How do you save an obese baby?

An 8-month old is "rescued" -- but what's the right treatment for someone so young?

By Mary Elizabeth Williams

Senior Writer

Published March 20, 2014 7:23PM (EDT)

Santiago Mendoza      (Reuters/John Vizcaino)
Santiago Mendoza (Reuters/John Vizcaino)

Santiago Mendoza is morbidly obese. He tips the scales at triple the average weight of his peers. The Daily News reports he "has suffered medical complications due to his weight since he was born, and has already been hospitalized on several occasions." His doctors call him a "compulsive eater" who faces, they say, a lifetime of health problems. His size inhibits his ability to move around comfortably. He is 8 months old.

After his mother, Eunice Fandino, recently sent out a plea for help, the 44-pound Colombia boy this week was "rescued" by an organization called Chubby Hearts Foundation (Gorditos de Corazon) and flown from his home of Valledupar to Bogotá for treatment. His mother says it was her "ignorance" of how to care for him that led to his current state, telling El Espectador that "He was born with an anxiety, so if he cried I just fed him."

Now, doctors are saying they're going to try to reverse his condition, "weaning him off formula and adding more fruit and veggies to his diet." Chubby Hearts director Salvador Palacio González says that after the boy is evaluated thoroughly and put on the proper diet, he will likely then have a "series of operations … Otherwise, in the future, he could suffer from diabetes, high blood pressure and severe problems with his joints."

When an adult wrestles with obesity, it's the stuff of reality TV drama. But when it happens to a child – a baby – the questions of how things got so out of control and how to best treat the problem are murky. Could Mendoza's condition really be strictly the result of overfeeding by his mother? Are the possibilities of any unusual medical reasons for his size also being explored? His highly unusual size suggests something far outside of the ordinary. But what if the problem really was that his mom didn't feed him properly? In the U.S., childhood obesity has been known to be cited as "a form of medical neglect" and children have been removed from their homes for it.  In the U.K., approximately 74 obese children have been similarly removed in the past five years. National Obesity Forum spokesperson Tam Fry told the Independent just last month that extreme obesity was "quite simply child abuse and neglect … It is a national tragedy." Make that an international one. But is Mendoza's mother, who admits she didn't know how to handle a baby "born with anxiety," a child abuser – and if so, what happens to that family now?

Mendoza's condition raises other issues as well. His doctors say they're "weaning him off formula" and trying to get him to eat fruits and vegetables, but he's not even a year old yet. Babies and their growing brains and bodies have profound nutritional needs. Though the child clearly needs a change, he also needs to be carefully fed so he's meeting all his health requirements, based on the needs of a growing child.

And then there's the suggestion that surgery may be in his imminent future. It's not unheard of. Last year a 72–pound Saudi Arabian toddler became the youngest person in the world to undergo an irreversible bariatric surgery, and in India, an obese 4-year-old underwent the same procedure. In Texas this Friday, Alexis Shapiro, the 200 pound 12-year-old whose family waged a very public fight to get her gastric bypass surgery covered by insurance, will undergo the procedure at last. A brain surgery two years ago caused her appetite and metabolism to go off the rails, and her family has been fighting to save her life ever since. She will be one of the youngest patients her surgeon has ever treated.

Children are not miniature adults. They have different responses to drugs and to surgeries and they have different nutritional needs. We are still deep in the midst of a global childhood obesity problem, and we need to figure out how to chart the ethical medical conundrums around it now. Obesity and its array of related health problems are a serious threat to millions of children. But it won't be fixed with telling families to eat more vegetables, or surgery alone. And at 8 months old, Santiago Mendoza is likely already at the beginning of a fight he'll wage his whole life long.

By Mary Elizabeth Williams

Mary Elizabeth Williams is a senior writer for Salon and author of "A Series of Catastrophes & Miracles."

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Alexis Shapiro Child Abuse Childhood Obesity Obesity Santiago Mendoza