Is obesity reason to remove, and perhaps medicate?

An article found in UK's Mailonline features the story of a family broken and separated by social workers because the parents have many obese children.  According to media reports, immediately after birth, the newest addition to the "very large" family was taken away by a social worker, and that newborn infant was put in foster care.  Perhaps we are to presume the placement was a preventative measure, and the removal of the parent's older children was in the name of "a child's best interest".

Before she became pregnant, the mother, 40, who cannot be named for legal reasons, weighed 23st.

At that time one of her children, a toddler, weighed 4st, her 13-year-old son weighed 16st and an 11-year-old weighing 12st.

On Monday afternoon, the mother gave birth to a girl by Caesarean section.

And 28 hours later, social workers arrived at the maternity ward to take the baby into care, after serving child protection papers on the patents.

Yesterday morning, a meeting of the Children’s Panel of Dundee Council decided the three youngsters still living at home should also go into care.

They are expected to be removed from the family home before the end of the week.

Yesterday the mother pleaded: ‘I just want my wee girl home. She’s only a day old.’

The 18st father, 54, who was at the Children’s Panel hearing, said: ‘The panel members wouldn’t listen to me.

‘They would only listen to the social workers. They were accusing me and my wife of physical and emotional abuse and physical neglect – and we deny all that.

[From:  Newborn baby of 23st mother and her SIX siblings taken into care 'over obesity fears' October 22, 2009 ]

According to a different article, written in 2007, several children in the past have been taken into care because of obesity.

Meanwhile, across the pond... a similar situational case took place this past summer, in the United States.  According to media reports, a South Carolina mother lost her obese son to social services/foster care.  This case had Newsweek reporters raising the question, is child obesity reason enough to be charged with criminal neglect/child abuse?

Gray followed nutritional guidelines set for her son by the state Department of Social Services, Varner says, but Alexander apparently got other food on his own while not under his mother's supervision.

The boy has been placed in foster care, and Varner says he hasn't been allowed to speak to him.

[From:  S.C. case looks on child obesity as child abuse.  But is it?, July 23, 2009 ]

As a Registered Nurse, I can appreciate the long-term problems obesity can cause a person.  There are well-known associated health-risks, making future health-costs a real concern for those needing specialized medical care.  However, the more I read about obesity, and suggested treatments being offered by select groups, the more I see a troubling trend... one that carries it's own serious risks to a young patient.

Drugs used to treat hyperactive children, such as Ritalin, could be used to help solve Britain’s obesity crisis as new research has shown one in three severely obese adults who fail to lose weight have undiagnosed Attention Deficit Hyperactivity Disorder.

Doctors behind the latest findings claim a chemical imbalance in the brain caused by undiagnosed ADHD prevents severely obese patients from having the willpower to lose weight.

And they claim once the condition had been treated with drugs such as Ritalin [it] improve[d] their dieting success dramatically.

Almost one in four people in Britain are now obese, official statistics show, and research suggests the figure could rise to one in three by 2012 because of poor diet and sedentary lifestyles. 

[From:  Mass drugging suggested to halt Britain’s obesity crisis, July 4, 2009 ]

For those who don't know, for quite some time, much question has gone into the legitimacy of certain diagnostic assessments made by those caring for children placed in foster care.

"Children who are having normal reactions to the trauma of being separated from their families are often misdiagnosed or overdiagnosed as suffering from psychiatric problems, and the system is too quick to medicate," said Mike Arsham, of the Child Welfare Organizing Project. "It's a chemical sledgehammer that makes children easier to manage."

[From:  Critics:  States quick to drug foster kids ]

If being wrongly-labeled and medicated isn't dangerous enough, there are more concerning issues related to black-box warnings written on specific drugs, especially those not intended for pediatric use, like anti-depressants and anti-psychotropics.

In 2006, two FDA advisory panels recommended new black box warnings, (the most serious warnings added to a drug's label information), for amphetamine-based drugs used to treat ADHD. However, the panels didn't quite agree on the warnings. Ritalin and Concerta, two other drugs used to treat ADHD, aren't amphetamines, so they don't bear the black box warning about amphetamine use.

