Law prof highlights CPS abuses in article Civil suit pending

Article13 July 2004
The lock-up diet

by Paul Campos


Derbyshire County Council in England has threatened to take into care a
nine-year-old girl, Samantha Collier, who weighs more than 13 stone. Samantha's
parents claim that their daughter's weight problem is due to steroids that she
took to combat asthma - but that hasn't stopped the local authorities from
getting involved, after being alerted by a school nurse. Here Paul Campos,
author of The Obesity Myth, describes what happened when obese toddler Anamarie
Regino was removed from her family in Albuquerque, New Mexico.


Although obesity has not yet been criminalised in the USA, it is possible to
have your three-year old child taken from you for the offence of 'allowing' her
to become fat. That is the stark lesson of the Anamarie Regino saga, which
continues to play out in Albuquerque, New Mexico. The story of what was done to
a child and her parents by an assortment of doctors, social workers, and
government bureaucrats is a chilling tale of what can happen when people of
modest means and social status find themselves, through no fault of their own,
facing the full brunt of the prejudice that fuels the war on fat.


Anamarie - who weighed six pounds, 13 ounces at birth - gained 32 pounds in her
first eight months of life. Her mother, Adela Martinez-Regino, realised from
the beginning that there was something different about her daughter. 'She was
drinking 10 and 12 bottles a day and still wanting more', she says. So
Martinez-Regino, a native New Mexican and a counter agent for Mesa Airlines,
started taking her daughter to doctors, in what became an increasingly
desperate attempt to determine why her daughter was so large. (Besides her
weight, Anamarie soon grew to be nearly twice as tall as other children her
age, and developed a full set of teeth by the time she was a year old.)


Over the next few months, a parade of paediatricians, endocrinologists, and
specialists in rare childhood syndromes examined Anamarie. None of them was
able to successfully diagnose her condition. By the time the girl was 16 months
old, her mother had taken Anamarie to 57 doctors' appointments, yet her
condition remained as mysterious as ever. And still, Anamarie continued to grow
at a remarkable rate: she weighed 67 pounds at 16 months, 97 pounds at 28
months, and 130 pounds by July of 2000, when she was little more than three
years old.


The following month, after Anamarie's parents hospitalised her for a third time
in an Albuquerque hospital for yet more tests, her mother was taken aside by a
group of doctors and social workers. In Martinez-Regino's words, she was told
'Ana's in grave danger. We know it's hard not to give in to everything she
wants. We just think you can't handle your daughter. And we don't want her to
die down the line'.


What Anamarie's mother didn't know was that the state's Child, Youth and
Families Department was already preparing an affidavit that would accuse her
and her husband, Miguel Regino, of endangering their child's life by making her
fat. According to the social workers who filed this document, Anamarie would
'surely die' if she was not placed immediately on a rigid diet and exercise
programme. This, the social workers said, was 'something which the parents have
not been willing or able to do'. The affidavit concluded with some devastating
charges. New Mexico's social service bureaucracy claimed that Anamarie's
'family does not fully understand the threat to their daughter's safety and
welfare due to language or cultural barriers'. Furthermore, the social workers
said, Anamarie might be a victim of Munchausen's syndrome by proxy - a
psychological disorder that causes parents to harm their children in order to
draw attention to themselves.


The next few days were a nightmare for Anamarie's parents. They were told the
hospital would call security if they tried to take their child home. Deeply
confused and angered by the charges being made against them, they watched with
a growing sense of helplessness as the state proceeded to take Anamarie from
them.


Martinez-Regino's description of the final scene would chill the blood of any
parent. On the morning of 25 August, they were forced to explain to their
three-year-old that 'you will be going to stay with some different people now,
but mommy and daddy will come to visit'. Her mother recalls that, as a nurse
pushed the child away down the hospital hall in a stroller 'she kept screaming
that she wanted her daddy to push her. But we knew there were armed guards
outside, so we couldn't do anything. It was so difficult to sit there and do
nothing because you could hear her scream all the way down the hall'.

It is difficult to describe the sheer irrationality of the decision process
that led to this appalling abuse of state power. Here are just some of the
aspects of this fiasco that illustrate the depths of the craziness to which the
war on fat can drive public officials:

-- At the time she was taken into state custody, there was no evidence that
Anamarie's health was in danger. Despite her extraordinary size, an almost
endless battery of tests had concluded that she was not suffering from any
detectable cardiovascular problem, or any other major difficulties. Despite
this, the state social workers' affidavit claimed Anamarie was in grave danger
of suffering 'fatal heart damage' if she was not taken from her parents
immediately.

-- Although the justification for taking Anamarie from her parents was that she
was in immediate medical danger, the state took her from the hospital into
which her parents had admitted her three times in the previous few weeks, and
moved her to a private foster home, where she remained for the next
two-and-a-half months.

