Childhood obesity is an escalating public health concern, affecting millions globally with consequences ranging from immediate health issues to long-term physical and psychological complications. As societies grapple with rising childhood obesity rates, questions emerge: Should obesity be considered a child protection concern? If so, to what extent should state authorities intervene? Interweaving this discussion with the principles outlined in the UN Convention on the Rights of the Child and insights from the Safeguarding Network provides a comprehensive lens through which to view this issue.
Childhood obesity isn’t just about physical appearance. It’s a significant health concern with children at risk for conditions like type 2 diabetes, cardiovascular diseases, joint problems, and more. Beyond physical health, the emotional and psychological repercussions, including stigma and social isolation, can be profound. However, obesity’s root causes are multifaceted, encompassing genetics, environment, socioeconomic status, access to healthy food and recreational spaces, and psychological factors.
Bowden and Another v Lancashire County Council [2001] LGR 409 underscored an extreme scenario, where force-feeding children was clearly shown as a child abuse concern. Such cases, while clear-cut in their implications, leave a vast gray area in-between.
The Children Act 1989, s.31, while not explicitly dealing with obesity, delineates conditions under which child protection can intervene, emphasising situations where children are “suffering, or likely to suffer, significant harm.” – The “significant harm” element being particularly relevant.
The Safeguarding Network, while not categorically defining childhood obesity as a safeguarding issue, highlights the profound impacts of obesity on children’s physical and mental well-being. Their insights suggest that while childhood obesity alone might not be a direct child protection concern, consistent failures to change lifestyle, especially in younger children, combined with a refusal to engage with external supports might warrant concern. Stating that:
“Medicine is not at a stage where every child will lose weight following management programmes. If there is engagement from all sides, then criticism is unrealistic. it is important that we look at the situation in the whole and ask, “what else am I seeing here?” Are there other concerns of which obesity is just one part?”
Bringing in the UN Convention on the Rights of the Child provides additional depth. Article 3 emphasises that in all actions concerning children, their best interests should be of primary concern, implying that any interventions or policies surrounding obesity must foremost consider the child’s overall well-being and long-term health.
But, that being said, Articles 5 and 18 resonate with the principles of parental autonomy and the state’s supporting role. They stress the evolving capacities of the child and the shared responsibility of parents in upbringing, emphasising the state’s responsibility to provide necessary support services. But in the context of childhood obesity, the challenge is to balance parental autonomy with a child’s right to health, and where the issue is a step-removed consequence of providing care and support, it is very difficult to draw the line and arrive at a clear balance.
The Safeguarding Network further highlights that systemic factors, including the capacity of parents to understand and respond to the child’s needs and the overall environment the child is in, play a pivotal role in addressing the issue. An essential takeaway is that we should look at the entire circumstance that that child finds themselves in, obesity alone is unlikely to be the sole concern or factor. As many Local Authorities explain:
“Childhood obesity alone is not a child protection concern—A consultation with a family with an obese child should not raise child protection concerns if obesity is the only cause for concern.”
Furthermore, Article 19 of the UN Convention, which mandates protection from violence, abuse, and neglect, reinforces the state’s responsibility when obesity results from evident neglect. This is especially relevant when obesity aligns with other neglect indicators and could be where the line is crossed and should be considered to be crossed, the more wilful and insidious the ignorance of the consequences, the more likely it is abuse.
Labelling obesity, in isolation, as child abuse poses a significant risk of entering into a slippery slope fraught with ambiguity and arbitrariness. If obesity were to be considered abuse, where would we draw the line in determining culpability? Not every case of childhood obesity can be directly attributed to parental neglect, given the intricate web of socio-economic, genetic, and environmental factors at play. Treating it as a binary issue could lead to disproportionate interventions, potentially tearing families apart based on subjective or even discriminatory interpretations of ‘healthy’ weight and ‘appropriate’ parenting. It also risks penalising parents who, despite best efforts, face systemic barriers in providing optimal nutrition and lifestyle opportunities for their children. Further, it might pave the way for scrutinising other parental decisions, raising the haunting question: If obesity is abuse, what’s next on this path of defining ‘adequate’ parenting? Such ambiguity is problematic both ethically and practically, potentially causing more harm than good.
Framing childhood obesity strictly as a child protection issue also risks oversimplifying the complex interplay of factors that contribute to a child’s health and well-being. Moreover, it may inadvertently shift the focus away from broader societal responsibilities to address these underlying issues, placing undue blame on individual families, parents, and possibly the children themselves, rather than looking to the broader policy and societal concerns which often surround obesity. As noted in the Governments 2020 Childhood Obesity Strategy, the actions being taken include:
“Introduce legislation to require large out-of-home food businesses to add calorie labels to the food they sell; Consult on the intention to make companies provide calorie labelling on Alcohol; and legislate to end the promotion of HFSS foods by restricting volume promotions such as “buy one get one free”, and the placement of these”
Factors which not only miss the point, but leave the blame with those at the point of sale, rather than addressing root concerns and education. Additionally, it could lead to an erosion of trust between families and health or social services, making parents reluctant to seek help for fear of judgment or punitive measures. This environment of fear and mistrust could deter the collaborative efforts needed between families, communities, and authorities to effectively tackle the root causes of obesity. By potentially alienating those most in need of support, the framing of obesity as a child protection issue could hinder rather than help efforts to promote healthier lifestyles and well-being among children
Childhood obesity, when viewed through the combined lenses of child protection, the Safeguarding Network’s insights, and the UN Convention on the Rights of the Child, necessitates a rights-based, compassionate, and foremost educational approach. While state support and interventions are critical, punitive measures might not always be the best solution. A holistic perspective that respects family autonomy, recognises broader systemic challenges, and foremost considers the best interests of the child is imperative. The goal should always be to ensure every child’s right to health, life, and full development while respecting the rights and duties of parents.
Avaia Williams – Founder
This blog was published on 17 February 2023
Nightingale Rights Initiative 