Oddly enough, the panel wasn't meant to consider the issue of drug labeling. Instead, it was exploring whether some rare but frightening instances of sudden death occurring in people taking these drugs warranted further study. There have been 25 such cases reported to the FDA in recent years, though it's uncertain that the drugs caused the deaths. In addition, the panel looked at preliminary data suggesting an increased risk of arrhythmias and strokes associated with these medications. "The main purpose of the meeting was to look at study design to review this," explained Dr. Thomas Laughren, director of the FDA's division of psychiatry products.

But the meeting took an unexpected turn when cardiologist Steven Nissen of the Cleveland Clinic made a motion for a black box warning. Dr. Nissen, who was among the early warners on the risks of the now-withdrawn arthritis drug Vioxx, was concerned that the 25 cases might be just the tip of an iceberg. "There's no mandatory reporting of these cases," he says. He notes that the stimulants in question are known to raise blood pressure and heart rate. "Raising blood pressure of a child or adult continuously over many years worries me," Nissen told TIME. "There is a linear relationship between increased blood pressure and adverse cardiovascular events." Nissen further notes that two stimulants that are related to the Ritalin class of drugs—ephedra and phenylpropanolamine (PPA)?have been banned from the market because of cardiovascular risks.

The panel's recommendation also reflects a general concern among some members of the medical community that use of ADHD drugs has spun out of control in the U.S. "No where else in the world are 10% of 10 year-old boys diagnosed and treated for ADD," says FDA panel advisor Curt Furberg, a professor of public health at Wake Forest University, who voted in favor of the warning. "I don't argue that there are some kids who need that treatment, but it's probably overused." Doctors Furberg and Nissen are also concerned about the rising number of adults on these drugs. About 10% are over 50, a group that has a higher rate of cardiovascular problems to begin with. Says Dr. Nissen: "I want the physicians' hands to tremble a bit when they write a prescription for these drugs."

[From:  Getting Hyper About Ritalin, February 10, 2006 ]

So, as I read about obesity being a reason to remove a child from his/her home, and dangerous stimulants being given to obese individuals who may already be high-risk cardiac patients, I have to really wonder what's going through the minds of those promoting and protecting a child's "best interest", using removal and medication as the preferred plan of action.  I'm especially curious to see where this cure-obesity (and treat ADHD while they're young) belief is going, knowing there are doctors already complaining about the need for routine ECG/EKG's on each child put on Ritalin.  ["The cost!  The cost!  What about the poor consumer?" -- the consumer, in many of these cases, of course, being tax-payers footing child-welfare health bills.]

Is it wise to remove an obese child away from his/her home, (placing that child in foster care)... and is it wise to medicate these children with stimulant-drugs known to have serious - fatal - side effects?  Is losing weight really that critical?

If you ask me, I think there is a greater more immediate danger taking place in foster/adoptive homes -- one more social workers and medical professionals need to monitor because the risk of death can be so much sooner.  This danger I dare to mention is obesity's disturbingly ugly and damaging twin sister, malnutrition/starvation.

The following list features a special-breed of abuse cases PPL has collected so far.  Each case represents a child, (or several children), who suffered from starvation/gross neglect in their carefully chosen foster/adoptive homes.

76+ Children adopted by Diane and Dennis Nason
Alloma Gilbert, Christopher Spry and Child A
Amber King
Anthony Bars
Austin James Watkins
Boy adopted by Peter and Deedra Mitchell
Boy and girl adopted by Richard and Christine Dodson
Bruce, Michael, Tyrone and Keith Jackson
Children adopted by Harold Johnson and Sherry Johnson
Children adopted by John and Linda Dollar
Chrystal Ramirez (Chrystal Camarillo)
Danielle and Brittany Tucker (Dornan)
Dennis Gene Merryman (Denis Uritsky)
Genevieve Monique "Genny" Rojas
Lucas Ciambrone (Pedro Garcia)
Weyland Brown Mitchell