Mental Health March: My tears for a family torn apart

This is a super-long post.  I’m not going to embellish it with pretty pictures, because it’s not a pretty read.  I appreciate that this might put you off reading it, but so be it.  I’m a fun, bubbly person, but on some matters I’m deadly serious.  This is one of them.

It’s Mental Health March, and I wanted to write about something that’s affected my mental equilibrium by making me angry and upset.  But I know this feeling won’t last, because the circumstances don’t affect me directly.  For the poor family who is living through this nightmare, I can only imagine the mental trauma.  Actually, I can’t.

I don’t know whether you saw the article in ‘The Guardian’ which reports that two teenagers have been taken into care because they were not able to lose weight. Here it is, in case you didn’t.  https://www.theguardian.com/society/2021/mar/10/two-teenagers-placed-in-foster-care-after-weight-loss-plan-fails

Where do I even start with what is wrong with this whole story?

I have a cousin who used to work in Safeguarding for children’s services and had this exact job of removing children from their homes.  These were children at severe risk of abuse or neglect. It was always hugely traumatic for both the children and the parents, and I like to think that it would not have happened except in the most extreme of circumstances.

Those circumstances exist.  We know that there are children, perhaps thousands of children whose lives are directly  at risk right now because of abusive parenting, and whose mental health and ability to learn, grown and develop according to their rights and needs is compromised every day because of what is happening at home. In those circumstances, social services must reluctantly do what is necessary.  Some of them will die before this happens.

Obviously, we will never know the full story from a short report in a newspaper, or even from reading the court report, which I have now done. but it seems to me that, in today’s case, not only were the ‘at risk’ criteria not met, but the family was ripped apart for not fully engaging in behaviours that are more likely to harm their children than help them, and has been penalised when interventions that are known not to work did not, in fact, work.  In other words, it sounds to me as if these parents had their children taken away for the ‘crime’ of being good parents.

The report admits that the children were from a loving home where much of the parenting was done well.  They were described as, “Bright, polite and engaging”.  Indeed, the judge commented, “It was accepted by everyone that (the mother) has provided good parenting for these children”.  The father is described as, “A good man, who works hard and has provided a good role model for his children in so many ways”.

I’ve been a childcare assessor and know the signs and indicators for abuse that we must be aware of.  “Bright, polite and engaging” children would rarely be a cause for concern unless, perhaps, they were being sexually groomed.  But that isn’t the allegation here.  Considering that these are teenagers, “bright polite and engaging” would seem to indicate extremely good parenting and a strong family environment, given how a lot of teenagers can come across, regardless of parenting.

There were concerns around the children’s personal grooming, in particular the boy’s lack of dental hygiene and his body odour.  But neither of these things are uncommon in teenagers.  Show me a teenage boy who does NOT have body odour.  In any case, these were not the court’s main concerns. In fact, it was acknowledged that neither the children’s untidy home nor their personal hygiene would have constituted grounds for removing these children had their body weight been within an accepted range.

So, why did the court see fit to remove the children from their loving home and good parents?

It seems that social services were concerned that the children had larger body sizes.  In fact, it is stated several times in the court report that the children’s weight, and not their home circumstances or personal hygiene, was the primary concern.

What did the local authority do?

 For more than 10 years they tried to impose weight loss on the family by giving them gym memberships and exercise tracking devices and encouraging the family to join a slimming club.  Almost inevitably, these interventions failed and the parents were held responsible.

I have no problem with exercise, and I have no problem with exercise tracking devices.  In fact, I have one myself.  I do have a problem with the concept of exercise as a weight loss tool.  Firstly, it is very unlikely to be effective.  Most studies show that, in terms of weight, the difference between people who exercise as part of their weight loss programme and those that don’t is negligible. Secondly, focusing on something that doesn’t work is discouraging and may deter the young people from exercising.  It takes focus away from the real reasons why exercise is beneficial, such as muscle development, balance, strength, flexibility, stamina, energy, mental health (assuming you find the right exercise), and just the sheer joy of moving your body.

Worse still is the idea of putting a child in a slimming club. The court report states that one of the children, “had shown that he could lose weight… but he had been unable to maintain this loss”.  This should not be a surprise.  In fact, it’s a characteristic of around 95% of people who attend slimming clubs.  It is precisely what the business model of a slimming club, or indeed any diet is based on.  Slimming clubs make money because long-term, sustained weight loss is extremely rare, but people are shamed into thinking this is their fault, when it is the model itself that is faulty.  Furthermore, it has been shown that people who repeatedly diet are 5 times more likely to develop an eating disorder than to lose weight and keep it off.  One can only imagine how much more this is true if the person in question is a vulnerable child.