-- The state's affidavit charged Anamarie's parents with being unable or
unwilling to keep the child on an appropriate diet, when in fact they had, on
the advice of a constantly shifting cast of healthcare experts, placed her on a
series of diets, all of which they followed faithfully. These diets began at
1200 calories per day, then declined to 1000 calories, then 900, and finally
550. This final diet, which Anamarie was on at the time she was taken from her
parents, consisted of two Kindercal drinks (two such drinks might make up
perhaps a third of a normal three-year-old's daily caloric intake). In other
words, Anamarie's parents were being told to starve their child - yet even
after agreeing to do so they were accused of causing, or at least seriously
exacerbating, her still-mysterious condition, by feeding her 'too much.'


That there could even be a discussion about whether the state ought to take a
child away from her parents under these circumstances indicates how severely
the topic of fat distorts public debate in America today. It should be
unnecessary to point out that the whole idea that parental dietary practices
might play a significant role in producing a 130-pound three-year-old is
absurd. Such a theory is every bit as bizarre as the idea that Anamarie's
parents were damaging her health by forcing her to become twice as tall as
other children her age. Anyone who has ever parented small children knows how
difficult it is to get them to eat something they would prefer not to eat.


As for 'overfeeding' a toddler, lax parental supervision of a toddler's eating
habits might result in a three-year-old weighing five or perhaps even 10 pounds
more than she would otherwise weigh - but at the time of her third
hospitalization Anamarie weighed 90 pounds more than the average
three-year-old.


Anamarie's mother is not an obesity expert, but she is perfectly capable of
critiquing the bizarre idea that her daughter is three times heavier than a
normal toddler because her parents have made her that way. ' If we are
overfeeding her, then why is she so tall?' Martinez-Regino asks. 'Why did she
have all her teeth by the time she was a year old? Why does she have thick
hair, adult kind of hair? Can overfeeding do all that?' Martinez- Regino is
also well aware of the subtext of the state's claim that Anamarie's family
'does not understand the threat to their daughter's safety and welfare due to
language and cultural barriers'. A working-class woman of Mexican heritage
living in Albuquerque, married to a man who does not speak English well,
doesn't need a doctorate in sociology to understand the threat to her parental
rights emanating from that sentence. When she read those words in the
affidavit, Martinez-Regino says, 'I knew they decided about us before they even
spoke to us'.


Leslie Prichard, a paralegal and the wife of Anamarie's parents' lawyer, Troy
Prichard (the Prichards took on the case for free) asks the obvious question:
if her parents had been white, upper-class professionals, would they have been
charged with child abuse simply because their daughter was unusually large?
Troy Prichard has little doubt about what led the state to take such drastic
action. 'There were so many veiled comments which added up to: "You know those
Mexican people, all they eat is fried junk, of course they're slipping her
food." That's what they wanted to see.'


Yet whatever part class and ethnic prejudice may have played in the decision to
take Anamarie from her parents, it seems clear that another factor played an
even bigger role. 'Everybody we were dealing with was skinny. There were no
overweight doctors', said Martinez-Regino. 'People sometimes look at her and
think she sits in front of the TV and eats and eats. But ever since she was a
baby she's been moving around…. It comes down to people are fat because they
have a condition. But the public, they don't look at it as a medical problem.
They look at it as a mental problem. Her weight will go up and down. She will
never be a Barbie.'


Anamarie's story has a happy ending, at least to this point. Largely through
the heroic efforts of many size acceptance advocates, most notably lawyer
Sondra Solovay, and author and activist Marilyn Wann, a fierce legal and
political battle was fought to return Anamarie to her family. These and other
advocates volunteered countless hours of time - as well as their professional
expertise and a good deal of money - in order to bring Anamarie back home. They
played the most crucial role in an ultimately successful battle: a role that
was almost completely ignored in media accounts of the conflict.


So it was that, two-and-a-half months after she was taken from her parents,
Troy Prichard negotiated an agreement whereby the state retained legal custody
of Anamarie pending a hearing. In exchange, her parents regained physical
custody of their child. For the next two months Anamarie lived at her parents'
modest cinderblock house again, while a cadre of social workers made regular
visits, during which they sat on the family's living room couch and observed
her interactions with her parents. As part of the agreement Martinez-Regino
agreed to be evaluated by a psychiatrist, who found no evidence of Munchausen's
syndrome by proxy or any related psychological problems. In January 2001, a New
Mexico state judge dismissed the charges of child abuse the state had filed
against her parents, and returned legal custody of Anamarie to them.


Since then Anamarie has become something of a celebrity in the battle against
fat prejudice. In a particularly galling irony, her parents have been accused
of exploiting her situation to gain media attention. Such charges ignore the
fact that Adela Martinez-Regino and Miguel Regino never sought to be accused of
child abuse by the state of New Mexico, and that, given the underlying cultural
politics of their situation, fighting the battle to win back their child
through the media was one of their few realistic options.


