219-pound boy shows growing problem of extreme obesity

CLEVELAND (Reuters) - The case of a 219-pound 8-year-old boy taken from his mother for health reasons spotlights a problem that has almost tripled in the U.S. in the last 30 years -- cases of extreme child obesity.

"Not only do we have a higher percentage of kids who are obese but a higher percentage of children who are severely obese," said Dr. Garry Sigman, director of adolescent medicine and associate professor of pediatrics at Loyola University Medical Center near Chicago, in an interview with Reuters.

According to the Centers for Disease Control and Prevention, approximately 17 percent or 12.5 million of children and adolescents aged 2 to 19 years are obese, as opposed to merely overweight.

Obesity in children is defined by the CDC as having a body mass index (BMI) at or above the 95th percentile for children of the same age and sex. "Overweight" is defined as a BMI at or above the 85th percentile.

About 2 million U.S. children have a BMI at or beyond the 99th percentile, according to a July article on childhood obesity in the Journal of the American Medical Association, co-authored by Harvard University child obesity expert Dr. David S. Ludwig. The article ignited controversy by saying that in some cases, removing a child from a home may be justified.

An average 8-year-old boy is about 55 pounds, making the boy in question approximately 165 pounds overweight or four times more than average, according to the CDC.

The Cleveland-area boy's mother petitioned a state court two weeks ago to regain custody. But on November 14, a judge agreed with the Cuyahoga County Department of Children and Family Services that the boy, an honor student who gained 60 pounds in about a year, should not be returned to his home due to concerns for his health. The next custody hearing is set for later this month.

Sigman said he usually only sees that sort of rapid weight gain in teenagers, and this along with the sleep apnea is "life threatening."

"That kind of weight gain is a very serious imbalance in both movement and calorie intake," in a younger child, he added.

This is the first time an Ohio child had been removed from a parent's custody primarily due to weight concerns. Court records show that the boy was seen by endocrinologists, nutrition experts, and a sleep clinic in efforts to decrease his weight and remedy his sleeping problems. Medical professionals concluded that the boy's weight gain was due to environmental reasons such as his diet, and there was no medical reason for the gain, according to court records.

Social workers became aware of the boy's situation in spring of 2010 when the 7-year-old was hospitalized for two weeks with severe breathing problems. The child has since been diagnosed with sleep apnea and uses a breathing device and monitor at night, according to court records.

Sam Amata, an attorney for the mother of the child, did not returned repeated calls for comment.

According to social worker reports, the boy had been diagnosed as morbidly obese and lost weight during his two-week hospitalization.

The boy's weight continued to decrease for a short period of time but he then began gaining again at "a rapid pace," according to court documents.

Sigman noted that weight-related health issues like heart and fatty liver disease, usually thought of as adult or end-stage diseases, are effecting children with severe weight problems.

The Cleveland boy, who has a Body Mass Index (BMI) of 60, was enrolled in a hospital program for overweight children. Social worker reports said he frequently missed weigh-ins and appointments, the court document said.

During the year-and-a-half protective supervision of the child, a social worker reported observing the boy out of breath after walking down the length of a short hallway and that some of the boy's breathing problems are, "due to extra skin in his throat."

An 8-year-old boy with a moderate activity level would require about 11,200 calories in one week to maintain his current weight, according to the University Hospitals Rainbow Babies & Children's Hospital in Cleveland. For the same child to gain one pound in a week, he would need to consume about 14,700 calories.

The boy is now living in a foster home close to his mother who is allowed weekly visits. He has lost weight while in foster care, according to Mary Louise Madigan, spokeswoman for the Cuyahoga County Department of Children and Family Services.

Sigman warns that any young child with a severe weight problem will need years of care. "Even under the best conditions, it is not always possible to maintain significant weight loss in these children," explains Sigman. "It is going to take years to get that child well."

(Writing and reporting by Kim Palmer; Editing by Mary Wisniewski and Greg McCune)