The team, led by Dr Russell Viner of the UCL Institute of Child Health in London, says that while childhood obesity alone is not a child protection concern, parents who understand what is needed to help their child and subsequently fail to change their children's lifestyle are being neglectful.
Parental behaviours of concern include consistently failing to attend medical appointments, refusing to engage with professionals, or actively avoiding weight management initiatives.
The researchers say the issue is of particular concern with young children and those at risk of sleep disorders, hypertension, type 2 diabetes or mobility restrictions.
Dr Viner said, 'Parental failure to provide children with adequate treatment for chronic illness, such as asthma and diabetes, is a well accepted reason for a child protection registration for neglect.
'We suggest that childhood obesity becomes a child protection concern when parents behave in a way that actively promotes treatment failure in a child who is at serious risk from obesity.'
The researchers reviewed existing evidence for any link between childhood obesity and neglect, with the aim of proposing a framework for practice.
While they found increasing evidence linking adolescent and adult obesity with childhood sexual abuse, violence and neglect, there were no studies examining the relation between child protection actions and childhood obesity. Data was also lacking on the long-term outcomes of child protection strategies in relation to weight control and metabolic disorders such as diabetes.
The UCL Institute of Child Health is now calling for assessments of obese children to include family and environmental factors, as obesity may be attributable to wider matters of neglect or emotional abuse.
The researchers also recommend that guidelines for professionals be drawn up and more research carried out on the outcomes of child protection actions in obesity and the outcomes of early intervention.
Further information
'Childhood Protection and Obesity: Framework for Practice' was published online at www.bmj.com on 15 July.
