Childhood obesity as a safeguarding issue: positive experiences with the “new home” environment as a treatment for weight management
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Abstract
Objectives
Childhood obesity can lead to acute and chronic comorbidities and adult obesity, highlighting the need for prompt intervention. Families and caregivers play a vital role in treatment and when primary interventions fail, this may become a child protection issue.
Case presentation
We present two cases of severe childhood obesity where targeted lifestyle interventions failed to impact weight status. Both cases feature child welfare involvement with patients coming into the care of the local authority (under s20 of the Children Act 1989). Foster placement resulted in significant weight loss and improved BMI achieved through reduced portions, healthier choices, restricted calories to recommended daily intake for age and increased activity. Physical and emotional wellbeing benefits were observed and improvements in obesity related comorbidities.
Conclusions
Failure to reduce a child’s weight alone does not constitute a child protection issue. In severe cases, where maximum intervention has failed and when the child has obesity related comorbidites or at a higher risk of developing them, home environment change should be considered in the child’s best interest as a treatment for severe childhood obesity.
Acknowledgements
We acknowledge Shelley Easter (dietitian), Melanie Wenn (nurse specialist) and Claire Semple (Psychologist) for their contribution towards the management of this patient as a part of the multi-disciplinary team.
Research funding: This study did not receive any finding support.
Author contributions: RJC drafted the manuscript and made subsequent revisions. RA contributed to the safeguarding discussion part. JPH and DG supervised and oversaw the manuscript draft and subsequent revisions. All the authors have approved the final version of the manuscript.
Competing interests: The authors declare no conflicts of interests or competing interests.
Informed consent: Informed consent was obtained from individuals included in this study.
Ethics approval: Our research complies with all relevant national regulations and institutional policies. Informed consent was obtained from individuals included in this study.
References
1. The National Child Measurement Programme, England-2017/18 School Year [PAS]. NHS Digital; 2018.Search in Google Scholar
2. DiCesare, M, Soric, M, Bovet, P, Miranda, J, Bhutta, Z, Stevens, G, et al.. The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC Med 2019;17:212–32.10.1186/s12916-019-1449-8Search in Google Scholar PubMed PubMed Central
3. Fuemmeler, B, Behrman, P, Taylor, M, Sokol, R, Rothman, E, Jacobson, L, et al.. Child and family health in the era of prevention: new opportunities and challenges. J Behav Med 2017;40:159–74.10.1007/s10865-016-9791-1Search in Google Scholar PubMed
4. Alexander, S, Baur, L, Magnusson, R, Tobin, B. When does severe childhood obesity become a child protection issue? MJA 2009;190:136–9.10.5694/j.1326-5377.2009.tb02313.xSearch in Google Scholar PubMed
5. Williams, GMG, Bredow, M, Barton, J, Pryce, R, Shield, JPH. Can foster care ever be justified for weight management? Arch Dis Child London 2014;99:297–9.10.1136/archdischild-2013-304654Search in Google Scholar PubMed
6. Regber, S, Jormfeldt, H. Foster homes for neglected children with severe obesity – debated but rarely studied. Acta Paediatr 2019;00:1–10.10.1111/apa.14902Search in Google Scholar PubMed
7. Regber, S, Dahlgren, J, Janson, S. Neglected children with severe obesity have a right to health: is foster home an alternative? – a qualitative study. Child Abuse Neglect 2018;83:106–19.10.1016/j.chiabu.2018.07.006Search in Google Scholar PubMed
8. Viner, RM, Roche, E, Maquire, SA, Nicholls, DE. Child protection and obesity: framework for practice. BMJ 2010;341:c3074.10.1136/bmj.c3074Search in Google Scholar PubMed
9. Varness, T, Allen, DB, Carrel, AL, Fost, N. Childhood obesity and medical neglect. Pediatrics 2009;123:399–406.10.1542/peds.2008-0712Search in Google Scholar PubMed PubMed Central
© 2021 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Original Articles
- Clinical characteristics and treatment patterns with histrelin acetate subcutaneous implants vs. leuprolide injections in children with precocious puberty: a real-world study using a US claims database
- High serum neurotensin level in obese adolescents is not associated with metabolic parameters, hyperphagia or food preference
- Increased lipocalin 2 levels in adolescents with type 2 diabetes mellitus
- Clinical, biochemical, and radiological follow-up results of children and adolescents with Hashimoto’s thyroiditis: a single-center experience
- Evaluation of children with type 1 diabetes mellitus in terms of overweight/obesity in tertiary care hospital
- Association between anthropometric measures and insulin resistance in Brazilian adolescents: data from the national study of cardiovascular risk factors in adolescents – ERICA
- Evaluation of metabolic parameters and aortic elasticity in normotensive children with premature adrenarche
- Molecular and clinical findings of Turkish patients with hereditary fructose intolerance
- Quantitation and evaluation of perinatal medium-chain and long-chain acylcarnitine blood concentrations in 12,000 full-term breastfed newborns
- Metabolic syndrome and cardiorespiratory fitness in children and adolescents: the role of obesity as a mediator
- Short Communication
- Transient neonatal hyperinsulinism: early predictors of duration
- Case Reports
- An extremely high blood glucose level in a child with hyperglycemic hyperosmolar state and type 1 diabetes
- Different clinical entities of the same mutation: a case report of three sisters with Wolfram syndrome and efficacy of dipeptidyl peptidase-4 inhibitor therapy
- Short report: craniosynostosis, a late complication of nutritional rickets
- Childhood obesity as a safeguarding issue: positive experiences with the “new home” environment as a treatment for weight management