If I were a parent, this toxic environment is precisely what I would want to keep my children away from.

The report states, “It cannot be the case that she (the mother) and the children have been adhering to the healthy eating and lifestyle plans because, had they done so, when there is no evidence of any medical condition, it is undoubtedly the case that the children would have lost weight”.

And here is the real nub of the matter.

This ruling is harmful because it perpetuates the myth that 1) health behaviours must always result in weight loss and 2) losing weight is always better than not losing weight.  Neither of these statements is true.  In fact, the most likely outcome of dieting is to gain additional weight long term, which is precisely what has happened here.  The more we perpetuate these myths and disbelieve people who report doing their best with adherence, the less these myths will be challenged, and the more harm will be caused.

A brief interlude for a personal story.  At one time I was engaging in behaviour very similar to that advised for these children.  I went to the gym about 5 times a week, and I can promise you that I spent the time in there exercising.  I also used the same slimming club as this family and was pretty religious about adherence.  I did this for around 6 months.  I did not lose a single ounce in weight.  I can’t say whether or not I was healthier, as I didn’t measure any biomarkers. It’s not rare for this stuff not to work for weight loss; it’s fairly common.

Returning to the children, there’s no evidence from the court documents that there was any attempt made to assess any actual measure of their health (for example blood pressure or blood sugar control) or find out whether, in fact, there were any underlying medical conditions.  For example, did anyone assess their thyroid function, or look at the composition of their intestinal flora? Were there, in fact, any nutrition professionals involved at all?  The only intervention referred to in the documents is a social worker bringing scales into the home to weigh the children.  Why is someone who is not qualified in either health or nutrition allowed to perform a medical procedure on a minor?  The judge says, “It is a question of the children’s health which has driven my decision-making process”.  But aside from weight, there doesn’t seem to have been any assessment of physical health criteria.

The impact of the last decade of interventions seems to have been to cause the younger child severe depression.  Tablets were found in her room, with a note indicating that she had thoughts of taking an overdose, and a doctor recommended that the child have therapy.  But the local authority representative did not arrange this, saying that it “would not have significantly altered the situation”.

Seriously?

Someone with no medical qualifications is denying the child an opportunity to access therapy when her mental health is clearly of concern, and she is described as, “a very sad little girl”.  But let her be unhappy enough to hide tablets with a view to suicide, deny her therapeutic intervention and separate her from all the people she loves because as long as she’s fat it’s OK for her to feel like that.

There is no acknowledgement that hounding the family for more than a decade, repeatedly focusing on the children’s weight, forcing them to join harmful slimming clubs and threatening them with removal from the home could have had any impact on the children’s physical or mental health or their eating behaviours. I’ll leave you to draw your own conclusions about that.

Furthermore, it is accepted that being placed in care may not have the outcomes the court wishes for these children.  In fact, it is well known that children in care generally fare less well than children who remain at home, even when children are living in a toxic home environment, which is not the case here.  The court even acknowledges that care could be counterproductive because it will significantly impact the children’s mental health, make it much more difficult for the older child to continue in his job, and may mean that the children resort to comfort eating and in fact gain more weight.  After all, it’s pretty difficult to control what a teenager eats.

So, tonight I am thinking of a mother who is already depressed and overwhelmed crying herself to sleep in an empty house.  A hardworking father who is bewildered at why he cannot have unsupervised contact with his children given that it’s acknowledged that he poses no threat to them.  A son who is torn between going into foster care to support his sister and enforcing his right to refuse to comply with a court order he believes to be unfair and unjust.  And most of all, a severely unhappy little girl who has suffered for over a decade through no fault of her own and will now be subjected to further suffering torn away from the people she loves.

All because we still believe that weight is the only, or the most important measure of health.

I am crying as I write this.  Perhaps, if I had had less privilege, that little girl could have been me. But it wasn’t and I will get over the story very quickly.

I don’t think that this family ever will.

Did this post resonate with you?  Here are 3 things you can do right now.

1. Follow Dr Natasha Larmie @Fatdoctoruk on Insta.  She knows more than I ever will, and, unlike me, she has the gift of being concise.

2. Join my free Facebook group https://www.facebook.com/groups/nutritionkitchen.  If you’re intereted in nutrition and mental health in a size-friendly environment, this is the place for you.

3. If you can think of a way to support this family and others like them, or if you want to register how you feel about this story, please look up Health Professionals Against Weight Stigma, who are looking into what they can do to help.  You can also share with them your experiences of weight discrimination in a medical setting so that they can collect information about the current state of affairs and take action.