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Sherry F. Colb

Child Obesity as Child Neglect: Is the Standard American Diet Dangerous?


Wednesday, July 22, 2009

This past May, the South Carolina Department of Social Services accused Jerri Althea Gray of unlawful neglect of a child, because her 14-year-old son, Alexander Draper, weighed 555 pounds. After a hearing was scheduled to determine whether Gray was in fact medically negligent in caring for her son, Gray and Draper fled the state. They were found a few days later in Baltimore. The police arrested Gray and placed Draper in protective custody in South Carolina. Though Draper's weight is extreme (and may well reflect a metabolic disorder), the arrest of his mother and his removal from her custody raise an important question about parental obligations and nutrition: Might it be child neglect simply to feed our children the Standard American Diet?

Why Jerri Gray Should Still Have Custody of Alexander

Without venturing very deeply into the issue of over- versus under-nutrition, it is readily apparent that taking Jerri Gray's son away from her was the wrong decision. Here we have a woman who loves her son and who has spoken out publicly, explaining that she works so many hours at more than one job – to support herself and Alexander – that she must rely on fast food far more often than she would like. She is not saying that she believes strongly in a fast food diet and wants her son to eat it in great quantities so that he can remain morbidly obese.

Gray has no commitment to unhealthy food. If the government is prepared to spend time and money helping her son, Alexander, lose weight and eat the right kinds of foods, then she would seem by all appearances to be more than happy to receive such aid. Gray stated, convincingly, that "[m]entally he needs to be with me. We both need to be included together in whatever program that they have to offer so that we both can benefit from it. So as our lives go on together, then we will have learned how to control it and keep it under control."

Rather than employing people to take away Gray's beloved child, in other words, the government could spend considerably less money providing her with healthy food and information about nutrition. What she evidently lacks are resources, not love or concern for her son.

Imagine a contrasting scenario. A single father has a 14-year-old daughter who is severely underweight. Preliminary investigation reveals that the daughter suffers from anorexia nervosa and refuses to eat more than a few hundred calories each day, because she believes she is fat. The father tells his daughter that she is too thin and should eat more, but she refuses to do so and in many contexts eats (or fails to eat) outside the presence of her father (because he is at work, or she is in school). The father is unfamiliar with the condition of anorexia nervosa and does not realize that there are mental health treatments for it.

In this situation, a government official wanting to help the anorexic girl might begin by notifying the father that his daughter is suffering from a dangerous mental illness, an illness that could prove fatal if left untreated. The same official could give the father information about places that assist victims of anorexia. Indeed, the official might even encourage the father to have his child forcibly admitted to a hospital and given nutrition, if all else fails.

What would not make sense, however, would be for the government to remove the daughter from her father's custody on grounds of child neglect. Doing this would break apart an otherwise loving family and needlessly add psychological trauma to an already fragile child's life. And in the case of Jerri Gray and her child, that seems to be exactly what has happened.

The Grain of Truth Behind the Government's Suggestion that Obesity Is Evidence of Neglect

Despite the arguments presented above, there is something refreshing about entertaining the notion that we might consider a family's feeding of fast food to its children a form of child neglect. In the particular boy's case, we have an extreme example. It seems unlikely that, in the absence of some metabolic disorder, a child would gain so much weight by the age of 14, even if he did eat too much of the most unhealthful sorts of food. A preponderance of what we might call "dietary child neglect" is far subtler and does not have outwardly obvious manifestations.

To give just one example, the public schools in New York City provide lunch for their students. As of last year, when my daughter was at a public school, the lunches were virtually always high in fat, high in processed carbohydrates, and low in fiber and vitamins. A typical example was macaroni (made of white flour, from which fiber and other nutritious elements have been stripped) and cheese (high in fat, cholesterol, and sodium). Other examples were meatballs (high in fat and sodium) and spaghetti (made of white flour, again). On top of this, the school distributed (or requested that parents distribute) high-sugar, high-fat pastries and other "snacks" to the children on a regular basis.

This government-sponsored nutritional program represents a diet that will predictably line the arteries with fatty striations and plaques that eventually lead to cardiovascular disease. Based on the comprehensive longitudinal work of Cornell Emeritus Professor T. Colin Campbell, moreover, as he engagingly presents in The China Study, the animal proteins that are ubiquitous in American school lunches (and in the breakfasts and dinners that most Americans eat) facilitate the development of cancer, diabetes, osteoporosis, and Alzheimer's disease as well. Small increases in the intake of the dairy protein casein, for example, dramatically increase the prevalence of cancer (in human beings and animals). The popularity of the Atkins Diet (which directed people to consume fat and protein in large quantities) and Atkins-lite diets likely did not help matters.

In most cases, of course, cancer, cardiovascular disease, and diabetes do not show up until later in a person's life (though Type 2 Diabetes has become increasingly common among children). Most children – at least outwardly – appear to be healthy, notwithstanding an unhealthy diet. And obviously, a child who weighs 555 pounds is an exception to the rule, which is probably why the Department of Social Services felt empowered to intervene in the first place. Were Alexander Draper eating the same unhealthy foods but weighing what other children weighed, things would have looked fine. That "all is well" appearance, however, would have been deceptive.

Consider some statistics. In its 2008 Report, the American Heart Association estimated that in 2005 (the most recent year for which such statistics were available), 81 million people in the United States had one or more forms of cardiovascular disease. This number represents one in four Americans. In 2004 (the most recent year from which concrete mortality rates were available), 860,000 people died of cardiovascular disease (which is more than the total number of people lost to cancer, accidents, and HIV combined).

At the same time, children who are obese are showing early warning signs of cardiovascular disease (including thick artery walls and an enlarged heart), and the rate of childhood obesity as of 2007 was close to one in five. With inactivity and an unhealthful diet, these numbers may not be surprising, but they should be alarming. And they are unlikely to improve if we scapegoat people like Jerri Gray, by taking away their children and/or criminally prosecuting them for child neglect.

Not a Bad Apples Problem; A "No Apples" Problem

The Department of Social Services' pursuit of Jerri Gray represents the kind of "bad apple" approach that is all too common in this country. Gray's son's being extremely overweight is a symptom of an unhealthy trend in eating in the U.S., and it is exceptional only in its extremity. The so called "Standard American Diet" is a recipe for obesity in children and adults, for cardiovascular disease, and for the other illnesses that are sometimes called "diseases of affluence" (including diabetes and many cancers) that afflict people who are largely sedentary and eat large quantities of fat, processed sugar, meat, and dairy.

We should not be arresting people and taking away their children for simply following the pack on dietary matters. What we should do, instead, is educate everyone and demand that the government – in the form of public schools – begin to serve as a model for healthful nutrition, rather than as a parody of American over-indulgence. We must not look for "bad apples" who over-feed their children. We must instead circulate the information that apples and other fresh, plant-based foods are nutritious, delicious, and conducive to preventing and fighting the illnesses to which we have become all too susceptible.

Sherry F. Colb, a FindLaw columnist, is Professor of Law and Charles Evans Hughes Scholar at Cornell Law School. Her book, When Sex Counts: Making Babies and Making Law, is available on Amazon.

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