www.preventchildabuse.com/neglect.htm (last visited
Feb. 16, 2004).
51. Id.
52. Info on Child Abuse, at http://www.pcain.org/InfoOnAbuse/medical_neglect.htm (last visited Feb. 16,
2004).
53. Id.
54. Id.
55. In re S., 322 N.Y.S.2d 170 (N.Y. Fam. Ct. 1971).
56. Kelley, supra note 39.
57. Child Neglect and Child Abuse, at http://www.healthyeatingliving.com/Abuse.htm (last visited Nov. 30,
2003).
58. Arani, supra note 1, at 876.
59. Id.
60. In re Sampson, 37 A.D.2d 668 (N.Y. App. Div. 1971).
61. Childhood Obesity: Magazine Releases Key Findings from its 2003 Childhood Health Survey, Health
& Med. Wk., Nov. 24, 2003, at 160.
62. Id.
63. Id.
64. Id.
65. Id.
66. Id.
67. Connie Prater, Doctors Fight Children’s Obesity Epidemic, Houston Chron., Nov. 13, 2003,
at A38.
68. Amy Benfer, The Lost Language of Fat, available at http://www.salon.com/mwt/feature/2002/03/25/
fat_kids (last visited Feb. 16, 2004).
69. Id.
70. Id.
71. In re M.A.W., 256 Mont. 296 (1993).
72. In re Michael Z., 40 A.D.2d 1034 (N.Y. App. Div. 1972).
73. State ex rel. Lemaster v. Oakley 203 S.E.2d 140 (W.Va. 1974).
74. In re G.C., 66 S.W.3d 517 (Tex. Ct. App. 2002).
176 FAMILY COURT REVIEW
75. In re D.K., 58 Pa. D. & C.4th 353 (2002).
76. Id.
77. Id.
78. Id.
79. Id.
80. Id.
81. Id.
82. Rebecca Roybal, Still a Struggle, Albuquerque J., Aug. 12, 2001, at A1.
83. Id.
84. Id. (The caveat with this case is that the parents claimed they had always followed the doctor’s orders
and not just after she was returned to them).
85. See Linda Yglesias, Obese Teen’s Death Now a Cause Celebre Charges Against Child’s Mother Spark
Outcry Against “Fat Bigots,” Toronto Star, Jan. 8, 1998, at F6 (This case is not published).
86. Id.
87. Id.
88. Id.
89. Id.
90. Id.
91. Id.
92. Linda Yglesias, Love Was Not Enough; A Mother Who Didn’t Know Where to Turn Loses a Daughter to
Morbid Obesity, Pittsburgh Post-Gazette, Jan. 20, 1998, at F6.Super sized kids Psychology Paper
93. Kelley, supra note 39 (This case is not published).
94. Id.
95. Id.
96. Id.
97. Id.
98. Id.
99. Id.
100. Id.
101. Id.
102. Id.
103. Vic Ryckaert, Mother of Obese Boy is Sentenced, Indianapolis Star, Mar. 24, 2001, at 1B.
104. In re L.T., 494 N.W.2d 450 (Iowa Ct. App.1992).
105. Id.
106. Id.
107. Id.
108. Id.
109. Id.
110. Id.
111. N.M. Stat Ann. § 32A-4-2(E)(2) (Michie. 1978).
112. Arani, supra note 1.
113. In re D.K., 58 Pa. D. & C.4th 353 (2002).
114. Lisa Belkin, Watching Her Weight, N.Y. Times, July 8, 2001, at 30.
115. Id.
116. Id.
117. Leslie Hoffman, Judge Says Return Home Still Goal for Obese Girl, Albuquerque Trib., Sept. 9, 2000,
at A1.
118. In re G.C., 66 S.W.3d 517 (Tex. Ct. App. 2002).
119. Commonwealth v. Cottam, 616 A.2d 988 (Pa. Super Ct. 1992).
120. Id.
121. Id.
122. Id.
123. Higbee v. State, 1999 Tenn. Crim. App. LEXIS 1216 (1999).
124. Jason Laughlin, Boys Found Severely Malnourished, Courier-Post, Oct. 26, 2003, at 1G.
125. Patrick Armijo, Judge: Girl To Return Home, Albuquerque J., Oct. 25, 2000, at B1.
126. Victoria Stagg Elliott, A Weighty Matter: Obesity, Leptin and Beyond, at http://www.ama-assn.org/amednews/
2001/08/06/hlsa0806.htm (last visited Jan. 31, 2004).
Patel / SUPER-SIZED KIDS 177
127. Melanie Margarida Nowling, Note, Protecting Children who Witness Domestic Violence: Is Nicholson v.
Williams an Adequate Response?, 41 Fam. Ct. Rev. 517 (2003).
128. Id. at 520–521.
129. Nowling, supra note 127.
130. Mary Leonard, U.S. Launches A Fight Against Obesity, Bos. Globe, Mar. 10, 2004, at A1.
131. Eric A. Finkelstein, Ian C. Fiebelkorn & Guijung Weng, National Medical Spending Attributable to Overweight
and Obesity: How Much and Who’s Paying?, 22 Health Affairs 219 (2003).
132. Childhood Obesity, at http://www.obesehelp.net/Childhood_Obesity.htm (last visited Sept. 13, 2004).
133. National School Lunch Program, available at http://www.fns.usda.gov/cnd/Lunch/Default.htm (last
visited Sept. 13, 2004).
134. Warner, supra note 32.
135. Terry Woster, Debate Over Requiring Phys Ed Pits Health vs. School Costs, Argus Leader, Jan. 24,
2004, at 1A.
136. Letters Sent to Fat Kids’ Parents, available at http://wp.netscape.com/ex/shak/news/stories/0203/
20020321fat.html (last visited Sept. 13, 2004).
137. Id.
138. Id.
139. Yglesias, supra note 92.Super sized kids Psychology Paper
140. Glamour Surveys 500 Men and Women on Controversial Topics, Bus. Wire, July 5, 2001, at 158.
141. Id.Super sized kids Psychology Paper
142. Id.
143. Kelley, supra note 39, at 9.
144. Childhood Obesity, supra note 40.
145. Nanci Hellmich, Obesity predicted for 40% of America, U.S.A. Today, Oct. 14, 2003, at 7D.
146. William J. Klish, Childhood Obesity, at http://www.baylorcme.org/gi /presentations / klish / klish.pdf. ( last
visited Sept. 13, 2004).
147. Id.
Deena Patel is the Notes and Comments Editor of Family Court Review. She graduated from Boston
University with a B.S. in Business Administration.Super sized kids Psychology Paper

SUPER-SIZED_KIDS