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Are Obese Kids Victims of Child Abuse?

Recently I was asked by BBC radio to discuss (in three minutes flat) the question of whether morbidly obese children were the victims of abuse by their parents. By coincidence, the Lancet of that week published an editorial on the psychological abuse of children and what doctors could or should do about it.

Nothing illustrates better than child abuse the tendency of ill-defined but nevertheless meaningful concepts to spread beyond their original signification to include more and more phenomena. The evolutionist Richard Dawkins has even suggested that to bring up children in any particular religious faith is a form of child abuse, since the child’s subsequent freedom to choose his beliefs according to the evidence is thereby impaired: in which case the history of all previously existing societies is not that of class struggles, as the Communist Manifesto has it, but of child abuse.

The editorial in the Lancet referred to a report on the psychological maltreatment of children by the American Academy of Pediatrics, the general drift of which was that such maltreatment is protean in nature and has bad effects upon children later in life, from mental illness and criminality to inability to form close relationships and low self-esteem. Maltreatment is dimensional rather than categorical: at what point does "detachment and uninvolvement" give way to "undermining psychological autonomy"?

Likewise "restricting social interactions in the community" can be a form of maltreatment, but so can failure to do so, in so far as association with undesirables might "encourage antisocial or developmentally inappropriate behavior." Parenthood is thus a constant navigation between various Scyllas and Charybdises, and is rarely entirely successful. Surveys show that about one in sixteen people in Britain and America consider themselves to have been the subject of psychological abuse in childhood. I count myself as among the abused.