The government should have the right to remove severely obese children from their parents’ home and place them in foster care, two US doctors argued in a controversial editorial.

“State intervention may serve the best interests of many children with life-threatening obesity, comprising the only realistic way to control harmful behaviors,” wrote Lindsey Murtagh of the Harvard School of Public Health and David Ludwig of Children’s Hospital in Boston.

“In severe instances of childhood obesity, removal from the home may be justifiable from a legal standpoint because of imminent health risks and the parents’ chronic failure to address medical problems.”

Some two million children in the United States are considered severely obese with a body mass index at or above the 99th percentile, the doctors wrote.

“Obesity of this magnitude can cause immediate and potentially irreversible consequences, most notably type 2 diabetes,” they said.

Child abuse laws have long addressed situations in which children are starved or neglected, but “only a handful of states, including California, Indiana, Iowa, New Mexico, New York, Pennsylvania, and Texas, have legal precedent for applying this framework to overnourishment and severe obesity.”

Murtagh, who is also a lawyer by training, and Ludwig said that while it may be an undesirable option, placing a child in temporary foster care could allow better habits to take root and avoid the risks of weight loss surgery.

“Although removal of the child from the home can cause families great emotional pain, this option lacks the physical risks of bariatric surgery.”

The opinion piece in the Journal of the American Medical Association made waves in the medical community and US media, and JAMA issued a statement pointing out that the piece did not reflect the institution’s view.

“This commentary does not reflect policy or opinion of the American Medical Association (AMA) or JAMA. The content of this commentary is solely the responsibility of the authors,” it said.