The mother of a 555-pound, 14-year-old boy in South Carolina was charged with neglect last week for allegedly failing to control her son's weight.
Before fleeing town with her son, Jerri Gray had been contacted by the local Department of Social Services previous times about her son's weight and was even issued a treatment plan to turn around Alexander Draper's morbid obesity, Gray's attorney Grant Varner told ABCnews.com.
But when Gray failed to bring Alexander in for some of his medical treatment appointments recommended by the department and he continued to gain weight, the state sent notice that Gray would lose custody of her only child.
"She panicked," Varner said. "She had no lawyer, she couldn't afford a lawyer and they took off. They had no destination really. They stopped in Baltimore to do laundry, which is where they were found."
Alexander has been placed in foster care and Gray of Travelers Rest, S.C., will appear in court to face two felony charges -- custodial interference, which carries a 5-year sentence, and child neglect, which carries a 10-year sentence.
"I have not heard a case involving parents charged in neglect with obesity," said Thomas L. Hafemeister, associate professor of law at the University of Virginia Law School in Charlottesville.
But Hafemeister said state interference with children for health care reasons has become an increasing problem in the past 20 years. Take, for example, the case of Daniel Hauser, whose Minnesota family initially refused chemotherapy treatments for his Hodgkin's lymphoma in May.
"Certainly, there are cases out there where parents are facing neglect and abuse charges for failing to provide needed medical care, in this case nutritional care," Hafemeister said. "But this is a very unusual case."
Jane Spinak, a professor at Columbia University Law School in New York, said that in many cases of medical neglect, public health officials are expected to offer help to a parent.
"I think the question is when is the outreach sufficient that a court could then say, 'Look, we're giving you all these opportunities to better care for your child?" Spinak said. "The state has to decide at what point is not accepting that voluntary assistance neglect."
Sometimes at issue, however, is whether child welfare officials can expect parents to show up to an appointment they reasonably cannot make.
"The offers have to be realistic," Spinak said. "They have to be things that [a mother] and her child can actually take advantage of. If they want her to take him every day to something and she's working two jobs, that's not really realistic."
Only in the case of life-and-death situations do state officials normally intervene, family law experts say.
"If the child's life is at risk, the state can intervene: If it is a relatively non-life threatening situation, the state stays out," Hafemeister said. "With regard to obesity, in general, I don't think you're going to see a lot of interventions."
But in the case of a 550-pound teenager, pediatricians with an expertise in obesity say Alexander's health could be an issue of life or death. If not immediately, the extra weight may result in death 40 years down the road.