How diet culture destroyed a family

A story broke in the UK today about 2 teenagers who were removed from their parent’s care because they were ov*rweight. I have since had a chance to read through the entire court document and the evidence is pretty damming. This is a clear case of weight based discrimination on the part of the Local Authority and the presiding judge. Diet culture has officially destroyed a family.

I believe that this case highlights a number of issues that demonstrate just how toxic and dangerous diet culture has become. Rather than lay blame at the feet of individuals, I think we all need to take a step back and reflect on what we can learn from this case.

Being fat is not a health condition

Some people argue that is a risk for several health conditions. I argue that whilst being a fat person may put you at risk, the fat itself is not the issue. It is the lack of adequate and equal healthcare. It is the chronic stress, the chronic dieting and the delayed treatment. We fat folk are less likely to succeed at a job interview, get a pay rise or bonus, or get promoted. We are more likely to live in poverty and have less access to adequate nutrition or time to take care of our health through physical activity, getting enough sleep, rest etc.

I don’t believe it is the adipose tissue itself that is the real issue. That’s why fat people who are admitted to ICU are more likely to survive. That’s why people who have had a heart attack or developed heart failure live longer if they have a BMI over 30. It’s called the ob*sity paradox and I don’t think it’s an actual paradox because I don’t agree with the original statement. I don’t think fat was ever bad for us. I just think people wanted us to think that so they could sell us weight loss.

And let’s talk about weight loss for a moment. Weight loss is not the solution to the increasing levels of fatness within our society today. In fact, many studies suggest that it is one of the main causes of these increasing levels. Preoccupation with weight loss and chronic dieting is a big risk factor for weight gain. In fact, studies show us that up to 95% of people who lose weight by going on a sensible calorie controlled diet (no fad diets here) end up gaining back the weight within 5 years. The majority of weight is regained within the first 2 years. Two thirds of individuals who go on a diet will end up heavier than when they started.

West Sussex Local Authority Versus A&B

Now let’s take a look at the case itself. The Local Authority have had involvement with this family since 2010, when the oldest of the two siblings was 6. He is now old enough that he cannot be compelled to go into foster care, but his 13 year old sister was separated from him and taken into care in October 2020. The proceedings were issued in December 2019, around the time that their parents separated. The majority of the assessments that took place for the court occurred during lockdown.

It is clear from the court documents that this case was about weight and weight alone. The judge states that “concerns have been raised about the children’s weight, about their poor hygiene, and about the home conditions”. Apparently the social worker was concerned about the children’s personal presentation because they had dirty nails, tangled hair and body odor.  She even went as far as to say that “every effort had been made by the Local Authority to encourage regular washing and teeth-brushing but to no avail”.

Can anybody else relate to this? During lock down I barely brushed my hair at all. It is in such a state and in such desperate need of a cut that it is virtually impossible to keep tidy. And I certainly haven’t been washing as often as I used to. So yeah, I quite often have dirty fingernails, unkempt hair and body odor. I’m also a practicing doctor. What has that got to do with anything?

Furthermore, she “considered the home conditions were poor, with piles of washing-up on the side and a very unpleasant smell”. Piles of washing up and an unpleasant smell described my kitchen perfectly right now. Are social services gonna come take my kids away too? Of course not. Because even the court accepted that “concerns about home conditions and hygiene would not justify the making of a care order“.

How diet culture destroyed a family

So why did they make a care order? The judge summed it up for us:

There have been numerous interventions by the Local Authority, the majority of which have effected short-term improvements but sadly these have not been sustained.  Unfortunately, throughout this Local Authority involvement, there has been a gradual weight increase of the children, which has continued even since these proceedings have been issued… Throughout this time, the children have remained at home with their mother, the parents having separated shortly after proceedings were issued, although B [dad] has returned home from time to time, the relationship between the parents remaining amicable.  However, unfortunately, there has been no reduction in the children’s weight since the proceedings began. 

Like I said, it was all about the weight. From what I understand, social services have tried numerous “interventions” to get these kids to lose weight and since they haven’t been successful, they believed they had no choice but to remove these children from their home and place them in foster care.

Were the parents bad? Quite the contrary. According to the judge, the case was “such an unusual one because the children had clearly had some very good parenting, as they were polite, bright, and engaging.”  Apparently mum presented as “a loving mother, who clearly has a good relationship with her children”.  The judge went on to say that it was “accepted by everyone that she has provided good parenting for these children, and I hope that the more negative comments which follow do not detract from the fact that, in many ways, she has been a good mother”.

