A personal note on Childhood Obesity

The topic of childhood obesity has personal meaning to me. Throughout my childhood, I was overweight. I remember being teased in school as well as having to endure “well meaning”, but often rude, comments from family members.  Now as an overweight adult, I am a living example of the correlation between overweight and obese children growing into overweight and obese adults.  As an adult, I have more control over my diet and the knowledge to improve it; but children lack a level of control over their environments and often times lack the knowledge to make healthy choices. As a social worker in training, I recognize why childhood obesity interventions are so important. Parents cannot be expected to impart healthy lifestyle practices onto their children if they have never had the opportunity to learn it themselves.  Examining the causes of the current epidemic of childhood obesity allowed me to understand that the individual is not always to blame for their condition.  The problem is linked to how our society is structured. Low-income families have high rates of obesity due to less access to healthy food, healthcare, and safe environments for physical activity. Social workers have the responsibility of understanding the social and political forces that influence society, and advocating for members of the population who are adversely affected by those forces.   The research for this project helped me develop the following competencies:

Competency 3: Apply critical thinking to inform and communicate professional judgments and Competency 6: Engage in research-informed practice and practice-informed research. 

Is Morbid Childhood Obesity Child Neglect?

Ethical Approaches to Childhood Obesity

Competency 4: Engage diversity and difference in practice.

The First Lady Tackles Childhood Obesity

Global Policy Approaches to Childhood Obesity

Competency 8: Engage in policy practice to advance social and economic well-being and to deliver effective social work services and Competency 9: Respond to contexts that shape practice.

Global Policy Approaches to Childhood Obesity

Does Breastfeeding reduce the risk of Childhood obesity?

Physical Activity to reduce obesity rates

The First Lady Tackles Childhood Obesity

Farm to School Programs

The First Lady Tackles Childhood Obesity

In the wake of rising childhood obesity rates in the U.S., First Lady Michelle Obama has pioneered the Let’s Move! initiative in an effort to educate children and parents on how to create healthy life long practices. The initiative follows the five principles of 1. Creating a healthy start for children, 2. Empowering parents and caregivers, 3.Providing healthy food in schools, 4. Improving access to healthy, affordable foods, and 5. Increasing physical activity (www.letsmove.gov), which developed from the Task Force on Childhood Obesity’s review of national programs and policies concerning child nutrition and physical activity. The Task Force on Childhood Obesity has passed several pieces of legislation, like the Healthy, Hunger-Free Kids Act of 2010; which authorizes funding for nutrition and school meal programs, to combat social and environmental determinants that contribute to childhood obesity.  The Let’s Move! initiative emphasizes the need for collaborative efforts to ensure the well being of children, and the need for collective responsibility when addressing childhood obesity. 

First Lady Michelle Obama explains Let's Move!

Related links:

Let's Move!

White House Task Force on Childhood Obesity Report to the President

Course Competencies

The Council of Social Work accreditation requires that CSWE and practice behaviors are taught in each social work class. The specific competencies relate differently to each class and some classes focus more on some than others. The mastery of five core competencies was focused on in this blog and was demonstrated separately through each post.

Competency 3: Apply critical thinking to inform and communicate professional judgments was addressed in all of the posts by appraising and integrating multiple sources of knowledge through research and practice wisdom. Many organizations were studied and cited throughout this blog that related to childhood obesity: CDC, WHO, Department of Health and Human Services, Childwelfare.gov, Child Welfare Information Gateway, The New York Times, International Association for study of Obesity, ABC news, and many more.  

Competency 4: Engage diversity and difference in practice was focused on in the posts related to diversity and child obesity. Their are specific statistics that were addressed through cultural differences and obesity. Their were also different organizations listed that focus on cultural bias and obesity, which relates to the prevention of childhood obesity. The cultural structures and different values related to cultural beliefs were enhanced throughout these posts.  

Competency 6: Engage in research-informed practice and practice-informed research was addressed mainly in the research posts related to child obesity, which used evidence to inform practice and education. Much research has been done on childhood obesity and will continue to be done on this growing epidemic. It will be important for social workers to keep current with their research on this subject in order to help prevent this among children. Many of the posts address facts and evidence that has been done by researchers in order to reverse and prevent childhood obesity.

Competency 8: Engage in policy practice to advance social and economic well-being and to deliver effective social work services by analyzing, formulate and advocate for policies that advance social well-being. There was a post that was done on how child obesity is affecting the economy on a global scale and a youtube video was correlated with this post as well. Their were also posts done related to childhood obesity and policy, which was focused on through a global standpoint.

Competency 9: Respond to contexts that shape practice was addressed in most of the posts by continuously discovering, appraising and advocating for policies that affect childhood obesity. Each week we were able to help shape our beliefs and future practice methods by researching this topic and relating it to social work practice. By educating ourselves and others we are able to improve our skills and develop better practice methods.

