rebecca puhl, Other, 11:57AM Dec 6, 2011
Last week, there was significant media attention to a case of alleged medical neglect in Ohio involving an obese 8-year old boy who was removed from his mother because of his obesity. I've written about this general topic before (click here), so I won't repeat my concerns again here.
However, in light of the widespread attention to this case and increasing debates in the medical community about whether some extreme cases of childhood obesity constitute medical neglect, it seems warranted to consider how the publicized discourse on this topic might impact millions of families who are affected by obesity.
What do parents of obese children think about this issue? How is it affecting them? To my knowledge this hasn't yet been studied. However, a very recent qualitative study was just published by Turner, Salisbury, & Shield (2011) in the journal Family Practice1. Although it was a small study, parents of obese children between the ages of 5-10 years were interviewed, and asked about their views on the treatment they have received for their child's weight, their views on primary care as a treatment setting, and their experiences of working with primary care practitioners.
Similar to previous research by Edmunds (2005)2, parents expressed beliefs that primary care is an appropriate setting to treat childhood obesity, but reported often avoiding medical care because they anticipated being blamed for their child’s weight and were concerned about protecting their child's mental well-being. Parents also expressed uncertainty about whether physicians had the time, knowledge, and resources to effectively manage childhood obesity.
Some parents also expressed reluctance to consult a medical provider for their child because of worries that social services would become involved because of the child's weight; concerns which were compounded by recent media reports. As one parent stated in the study, "If we’re going to get things like ‘we are going to take your child away if they’re fat’, you’re not going to get a parent in the door. That was the worst bit of publicity they ever did [media reports about children going into care] . . . parents thought, 'I’m not going anywhere near the doctor...because they’re going to take my child away from me'."
Although the media reports surrounding the recent Ohio case were primarily critical of the decision to remove the obese child from his mother, we need to think carefully about how the public discourse about this issue affects families who are struggling with obesity, and may actually lead some parents to avoid seeking care for their children because of fears their child will be taken from them.
Now, more than ever, we need to ensure that parents of obese children feel supported by the medical and health communities. The goal for both providers and parents needs to be prioritizing children's health, and helping families find comprehensive treatment for their obese children. The authors of the study conclude that if we want to encourage parents to seek help for their child's weight, medical providers "need to be accessible, discuss childhood obesity in a non-judgmental manner, tailor advice and give attention to broader issues, like self-esteem, where necessary." This means improving training and education of providers so that their interactions with families and obese children can be positive, productive, and free of bias.
1Turner KM, Salisbury C, Shield JPH. Parents' views and experiences of childhood obesity management in primary care: A qualitative study. Family Practice 2011. doi:10.1093/fampra/cmr111
2Edmunds LD. Parents’ perceptions of health professionals’ response when seeking help for their overweight children. Family Practice 2005; 22: 287–92.