“French Fries are not a Vegetable”: Childhood Obesity Back at the Center Stage

News from Ohio of an eight-year old obese child being taken away from his mother’s custody and placed in temporary foster care has galvanized the debate over whether state social services can rightly penalize a child’s parents in this extreme fashion.  Is it fair to apportion all the culpability for morbid childhood obesity to the parents and ignore the role played by the permissive regulatory environment fostered by the government?

The Ohio intervention, which will be challenged in court, could have significant repercussions for social policy in the United States, where childhood obesity has more than tripled in the past 30 years. According to the Center for Disease Control and Prevention, in 2008, more than one-third of children and adolescents were overweight or obese.

Children are typically relocated into foster care due to physical abuse, undernourishment, or neglect. In the Ohio case, the county’s family services department equated the child’s condition with a form of medical neglect—a claim in which they are supported by some health experts in an article published in  in the Journal of the American Medical Association in July of this year. The boy weighed more than 200 pounds, which put him at risk for developing serious health problems like high blood pressure and Type 2 diabetes.

Lawyers for the child’s mother counter that the crux of the issue is whether the obesity can be considered an imminent danger to the child’s life. They argue that the fact that excess weight puts her son at risk for future health problems—problems he does not have yet—cannot suffice for justifying the extreme step.

The merits of intervention in this particular fact situation notwithstanding, we must investigate some basic policy conundrums: How will government agencies determine precisely where obesity ends and “acute obesity” begins? At what point does acute obesity attain the character of “neglect” and “abuse”? Who determines the actual cause of the weight problem, especially given the role played by genetics in determining weight?  Given that young children do not possess the capacity or the wherewithal to make independent shopping or cooking choices, it is often logical to hold the parents accountable for the purchase and/or preparation of the food consumed. However, there are other contextual factors to be kept in mind: there might well be a correlation between the parent’s poverty (or lack of education) and poor nutritional choices in the home, as starches are significantly cheaper than proteins and fresh fruit and vegetables. Such an approach may well have an unduly onerous impact on parents in low-income households.

Other critics of the government’s stance in general counsel a more holistic approach to tackling the escalating problem of childhood obesity. They claim that penalizing parents alone is “schizophrenic” and hypocritical, given that the government has itself  deemed pizza a vegetable for the purposes of school lunches. So before rounding up young people and sending them to “government fat camps”, they suggest that the country needs to revamp its food culture.

Earlier this week, San Francisco’s ban on free toy giveaways in kids’ meals that do not comport with certain nutritional guidelines kicked in. The rationale was that the prospect of new toys would make children clamor for these meals, which often exceed prescribed standards for calories, sodium and fat, and do not serve the required portions of fruits and vegetables (french fries notwithstanding). However, McDonald’s recently announced—and Burger King followed suit—that it will seek to “comply” with the law by charging a nominal amount of 10 cents for the toy, to ensure that their consumers are not deprived of their free choice. The move has been castigated as a “marketing ploy” to nullify the effects of the ordinance.

However, city officials claim that the ordinance has fulfilled their objectives, which was to raise awareness about the poor levels of nutrition and to encourage fast food joints to voluntarily revamp their kids’ meal specials. An alternative response would be to take a more aggressive approach, in order to demonize, or at least name and shame, companies that sell and market food with little or no nutritional value, in a manner akin to the way tobacco companies were targeted (and taxed, presumably).