Hallam study reveals divide over whether childhood obesity is a child protection issue

8th September 2020

Almost half of all health and social workers questioned as part of a new study by academics at Sheffield Hallam University have indicated that they feel childhood obesity should be considered a child protection issue.

The findings, which are being presented at The European and International Congress on Obesity (ECOICO) online conference and published in the British Journal of Social Work, suggest that threshold judgements about whether obesity amounts to ‘significant harm’ and warrants intervention are inconsistent and may be limiting the support services being offered to, and accepted by, children and their families.

In the UK, one-in-four children leave primary school with obesity.

Dr Peter Nelson, research lead at Sheffield Hallam University, said: “Our study offers a unique insight into current multi-agency practice on child obesity and child protection. We’re seeing that thresholds do not operate simply as a line to be crossed for a referral to be accepted by social services, but they are nuanced and complex, with personal values and beliefs about obesity influencing individual decision making, and different agency thresholds.”

Children who are obese experience low self-esteem and bullying and are at risk of serious long-term health problems – including type 2 diabetes, heart problems, cancer and even premature death. Whether childhood obesity is a consequence of neglect, and obese children should potentially be removed from parents who do not try to reduce their child’s weight, is a question that has divided opinion.

The divide is reflected in the health and social care professions where there is resistance to ‘bodily surveillance’, whilst acknowledging the need to investigate neglect where evidence exists of clear parental failure to manage a child’s diet, health and fitness.

Practice varies across the UK, with childhood obesity incorporated in some multi-agency child protection procedures but with no mention in others, and little research to explain these variations.

To provide more evidence, researchers interviewed 23 health and social care professionals and conducted focus groups with 24 health and social care professionals working in child protection and obesity services for a local authority in the north of England. They conducted semi-structured interviews and focus groups to explore their decision making, views and experiences of working with obesity and the child protection system. All responses were anonymised.

Analysis of responses indicate that 10 out of 23 interview participants believe that child obesity is a child protection issue, with a further three agreeing if obesity was also associated with wider concerns about neglect. Seven interviewees thought obesity was not a child protection concern, and three considered the problem as too complex to have a view either way.

Obesity was more likely to be seen as a child protection issue when families did not engage with the support offered and make lifestyle changes.

In addition, the research found that personal beliefs and values about obesity and parenting skills were affecting threshold judgements and referral decisions. Assumptions that social work thresholds were high, and differing agency thresholds, also impacted subsequent actions and interventions.

Dr Catherine Homer, Sheffield Hallam research fellow and report co-author, said: “The questions we should be asking are whether, by taking a child protection approach, we are passing the problem of child obesity to families and then blaming them when they fail to help their child lose weight and, in so doing, ignore the clear links between obesity and disadvantage. Or could a child protection approach act as a catalyst for families who fail to engage and take up support as well as a gateway to more intensive support. 

“There's a real opportunity to address these issues now. Failure to do so will lead to potentially lasting damage to each child’s health and well-being.”

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