Oct. 27, 2009 -- A severely obese family in Dundee, Scotland, whose newborn child was briefly taken from them by child protective services while the mother was still recovering in the hospital, is now gaining international attention over the issue of whether childhood obesity can be a sign of abuse or neglect.
The couple, whose names aren't being released, has six children and told the British media that child protection authorities warned them they face losing custody if they could not get their older children's weight under control.
According to The Times of London, authorities already removed two children, aged 3 and 4, from the family home, leaving three other children with the couple. Investigations showed that the 40-year-old mother weighed at least 322 pounds before she got pregnant with her sixth child, a toddler with the family weighed 56 pounds and an older sibling weighed at least 224 pounds by age 13.
The order to remove the baby from the parents, custody was reportedly overturned late last week after the couple promised to work with Dundee protective services to improve the health of all their children.
"My wife is absolutely over the moon, and I am really pleased and relieved too," the father, 54, told The Times of London. "We are going to have to give 110 percent to this and try and work with the social work department and the family's project."
The Dundee City Council, which does not have the final word on whether a child is taken into protective custody, defended the decision to remove the newborn, saying there is more to the case than the family's weight issues.
"We will not comment in detail on any family with whom we are involved, but we have made it clear on numerous occasions that children would NOT be removed from a family environment just because of a weight issue," a press statement from the Dundee City Council read.
"In many cases, social workers will have been providing a high level of professional and caring support to a family for many years in a bid to keep them together. However... in some cases, despite the strenuous efforts of the agencies providing this support, the best option is for them to be looked after away from their home," the statement continued.
America saw a similarly rare case earlier this year when a 14-year-old, 555-pound teen from Greenville County S.C., was removed from his mother's care in a complicated struggle with child protective services.
Mom Who Lost Custody of Obese Son
Authorities say the boy's mother, Jerri Gray of Travelers Rest, S.C., failed to comply with court-recommended treatments for her son's morbid obesity. She and the boy were picked up by police May 21 in Baltimore Md., after the mother failed to appear at a Department of Social Services hearing in Greenville, S.C.
Such extreme cases can often grab the public eye.
But family law experts commenting on the South Carolina case said state officials normally will intervene in the case only if it is a life-and-death situation.
"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," Thomas L. Hafemeister, associate professor of law at the University of Virginia Law School in Charlottesville, commented to ABCNews.com in June. "With regard to obesity, in general, I don't think you're going to see a lot of interventions."
Indeed, medical and psychological experts say childhood obesity alone is too complicated a problem to pronounce it as a form of neglect or abuse by itself.
"There are a lot of gray terms in there: is spanking your child abuse? Beating them is an abuse. Is sending your child to bed without dinner abuse? Withholding food is," said Dr. Richard Pesikoff an adult and child psychiatrist with Baylor College of Medicine, in Houston, Texas.
Pesikoff said situations where children are morbidly obese may easily fall into similar gray areas of parenting across the country. And while it might be tempted to use the degree of obesity as a yardstick for measuring parental neglect or abuse, in Pesikoff's experience he said it isn't always a great measure of parental control.
For instance, Pesikoff treated a boy named "John," a pseudonym for privacy reasons, who was 5 feet 2 inches tall and weighed 450 pounds by age 14.
"Even if you tried to stop him from eating, he'd just push his mother off, push her away and go to the refrigerator," said Pesikoff.
Pesikoff said he doubted courts could "say that we know the etiology of obesity so well that we could point the finger and say you [the parent] are doing this to this kid."
Parent-Child Attachment Most Important
Pesikoff also points out that the parent-child attachment is so important, that he would recommend removing a child from the home only in the case where parents are putting the child in immediate physical danger because of their obesity.
Yet, despite the risky health conditions, such as heart disease, that are associated with obesity, those who treat childhood obesity rarely come across cases what would constitute an emergency removal of the child.
Is Health Risk From Obesity an Emergency?
"First of all, you do have to work out if there are genetic syndromes -- they are rare -- and they don't run in families like this," said Keith-Thomas Ayoob, an associate professor in the department of pediatrics at the Albert Einstein College of Medicine in New York.
"This may be a case where the expression of a problem is nutritional, but the problem may be rooted in a mental issue," said Ayoob.
Apart from mental issues such as eating disorders, Ayoob says he works with people who simply have parenting issues.
"And if there are parenting issues, these kids aren't in any immediate emergency danger," he said.
Instead of an immediate removal, Ayoob said he prefers to work with families over a period of time.
"Healthy eating is a family issue if the parents are both overweight," said Ayoob. "Removing them is not going to address those eating habits."
Dr. Marc S. Jacobson, of the obesity leadership work group of the American Academy of Pediatrics, also points out that childhood obesity isn't always a matter of mental health, or poor parenting.
"There's clear evidence that the food industry -- fast food restaurants, vending machines, sweetened cereals -- influences childhood obesity," said Jacobson.
"I can't say which is relatively greater in influence, but they certainly are important," he said. "The more fast food restaurants in a community, the more likely the kids are to be obese."