Today in OH NOES OBESITY CRISIS!

[Trigger warning for fat hatred and body policing; sexual violence.]

Experts: Really obese kids might need foster care.

Should parents of extremely obese children lose custody for not controlling their kids' weight? A provocative commentary in one of the nation's most distinguished medical journals argues yes, and its authors are joining a quiet chorus of advocates who say the government should be allowed to intervene in extreme cases.

It has happened a few times in the United States, and the opinion piece in Wednesday's Journal of the American Medical Association says putting children temporarily in foster care is in some cases more ethical than obesity surgery.

I love that the only two options for fat children are "forcibly removed from family" or "forcibly subjected to invasive surgery."

Dr. David Ludwig, an obesity specialist at Harvard-affiliated Children's Hospital Boston, said the point isn't to blame parents, but rather to act in children's best interest and get them help that for whatever reason their parents can't provide.

So, let's say there's a kid who is very fat, and the reason is because hir family lives in abject poverty in a food desert, so zie is consuming too many empty calories in a desperate bid for nutrition that the family can't afford to provide, and doesn't get enough exercise because zie lives in an area with endemic drug-related violence in which open spaces originally designed for play are controlled by gangs, which describes millions of kids in the US, some of whom are very fat, framing that fatness as "parents failing to provide" is, despite the caveat about not placing blame, some straight-up victim-blaming bullshit that, as per usual, tasks individual people (parents) with responsibility for a systemic problem (poverty).

Provided the Experts who want to separate very fat children from their families take the time to exclude outsized fatness as a symptom of illness or disability, and/or as a side effect of treatment for illness or disability, and seeing aside for a moment fatness as a symptom of poverty, I will note again that are also children who compulsively overeat as an emotional salve. Children (for the most part) cannot access on their own the appropriate tools adults use to process trauma, like therapy.

They can't access "inappropriate" tools adults use to cope with trauma, either; they don't have access to drugs or booze, but they do have access to food—and children in emotional distress can use food to self-medicate.

Several studies have found associations between childhood sexual trauma and childhood and/or adult obesity, especially in girls and women (example). Even a child thought to be overeating out of "boredom" may really be eating out of loneliness or abandonment.

That we know children may self-medicate with food to fill an emotional void left by neglect or abuse means one of our primary concerns for any fat child is the potential that trauma is underlying disordered eating.

To ignore this possibility is to risk subjecting children not merely to the secondary trauma of indifference, but also to deepening wounds, by piling shame about their only coping mechanism on top of the original trauma.

And to ignore the potential of existent but unreported trauma in a child in order to forcibly separate that child from hir family and put hir in the care of strangers (provided the trauma was not of family origin) is to risk profoundly and irreparably exacerbating that trauma.

To assert to be concerned for the "health" of a very fat child with disordered eating while reducing the definition of "health" in its entirety to "physical benchmarks closely hewing to age-based averages," to the exclusion of all emotional concerns (besides, perhaps, "zie might get bullied because our culture hates fat people, so let's make hir skinny!"), is garbage.

This recommendation is garbage.

We have systemic problems. We need systemic solutions.

[H/T to Eastsidekate, who first sent this story to me yesterday. I've since gotten it from about a dozen other Shakers, and thanks to each and every one of you.]