Parents who refuse to help their obese children lose weight are
neglectful, researchers said today.
While obesity alone is not a child protection issue, a "consistent
failure to change lifestyle and engage with outside support indicates
neglect", they said.
"Childhood obesity becomes a child protection concern when parents
behave in a way that actively promotes treatment failure in a child who
is at serious risk from obesity," said experts writing online in the
British Medical Journal (BMJ).
This involves parents who understand what is needed and are helped to
get the right treatments for their child.
"Parental behaviours of concern include consistently failing to
attend appointments, refusing to engage with various professionals or
with weight management initiatives, or actively subverting weight
management initiatives."
The team included Russell Viner, a reader in adolescent health at the
Institute of Child Health in London.
They said poor parental behaviour was most worrying when the child
was at risk of complications from their obesity, such as high blood
pressure, Type 2 diabetes and difficulty with movement.
Failure to act should be regarded as a child protection issue when
there is clear evidence of this behaviour "over a sustained period",
they said.
And they added that "obesity may be part of wider concerns about
neglect or emotional abuse".
This may include poor school attendance, exposure to or involvement
in violence, neglect, poor hygiene, parental mental health problems or
emotional and behavioural difficulties.
The authors said childhood obesity alone is not a child protection
concern.
"A consultation with a family with an obese child should not raise
child protection concerns if obesity is the only cause for concern."
Failure to reduce weight alone is also not a child protection
concern.
"The outcomes of weight management programmes for childhood obesity
are mixed at best, with the body mass index of some children falling
substantially and that of others increasing despite high family
commitment," they said.
"As obesity remains extremely difficult for professionals to treat,
it is untenable to criticise parents for failing to treat it
successfully if they engage adequately with treatment."
The authors said professionals urgently need guidance on the issue
and further research and data is needed on child protection action
relating to obesity.
A statement from the Royal College of Paediatrics and Child Health
said: "As we have stated before, obesity is primarily a public health
problem, not a child protection issue.
"There may be a few families that give cause for concern where there
are other matters of neglect or emotional harm and this is where
paediatricians would have discussions with children's services.
"The Royal College of Paediatrics and Child Health (RCPCH) continues
to be concerned about the high numbers of children who are obese or
overweight.
"Thirty years ago, less than one in 10 children were obese or
overweight. Today, it is one in three.
"We need to find interventions that work. Perhaps it is time to
consider tightening the regulations around the advertising of fast food
or prohibiting the use of toys in association with high-fat foods."
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