   

Ethical Approaches to Childhood Obesity

Childhood obesity interventions should follow the ethical principle of not causing harm to children. Overweight and obese children are often teased in school and ridiculed for not fitting in. Bringing attention to a child’s weight can cause unintentional psychological harm that may lead to eating disorders (Austin, 2011) or other unhealthy habits. Jennifer A. O’Dea (2010) writes that “the risk of obese children and their parents adopting fad weight loss regimes is something that health educators need to be certain to avoid” (p.32); childhood obesity prevention policies must consider the health of the child by implementing plans that promote gradual change.  Focusing on nutrition, rather than weight loss, allows children of all sizes to strive for the same goal. Incorporating new nutrition and exercise plans can be difficult, but gradually introducing them into schools and homes, and understanding that change is not expected overnight, reduces the chance that children will develop negative attitudes towards obesity prevention programs.

Austin, S. (2011). [Commentary on] The Blind Spot in the Drive for Childhood Obesity Prevention: Bringing Eating Disorders Prevention Into Focus as a Public Health Priority. American Journal Of Public Health, 101(6), e1-4.

O'Dea, J. A., and Eriksen, M. P. (2010). Childhood obesity prevention: International research, controversies, and interventions. Oxford [U.K] ; New York: Oxford University Press.

Is Morbid Childhood Obesity Child Neglect?

When does a child’s weight become the concern of child welfare services? Morbid obesity is defined as a body mass index (BMI) greater than or equal to 40 kilos per meter squared (www.cdc.gov). Some scholars (Murtagh and Ludwig, 2011) and (Patel, 2005) believe that the definition of child neglect should expand to include severely obese children. According to the Federal Child Abuse Prevention and Treatment Act (CAPTA), child neglect is generally defined as the failure of a parent, guardian, or other caregiver to provide for a child’s basic needs. Neglect may be:

• Physical (e.g., failure to provide necessary food or shelter, or lack of   appropriate supervision).
• Medical (e.g., failure to provide necessary medical or mental health treatment).
• Educational (e.g., failure to educate a child or attend to special education needs).
• Emotional (e.g., inattention to a child’s emotional needs, failure to provide psychological care, or  permitting the child to use alcohol or other drugs). (www.childwelfare.gov)

Sciarani (2010) states that “negligence standards do not allow parents to claim ignorance of their child’s deteriorating condition as a defense” (p. 326), thereby allowing the state to intervene. But should state intervention come in the form of removing children for their homes?

There have been several publicized cases in which morbidly obese children have been placed in foster care. In a 2000 case in New Mexico, 3 year old Anamarie Regino, was taken from her parents and placed in foster care for 2 and ½ months; she weighed 124 pounds and was nearly 4 feet tall. Anamarie’s mother, Adela Regino, claimed that her daughter had been growing and gaining weight rapidly from the time she was born; doctors had not been able to diagnose why it was happening at the time. The lack of a medical diagnosis prompted the NM Child, Youth, and Family Department and Children’s Court judge to believe that Anamarie’s parents were neglecting her health by not addressing weight (Belkin, 2001). An even more controversial case happened in California, where 13-year-old Christina Ann Corrigan died in her home, covered in bedsores and weighing 680 pounds. Her mother, Marlene Corrigan, was originally charged with felony child abuse and endangerment. The charges were later reduced to misdemeanor child abuse through inaction (Darwin, 2008).

Looking at these cases from a child welfare perspective, removing morbidly obese children from their homes is not a feasible way to address the problem.  In Anamarie’s case, removing her from her home caused unnecessary emotional trauma. Child welfare services should have considered the fact that Anamarie was not only severely overweight but also significantly tall for her age, even though a diagnosis was never specified. The Regino family should have been offered nutrition services and information about any applicable programs to assist in regulating Anamarie’s weight problem before any thoughts of foster care ever surfaced.  In Christina’s case, child welfare intervention would have been effective if it came earlier. Marlene Corrigan had the added responsibility of taking care of her elderly parents in addition to caring for an obese child.  She would have benefited from programs that offer assistance for the elderly, and exercise and nutritional counseling for her daughter. Providing supportive family services to families with obese children reduces the need for out-of-home care.

Belkin, L. (2001, July 8). Watching her Weight. The New York Times. Retrieved from http://www.nytimes.com/2001/07/08/magazine/watching-her-weight.html

Child Welfare Information Gateway. (2008, April). What is Child Neglect? Fact Sheet. Retrieved on from http://www.childwelfare.gov/pubs/factsheets/whatiscan.pdf

Darwin, A. (2008). Childhood obesity: is it abuse?. Children's Voice, 17(4), 24-27.

Murtagh L, Ludwig DS. (2011) State Intervention in Life-Threatening Childhood Obesity. Journal of the American Medical Association. 306(2), 206-207. 

Patel, D. (2005). SUPER-SIZED KIDS: Using the Law to Combat Morbid Obesity in Children. Family Court Review, 43(1), 164-177.

Sciarani, S. (2010). Morbid Childhood Obesity: The Pressing Need to Expand Statutory Definitions of Child Neglect. Thomas Jefferson Law Review, 32(2), 313-338.