And yet you took her kids away from her.

What about dad? Was he a monster? Did he beat mum up, gamble away all their savings, or humiliate and ridicule his kids? Nope. In fact, he spoke very clearly about his love for his children and the close relationship he had with them. The judge however did not feel that this was enough because “there was no evidence either that he accepted the seriousness of the Local Authority’s concerns or that he was taking any steps to deal with them”.

Now I take personal offence at this statement. I grew up with a narcissistic dad who abused me physically and emotionally. He had no problems punishing me for my weight and humiliating me for being “fat”. This dad loves his kids and his only crime is not forcing them to diet and exercise. Does anyone else take exception to this or am I the only one?

The health risks

So the parents were good. The home was a regular home. The kids could do with a bath and a haircut but were otherwise polite, bright and engaging. What about their physical health though? They must have been near to death, right?

Wrong. They were both on the 99th percentile for weight. The son apparently had Non Alcoholic Fatty Liver Disease (NAFLD) but there was no mention of a pediatrician report, a dietitian report or even a Fibrosis score. The daughter was apparently at risk of Type 2 Diabetes. And that’s it. Apparently this warrants social services intervention.

There was nothing significantly wrong with their health. Can we just take a moment to take this in? There were signs of potential risks to their future health, but no expert report from any child health specialist. The only expert testimony came from a psychologist. Plus any child who takes up smoking, drinking alcohol or using substances is putting their health at significant risk (much greater risk than pre-diabetes or NAFLD) but how many of them get put in care?

Aside from their physical health, there were concerns raised about their mental health. There was a talk of a bottle of paracetamol which a 13 year old girl had claimed was for an overdose. Both had been bullied at school and had low self-esteem. I don’t think I can go on talking about this part. It’s too upsetting for me. It’s too triggering.

I just wanna hug them both so bad. I wanna hold them and tell them that everything is OK. They did nothing wrong. They never should have been taken out of their parent’s care. Social services should have closed the case 10 years ago once they realized that they were both being raised by parents who loved and cared for them. Sure they weren’t perfect, but who cares?

Do you know how many parents refuse to vaccinate their children? Do we report any of them to social services? What about the kids with terrible tooth decay that need to have several teeth removed because they have been eating too many sweets and sugary drinks and not brushing their teeth properly? Do we punish them with social services intervention over the period of a decade? No we don’t.

Wanna know why? Because we live in a democracy. This is not a police state. The local authority has no right to tell me how to parent my children unless I am putting them at risk through neglect or abuse. If you’re going to interfere with children who are simply at risk of future illness because of health behaviours, then you had better make sure you do it with all children who put their health at risk, not just the ones on the 99th percentile.

How social services made it worse

The social worker present at this hearing confirmed that the “Local Authority had been involved with this family since 2010 and her own involvement began in 2018.  She said it was a sad and frustrating case because the family would make progress in response to interventions but none of the changes have been sustained.  She was at a loss to suggest any other intervention which might work, in view of the considerable efforts made by the Local Authority over the years.”

And yet there was no mention of an Eating Disorder assessment for either child. Nor was there mention of a  doctor’s report or a dietitian’s assessment. In fact, it seems as though the only interventions put into place for either the parents or the children focused primarily on weight loss. There was mention of weight watchers referrals, gym subscriptions and fitbits. In fact, it appears as though they were keeping tabs of their use of all these interventions and considered it a failure if either child refused to engage with them.

This is problematic for two reasons. To begin with, it appears that both children were Gillick competent at the time of these proceedings. You cannot force a Gillick competent person to engage in any health behaviour against their will. This is a breach of their basic human rights and I cannot believe that a judge would enforce this. I would like to remind people that withholding food from someone is a form of torture and whilst I am not suggesting that enforcing a calorie restriction was meant as a punishment, I suspect it felt that way.

The second reason that I have serious concerns about the numerous interventions by the Local Authority is that I believe that they are responsible for causing harm. I am not saying that they did it intentionally. But nevertheless they did a lot of damage and I am not sure whether or not any of their victims will get over it.

The American Academy published a report that stated that any form or diet, calorie restriction or exercise for the purpose of weight loss was a risk factor for both ob*sity and eating disorders. The former just shows how useless their interventions were, and suggests that over the course of the 10 years they most likely succeeded in exacerbating the situation.

