Family Forum / Parenting / Parenting / July 2009

http://www.usatoday.com/news/health/weightloss/2009-07-20-obesityboy_N.htm

S.C. case looks on child obesity as child abuse. But is it?

By Ron Barnett, USA TODAY
Jerri Gray was doing all she could to help her son lose weight, her
attorney says. But something had gone terribly wrong for the boy to hit the
555-pound mark by age 14.
Authorities in South Carolina say that what went wrong was Gray's care and
feeding of her son, Alexander Draper. Gray, 49, of Travelers Rest, S.C.,
was arrested in June and charged with criminal neglect. Alexander is now in
foster care.

The case has attracted national attention. With childhood obesity on the
rise across the USA, according to the Centers for Disease Control and
Prevention, Gray's attorney says it could open the door to more criminal
action against parents whose children have become dangerously overweight.

"If she's found guilty on those criminal charges, you have set a precedent
that opens Pandora's box," Grant Varner says. "Where do you go next?"

State courts in Texas, Pennsylvania, New York, New Mexico, Indiana and
California have grappled with the question in recent years, according to a
2008 report published by the Child Welfare League of America.

In all of those cases, except the one in California, courts expanded their
state's legal definition of medical neglect to include morbid obesity and
ruled that the children were victims of neglect, the report says. Criminal
charges were filed only in the California and Indiana cases, but the
parents weren't sentenced to jail time in either.

What the court can order

The New York case in 2007 involved an adolescent girl who weighed 261
pounds, the report says. The court ordered nutritional counseling, cooking
classes and gym workouts.

Criminal charges should be a last resort, says Linda Spears, vice president
of policy and public affairs for the Child Welfare League of America.

"I think I would draw the line at a place where there are serious health
consequences for the child and efforts to work with the family have
repeatedly failed," she says.

What's more often needed is a structured plan of action that's accountable
to a court, she says.

Most of the time, the health problems tied to childhood obesity don't
become chronic until adulthood, which makes it difficult to charge parents
with child abuse, Spears says.

In the South Carolina case, 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. Gray has signed an agreement with a film
documentary company for exclusive rights to her story and couldn't comment
for this article, Varner says.

"There's a strong likelihood that this kid is going to school and could eat
whatever he wanted to at school, because you've got friends who will help
him buy food or will give him their leftovers," Varner says. "The big
question is: What is this kid doing when he's not in Mom's care, custody
and control?"

Greenville County School District spokesman Oby Lyles declined to comment.

"This is not a case of a mother force-feeding a child," Varner says. "If
she had been holding him down and force-feeding him, sure, I can
understand. But she doesn't have the means to do it. She doesn't have the
money to buy the food to do it."

Slippery slope ahead?

The case could have ramifications beyond parental control over obesity to
other eating disorders, and even other behaviors not related to weight,
Varner says.

"What about the parents of every 16-year-old in Beverly Hills who's too
thin? Are they going to start arresting parents because their child is too
thin?" he asks.

Jolene Puffer, a personal trainer in Asheville, N.C., says the problem
often is parents "loving their kids to death," especially in low-income
families where food is one of the few things they can afford to give their
children.

But school officials and doctors are "not sounding the alarm" when they
should, she says.

Puffer took a local family on as a volunteer project and helped a
16-year-old boy who weighed 434 pounds lose 110 pounds, while his mother
lost more than 80 and his sister shed nearly 50.

A social services counselor had recommended that the boy apply for
Medicare, which Puffer says could have set him up as a lifelong disability
case.

States have been taking steps to combat childhood obesity, according to a
report released this month by the Trust for America's Health and the Robert
Wood Johnson Foundation.

For example, 20 states have passed requirements for schools to do body mass
index (BMI) screenings or other weight-related tests of children and
adolescents, up from four states five years ago, says the report, title "F
as in Fat: How Obesity Policies are Failing in America."

But it also says that, although every state requires physical education in
schools, the requirements "are often limited, not enforced, or do not meet
adequate quality standards."

The same report says 30% of children in 30 states ages 10 to 17 are
overweight or obese, with the rate hitting a high of 44.4% in Mississippi.

The CDC says the number of obese children ages 6 to 11 more than doubled in
the past 20 years, while the rate for adolescents more than tripled.

A comparison to drugs

Ron Jones, a corporate wellness expert based in Atlanta and Los Angeles,
uses the phrase "child obesity is child abuse" in his promotional materials
and says the nation has turned its head the other way when it comes to
accepting that concept.

"If you gave your child a drug, you'd be held in the court. But if you kill
them with food, that seems to be acceptable," he says.

The difficulty with prosecuting such cases is that most state laws require
that the child's health be in imminent danger for criminal charges to be
filed, and the parent must be capable of helping the child but hasn't taken
the necessary action, says Richard Balnave, a professor at the University
of Virginia School of Law.

Obesity, although potentially dangerous, does not generally put a child in
imminent danger, he says.

Supreme Court rulings have recognized the right of parents to raise their
children how they see fit, Balnave says, but not to the point that the
child's health is endangered.

The arrest warrant in the Gray case alleges that her son's weight was
"serious and threatening to his health" and that she had placed him "at an
unreasonable risk of harm."

Virginia Williamson, counsel for the South Carolina Department of Social
Services, says her agency sought custody of Alexander "because of
information from health care providers that he was at risk of serious harm
because his mother was not meeting his medical needs."

The department "would not take action based on a child's weight alone," she
says.

Gray failed to appear at a family court hearing in which her child was to
be turned over to foster care, according to a warrant issued in May.

Police later found her with the boy in Baltimore County, Md., and took her
back to South Carolina, where she was released on a $50,000 bond, her
attorney says.

Barnett reports for The Greenville (S.C.)