Monday, August 20, 2012

'Childhood Obesity Intervention - Good or Bad?' Article by Mary Jo Rapini

Earlier this year, the state of Ohio made headlines when it removed a morbidly obese child from his home and placed him into foster care. Psychotherapist and coauthor of Start Talking: A Girl's Guide for You and Your Mom about Health, Sex, or Whatever, Mary Jo Rapini, shares her insights on the obesity epidemic.

Childhood Obesity Intervention-
Good or Bad
?

by Mary Jo Rapini, MEd, LPC
I was asked recently to be an expert for an HLN story involving an 8 year old boy in Ohio. This boy is morbidly obese tipping the scales at 218 pounds. The Department of Children and Family Services (DCFS) took the boy into foster care after they felt the mother was unable to follow through with appropriate measures prescribed for the boy to lose weight.

The mother's defense was that she was going to school in addition to working as an elementary teacher. She felt that she could not monitor the child at all times. Apparently family members and friends were sneaking food to the boy. DCFS reported that they had worked with mom for a year and saw no improvement.

The Ohio State Health Department estimates that more than 12 percent of third graders statewide (Ohio) are severely obese. That could mean as many as 1,380 kids in Cuyahoga County alone. This story is the first time anyone could recall a child being taken from a parent strictly due to weight-related issues.
To consider the idea that the state can handle this issue by removing an obese child from the home and placing him in foster care is not only absurd but dangerous to the development of children. Most likely there will not be enough foster homes and even if there were, will the parents in those homes be able to handle the issues an obese child struggles with? According to recent polls, one out of every three children is morbidly obese. This is not a child crisis; instead, this is a family crisis. In this situation, the child suffered from sleep apnea which meant he was hooked up to a machine at night which monitors and assists his breathing. Many obese children suffer asthma, diabetes, heart disease, hypertension, anxiety, and depression.
Obesity certainly has genetic components but to simply throw your hands in the air with complete surrender to fate is not being a responsible parent. Taking a child away from the family he knows and loves borders on cruelty. Removal of a child from his/her home should only be done as a last resort to protect that child from imminent harm (the child in this case had no other medical conditions except for sleep apnea). Many times removing a child from their home is experienced so intensely by the child that they would resort to food even more as the only thing they could control. Depression, anxiety, and a heightened loss of self-esteem may be the result.

What are we telling a child if we allow them to be taken from us, because we were not able to change our lives enough to help him? I make it clear to all of the parents I work with that if you have a morbidly obese child it takes a family to support them with a healthy lifestyle. There can be no enablers and "good guys" or "bad guys" with offering the child unhealthy foods or a lifestyle conducive to obesity.
If you have a child you are concerned with who struggles with obesity, you have more power within your family than any treatment facility known. The problem is that, many times, you know your child is hurting and that breaks your heart. The guilt you feel from that affects your ability to hold the firm and loving boundaries that your child needs. These suggestions will help you get started.

1. Talk to your pediatrician and tell them your concerns. Make a list of everything you have tried and go over this with your doctor. Don't let your doctor make light of your concerns. No one knows your child as well as you.

2. Have a family meeting and rather than addressing any one child, address the whole family. Become a united team with everyone participating in a healthy lifestyle. Identify the foods that are the most problematic (soda, chips, candy, and pastries) and replace those with raw fruits and vegetables. Make these food visible, keep a basket of raw fruit on the kitchen counter, bottled water in the fridge (or fresh water in pitchers stored in the refrigerator) and vegetables peeled and ready to eat in the refrigerator. The best way to get rid of the junk food is to throw it away. It's toxic! Why would you donate or give someone else what is poisonous to their body?
3. Quit telling yourself that in order for your kids to fit in they need junk food in the house. They don't. This thinking is keeping you from being an effective parent in helping your obese child. It is not fair to let the thin sibling eat junk food and not allow it for the child with weight issues. This builds resentment. Get rid of the junk food and make it forbidden for your whole family.

4. Family activities are helpful for all families as well as marriages. Protect and prioritize these types of days. Take a family walk, go to the park, or (in the winter) ice skating. Anything where there is movement will help everyone be healthier. Activities shared as a family help the child who is overweight feel less isolated and alone.
5. If you are unsure of foods and what to serve, a wise investment is to talk to a dietitian. Many physician offices have dietitians on staff. Getting advice and attaining more knowledge of foods can help you help your child.

6. If your obese child suffers from social anxiety or depression, seek help from a counselor. It is much wiser to begin counseling before your child's self-esteem is destroyed. Rebuilding an obese child's self esteem is much more difficult then learning healthy coping mechanisms that can comfort them so they won't resort to using food.
Child protective services have a huge job and they do it well. There are so many children that need to be placed with foster parents in order to survive. Morbid obesity should not be a reason we need to contact CPS. Parents must get serious with their children's health and well being. Being a parent means taking care of your child and making sure they have all they need to be healthy. If your child is overweight and struggling with health issues, begin making changes to the whole family's lifestyle today.
Mary Jo Rapini, MEd, LPC, is a licensed psychotherapist and co-author with Janine J. Sherman, of Start Talking: A Girl's Guide for You and Your Mom About Health, Sex or Whatever. Read more about the book at www.StartTalkingBook.com and more about Rapini at www.maryjorapini.com.

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