The latter is everything. Eating disorders have the highest death rates among all the mental health conditions experienced by teenagers. At no point during this entire court document did I read the term Binge Eating Disorder. And as far as I am concerned, this is gross negligence on the part of all the professionals involved.

How diet culture influenced the social worker

The social worker said it was understandable that “the family was fed up with social work involvement, in view of the time that it had been going on”.  She believed that mum “failed to set boundaries for the children, or to promote healthy eating and exercise.  In addition, she was concerned about “the unhealthy food which she had seen in the house during her visit on 14 October 2020.  She believed that she had seen packets of crisps, tubs of ice‑cream, and fizzy drinks which were not marked as sugar-free.  Even if they were for the mother’s own consumption, the mother was not modelling good behaviour to the children.” 

So it would appear that this social worker believed that packets of crisps, tubs of ice cream and fizzy drinks are all responsible for ob*sity. And who can blame her? That’s what we have all been taught to believe. Even the Latin root of the word means to eat too much that you become fat. But ask any expert and they will tell you that it is way more complicated than that. Weight gain is a combination of genetics, hormones, childhood experiences, underlying medical conditions, and chronic dieting. In fact weight talk, whether talking to children about your own weight or talking about your weight in front of them, is associated with weight gain and eating disorders.

Apparently, mum could not explain why the children were not losing weight, as they were sticking to the healthy eating and exercise plans. And it is clear from the judge’s decision that she did not believe mum. She said:

It is clear both from her evidence and the chronology in this matter that she has failed to instil in the children habits of healthy eating, exercise, and good self-care.  I accept what she says about the difficulty of compelling teenagers to act in a certain way but, clearly, had these habits been encouraged and modelled to the children from an early age, no element of compulsion would now arise. It cannot be the case that she and the children have been adhering to the healthy eating and lifestyle plans discussed 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.

Guess what judge Ellis? I am a doctor and whilst I am by no means an expert, I can tell you without question that you are wrong. Furthermore you have absolutely no evidence that this is the case, and therefore relied on your own understanding of the issues rather than expert testimony. I thought the whole point of being a judge is that you remain impartial? And yet you are so convinced that these children would have lost weight if they had just followed the plans set out by the Local Authority. I promise you there are a number of health professionals out there that disagree with this assessment. And since you presumably have absolutely no qualifications in the medical field, then you need to defer to our expertise.

How diet culture influenced the judge

I want you to take a look at some of the evidence that the judge based her ruling on:

“The children had failed to engage consistently in exercise despite the Local Authority providing Fitbits and paying for gym membership.  The children were supposed to provide recordings from their Fitbits but this had not been done.  The mother blamed lockdown for the inability to exercise but exercise could still be taken in the home or by walking outside.  The attendance of the family at Weight Watchers had been inconsistent.” 

Rather than investing all this money into enforced exercise and dangerous weight loss programs, did nobody think to offer these young people an eating disorder assessment? Or to pay for private counselling? Or to refer these children to a paediatrician or a dietitian? How about getting mum some help around the house?

“She accepted that the children, in particular D, might find the move into foster care upsetting but she said that D had been a sad, depressed little girl for some time, and that this had not been caused by the prospect of foster care. The discovery of tablets and a note in D’s room was concerning, and extra support would be put in place.  She believed this was a cry for help from D.  There were no prospects of the situation improving if the children remained in their mother’s care.” 

Can we acknowledge the clear lack of understanding surrounding mental health issues in young people here, and the damage it has done? Can we talk about the dangers of allowing social workers and judges to make decisions about whether the threat of a paracetamol overdose is credible? Because suicide rates among young people with eating disorders are extremely high, and we still don’t know whether these guys have eating disorders or not. Rather than getting them the mental health support they need, the Local Authority removed them from a loving environment and condemned them to foster care.

How we can tell that this judge was biased

“I accept that there are no other measures which can be taken by the Local Authority to assist this family, and I did not find any evidence of a lack of analysis or gaps in the evidence which would undermine the evidence given by the social worker”. 

I’m not even going to bother with this one. Please see above.

“She said that this was a very sad and very unusual case, in that the usual features of harm to the children are missing.  There is a very strong relationship between the children and their parents, and between each other, and the children are attractive and engaging.  However, they are in a dangerous situation in relation to their health and the mother has accepted that she does not know how to improve this.  The children must therefore be given a chance to improve their life chances, and foster care is the only option for this.”