To this day, Anamarie's parents realise they are under more or less constant
surveillance whenever they take their daughter outside their home. Recently a
state social worker called them to let them know the department had received a
report that Anamarie had been seen eating ice cream. Her mother was forced to
explain to the authorities that her child had been eating frozen yoghurt - an
approved treat within the strict confines of Anamarie's latest diet, which
forbids all candy, cake, ice cream, juice, fried food, or fast food.


As of this writing, Anamarie weighs 105 pounds - approximately 25 pounds less
than she did at her heaviest. In addition to her strictly monitored diet, she
spends three days per week at a local gym for children, called Kid Power. Here
she swims, jumps, and exercises muscles that have to be much stronger than an
average child's to simply allow her to walk.


Troy and Leslie Prichard are preparing a civil suit against many of the doctors
and social workers involved in the decision to take Anamarie from her parents.
Ironically, her parents plan to use any proceeds from this suit to take their
child to 'the best doctors in America', who they believe will be able to
determine why their daughter is the way she is, and to give her condition a
name. For Anamarie's family, this last desire is not a minor point. Her
godmother, says Martinez-Regino, is planning to have cards printed for the
benefit of inquiring strangers, who still insist on asking questions about
'what is wrong' with their daughter, and of course, about what her parents feed
her. 'The cards', says Anamarie's mother, 'will give the name of the condition
and explain what it is. Then they'll say, "Now mind your own business!"'.


The story of Anamarie Regino tells us a great deal about the meaning of fat in
America today. It tells us that, for all its pretensions to knowledge, the
medical profession still understands very little about the causes and
consequences of much of what is labelled 'obesity'. Nobody has been able to
determine why Anamarie's body is the way it is. Furthermore, nobody knows if
her size endangers her health (how could anyone know this, given the complete
failure to diagnose the nature of the underlying condition?). It follows that
nobody knows whether it is in Anamarie's best interests to severely limit her
diet.


That a barely three-year-old child was put on a starvation diet of 500 calories
per day says nothing about the potential efficacy of such a radical treatment
(again, as is so often the case with weight issues and medicine, the
Hippocratic injunction to 'first do no harm' was ignored in Anamarie's case),
but it does say a great deal about the hysteria that fat elicits among so many
doctors, social workers, and other members of helping professions.


Anamarie's story also illustrates the strength of the American belief that a
person's weight is something that is fundamentally under his or her control,
or, in the case of small children, under the control of their parents. This
belief is so deeply entrenched that it manifests itself in situations in which
it can only be described as profoundly irrational. Perhaps the only thing that
frightens Americans more than getting fat is the thought that there is often,
practically speaking, little or nothing people can do about getting fat. One
explanation for the absurdity of the state's response to Anamarie's situation
is that her skyrocketing weight became a kind of metaphor for the anxiety so
many Americans feel about their (or their spouse's, or children's, or fellow
citizens') expanding waistlines.


Most alarmingly, Anamarie's saga helps reveal the lengths to which state power
can be deployed in America today in the prosecution of the war on fat. Adela
Martinez-Regino and Miguel Regino cannot allow their child to eat a spoonful of
ice cream, or a piece of candy, or to drink a glass of fruit juice, without
running a very real risk of having their child taken away from them once again.
They and Ana live under this remarkably repressive regimen not because there is
any medical evidence that it will protect their daughter's health, but simply
because it gives the authorities a false but comforting sense that they are
'doing something' about what is, for them, a profoundly disturbing sight - the
sight of an unusually large child.


Anamarie's story illustrates the intimate relationship between, on the one
hand, slenderness and power, privilege, and money, and on the other, fat and
powerlessness, lack of social status, and relative poverty. In both instances,
these dichotomies manifested themselves along ethnic lines as well. (The
Hispanic social worker who interviewed Martinez-Regino when the state began the
process of taking her child from her insisted on doing so in Spanish, despite
the fact that English is Martinez-Regino's first language. According to
Martinez-Regino, the social worker kept demanding the telephone numbers of her
family in Mexico, even though Martinez-Regino was born in the USA and has spent
her entire life here.)


Perhaps the most striking irony of Anamarie's story is the faith her family
maintains in doctors and medicine. Despite being accused by doctors, on the
basis of no evidence whatsoever, of abusing their child, Anamarie's parents
cling to the belief that doctors can be trusted to explain the meaning of what
has happened to their daughter. Ultimately, it is this faith - a very American
faith in the ability of science and technology to answer what are, in the most
fundamental sense, political and cultural, rather than scientific, questions -
that plays perhaps the most crucial role in supporting the war on fat.


What remains difficult to see, even for those who have paid the heaviest price
in that war, is that it isn't people like Anamarie who have a weight problem.
We live in a nation in which those in authority can look at a three-year-old
girl with the 'wrong' sort of body and decide, on the basis of nothing more
than irrational beliefs born of their own fear and loathing of fat, that her
family must be torn apart. Now that is a weight problem.


Paul Campos is professor of law at the University of Colorado. This article is
an edited extract from The Obesity Myth: Why America's obsession with weight is
hazardous to your health (buy this book from Amazon UK or Amazon USA).









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