A 12-year-old is taken into hospital, grossly overweight, and put on a diet. His family is caught smuggling in 1lb bars of chocolate: parental love or child abuse? A two-year-old girl weighs four stones: a child protection issue, "big bones", or a public health problem?
The BBC has discovered that obesity has been a factor in at least 20 child protection cases in the last year. At the end of this month, the British Medical Association is due to debate the following motion: "The government should consider childhood obesity in under-12s as neglect by the parents and encourage legal protection for the child and action against those parents."
Dr Matt Capehorn, a Rotherham GP who runs an obesity clinic, is putting forward the motion. He says: "There is outrage if a child is skin-and-bone, but it only happens in extreme cases with obese children."
Actually, he's wrong - about the outrage if a child is skin-and-bone. If it's called anorexia, then in spite of the fact that the child may have starved herself, or himself, because of a range of reasons including power struggles with a mother and family dynamics, the parent is rarely held to account. Why? For the same reason that it appears daft to remove children from parents who are stuffing them silly. Both situations are a very large step away from child cruelty as defined by say, giving a child only bread and water or force-feeding a five-year-old à la foie gras.
Childhood obesity is a growing problem across the socio-economic classes, says the Department of Health. "Puppy fat" has become the calling card for a lifetime of spare tyres and associated diseases. But less noticed and just as worrying is the steady rise in eating disorders.
The mother of a living skeleton and the parent of a rotund eight-year-old are sisters under the skin - different ends of the same spectrum. So what are the kind of ingredients making up the complex mix that influences, in varying degrees, the hand of every parent spooning food into their offspring?
Genetics plays a part, as does the demise of exercise; the bizarre British view that children eat differently from adults, allegedly preferring anything that's fried and bright orange to "real" food; the hidden sugar coating on theoretically healthy food that requires a PhD in nutrition to detect; the exorbitant cost of "good" food to those on low incomes and the determination of the market place in the name of profit to use every imaginative and manipulative device known to man, to divorce what we swallow from our sense of what it means to be hungry and full. And that's the easy part.
Presumably, social workers considering taking a child into care will make note of all of the above - but how do they assess the still more intricate, subtle and elusive family dynamics; distorted views of what it means to nurture and "mother"; a parent's subconscious dislike of their own body; food used as discipline and bullying ("clear the plate or you don't go out"); sweets used as bribery; moderation regarded as an activity for wimps; a maternal ambivalence towards a child - much of which is moulded by the position of the female in society - and that nasty nagging voice in every woman's ear that says, "whatever it is you're doing, you're not doing it right"? Including bringing up a child.
In practice it means a stick-thin woman feeds her child over-abundantly - giving him what she denies herself. A woman less than interested in her child substitutes junk on its plate for emotional engagement and the investment of her time and interest.
The son, in turn, subconsciously picks up that as long as he's shoving things down his throat he has his mother's attention. He has become noticed; a character in the family - "the fat one". A mother subconsciously afraid of having to face the world as someone other than a parent infantalises her daughter, and constantly, literally, spoon-feeds her. The child is ostracised for her size by her peers and is made ever more dependent on the mother.
Psychiatrists could provide an even longer list. So how is any of this behaviour defined as "neglect"? How is the situation helped by removing a child into the care system, renowned not for giving children love and support, but instead spawning for them a multiplicity of extra problems?
Don't remove the child, remove half of what's on his or her plate and work with the parents, as many children's centres across the country are now endeavouring to do, so they can better handle food: that most lethal of all family weapons.
