County places obese Cleveland Heights child in foster care
CLEVELAND, Ohio -- An 8-year-old Cleveland Heights boy was taken from his family and placed in foster care last month after county case workers said his mother wasn't doing enough to control his weight.
At more than 200 pounds, the third-grader is considered severely obese and at risk for developing such diseases as diabetes and hypertension.
But even though the state health department estimates more than 12 percent of third-graders statewide are severely obese -- that could mean 1,380 in Cuyahoga County alone -- this is the first time anyone in the county or the state can recall a child being taken from a parent for a strictly weight-related issue.
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Lawyers for the mother, a substitute elementary school teacher who is also taking vocational school classes, think the county has overreached in this case by arguing that medical conditions the boy is at risk for -- but doesn't yet have -- pose an imminent danger to his health.
They question whether the emotional impact of being yanked from his family, school and friends was also considered.
"I think we would concede that some intervention is appropriate," Juvenile Public Defender Sam Amata said. "But what risk became imminent? When did it become an immediate problem?"
Children are ordinarily removed from their homes for physical abuse, neglect or undernourishment.
Amata said that in his decades as a public defender, he has seen children left in homes with parents who have severe drug problems or who have beaten their children, with the reasoning that there isn't an immediate danger to the child.
In this case, Amata said, other than having a weight problem, the boy was a normal elementary school student who was on the honor roll and participated in school activities.
Records show the child's only current medical problem, sleep apnea, is being treated and that he wears a machine nightly that helps and monitors his breathing.
"They are trying to make it seem like I am unfit, like I don't love my child," the boy's mother said.
"Of course I love him. Of course I want him to lose weight. It's a lifestyle change, and they are trying to make it seem like I am not embracing that. It is very hard, but I am trying."
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Last year, the boy lost weight but in recent months began to gain it back rapidly. That's when the county moved to take the child, records show.
The mother said that when she found out that other kids and a sibling might be giving her son extra food, she tried to put a stop to it and explain to him that he could eat only certain foods.
She tried to follow the recommendations of the doctors, such as getting him a bike and encouraging him to get exercise.
The mother wonders what role genetics plays in the boy's condition -- both she and his father and some other family members are overweight, she said. However, she also has a 16-year-old son who is tall and thin.
The mother agreed to enroll the child in a special Rainbow Babies & Children's Hospital program called Healthy Kids, Healthy Weight.
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Earlier this year, Dr. David Ludwig, Harvard University professor and pediatric obesity expert, urged children's services agencies to intervene in severe cases when parents have failed to address a weight problem that leads to imminent health risks.
Ludwig, the co-author of an article that appeared in the Journal of American Medical Association this summer, said other interventions should be tried first and that children should be removed only as a last resort.
The article cited the example of a 12-year-old patient of Ludwig's who weighed 400 pounds and had developed diabetes, cholesterol problems, high blood pressure and sleep apnea -- conditions that could kill her before the age of 30.
But others question whether a future risk is enough to separate a child from a family.
Arthur Caplan, a professor of bioethics and medical ethics at the University of Pennsylvania, said that before a trend of removing children takes hold, the broader public-policy issue needs to be explored.
"A 218-pound 8-year-old is a time bomb," Caplan acknowledged. "But the government cannot raise these children. A third of kids are fat. We aren't going to move them all to foster care. We can't afford it, and I'm not sure there are enough foster parents to do it. "
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