18 July 2011

Child obesity idea in controversial statement clarified

Boston paediatrician David Ludwig, wants to set the record straight on his view that the state should intervene in the most extreme cases of child obesity.


Boston paediatrician David Ludwig, at the centre of a media storm this week, wants to set the record straight on his view that the state should intervene in the most extreme cases of child obesity.

Dr Ludwig and co-author Lindsey Murtagh at the Harvard School of Public Health triggered a backlash with an opinion piece in the Journal of the American Medical Association about what could be done about highly overweight youngsters.

They argued that when all other efforts failed, the state should consider putting high-risk obese kids in foster care, and said doing so may be the more ethical choice that could avert drastic measures like weight-loss surgery.

Dr Ludwig, of Boston's Children's Hospital, has since responded to dozens of e-mails this week from angry and terrified parents. Other medical experts have questioned the rationale of removing a child from an otherwise functional and supportive family if they are obese.

Doctor tries to explain statement

In his first interview since the backlash began, Dr Ludwig said the article was meant to promote a dialogue on childhood obesity, which has become a life-threatening problem for many youngsters.

"It's absolutely understandable that if someone with an obese child heard the government could swoop in and take that child away, (they would) be frightened and outraged," Dr Ludwig said. "I want to emphasise that foster care should be the last resort, when all other options have failed."

In his response to parents, Dr Ludwig has provided copies of his opinion piece, which says there is a role for the state when it comes to helping obese children, but removing them from a home is very rarely the solution.

"It's just been heartbreaking to see how the story has been wildly exaggerated by some of the media, causing a great deal of pain and suffering for people," Dr Ludwig said.

Full statement released for clarity

With at least 20 million overweight and obese children in the United States and some 2 million of those kids at the very highest risk, childhood obesity may be the "most important threat that exists in this generation of children," he said. But placing a youngster in foster care "should absolutely not be an option" for most of the highest risk cases.

And that's what it says in the piece, he said. To prove his point and calm the fury that has erupted, JAMA is making the full text of the piece available free to the public for a week here in full.

Dr Ludwig explained that state intervention could include financial support to families, social services, access to safe recreation areas and even parenting courses to help manage a child's uncontrolled eating habits.

In 99% of the most serious cases, removing a child from a home is not an option. Dr Ludwig said that in over 15 years of treating some 10,000 patients battling obesity he only knows of one case where the child was taken from parents.

"The ultimate answer to the obesity epidemic is not to blame parents, it's to create a more healthful and supportive society," he said.

"But until we get there, what do we do about that 14-year-old, 400-pound child who's not facing increased risk of illness 20 years from now, but who's facing life-threatening complications today?" he said.

(Reuters Health, Lauren Keiper, July 2011)

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