You still haven’t explained what this danger is. They are fat. I get it. But do you remove children from the care of their parents because they are at risk of measles when they decline vaccinations? Or lung cancer from second hand smoke? No you don’t. Let’s face it, you were unable to look beyond the BMI and centile charts, and you refused to ask the advice of a health professional that isn’t biased themselves.

“She accepted that the children’s wishes and feelings were of great importance but said it would be unusual if the children did not express a wish to remain with their parents.  The Court has to make a decision based on the children’s long-term best interests, which may conflict with their wishes and feelings.”

From what I can tell here, the wants and needs of the children have never once been taken into consideration. Not 10 years ago when social services started interfering at the tender age of 3 and 6. Not when they were forced to attend weight watchers and wear fit bits against their will. Or when they became desperate and cried out for help. Nope, their feelings and desires were irrelevant. Because the Fat Phobic adults in their lives believed they knew what was in their best interest. And evidently they were wrong.

“She agreed that the credit should be given to D and C for there being no actual weight gain over the past few months but it remained disappointing that there had been no loss, especially in view of the significant gains during the course of proceedings, and the long‑standing nature of these problems.”

The judge is making it very clear here that the only thing she was interested in was weight loss. Failure to meet those expectations is what finally resolved her to removing these teenagers from their parent’s care. The family is being punished for not being thin enough. Now do you believe in weight stigma? Now do you see how dangerous Fat Phobia can be?

How have we come to this?

Are you angry? Good. Me too. This has got to stop. This has got to end. Enough is enough.

All I want to do is reach out to these vulnerable teenagers and tell them how sorry I am that this happened to them. I want to tell them that the court was wrong. The social worker was wrong. This decision clearly wasn’t in their best interest. I cannot believe this has happened to them. This is an outrage.   

I want to reach out to mum and dad too, and say I see you. I hear you. We know you have been trying your best. We can’t imagine what this ordeal has been like for you. We’re here for you. This little community of women and men who know just how damaging weight stigma can be and who want to help you to fight this decision.

Let’s end with a quote that sums it all up:

“The guardian, Ms Wells said that this is a very sad case of a close and loving family, who have been given every chance to make improvements, which sadly has not worked.  The Guardian accepted that the move into foster care would be hard but, in view of the mother’s acceptance there was nothing else she could do, it was the only option for these children.  These were children who had suffered significant harm and who are facing potential life-limiting health issues, and something must be done to protect them against this.”

12 Responses

  1. I am genuinely too angry to write more than a huge thank you for this break down and analysis. I am heartbroken for these teenagers and their parents.

  2. I could not read all of this post because I was so angry and upset about the extent that fat phobia has infiltrated into our society and how it has contributed to wrecking this particular family. It is scandalous but I bet so many people would think it right. We have all been brainwashed into thinking weight is everything. The weight loss industry has a lot to answer for. Thanks for your efforts
    and for being a sane voice in the madness.

  3. Should all of us fat mothers with big children be worried that they will be taken? I’m suffering for this family. And I wonder what other characteristics (of any) besides their weight influenced the decision. Thanks for sharing!

  4. Dr Natasha, thank you very much for writing such an eloquent and heart-rending piece. I have written a blog on the same subject which agrees with everything you say, but not nearly so good as yours. I hope that, though the words and actions of everyone who sees how wrong this is, the family will be reunited soon. But I suspect they will never fully recover.

  5. I find this case extremely distressing. I can’t believe that any sensible adult would think that the trauma of being put into care is preferable to being fat! If 50% of people are categorised as ‘overweight’ does that mean that half of all families are at risk of having their children taken away? I want to give them all a huge hug.

  6. I find this case absolutely extraordinary and heartbreaking. Did it not occur to anyone that these children haven’t lost weight because these interventions DON’T WORK?? What are the foster carers going to do differently – frogmarch them to WW at knifepoint? Lock the fridge and all the kitchen cupboards? What happens when the children have been in foster care for a year and they’re still fat? Or have been driven mad by obsessive calorie counting? Can they go back to their parents then? I saw the original news reports and don’t understand why this isn’t a national scandal. This poor family.

  7. So I have a child who has been on the 99th centile since birth. She is now nearly 9 and continues to be on the 99th centile. Should I be worried that social services will be knocking on my door? So so upset by this. Thank you for your analysis

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