Obese Tot’s Case Tests Idea of Neglect

Adela Martinez stared at her bare living room, usually scattered with her 3-year-old daughter’s coloring books and building blocks. The toys have been put away.

“She usually trashes this place and calls us [into the room] to say it’s dirty,” she said. “Now, I want those days back. It bothers me not having her in her own home.”

Anamarie Martinez-Regino, who is 120 pounds and 3 1/2 feet tall, was taken from her parents and put in state custody on Aug. 25.

Doctors said Anamarie “will surely die” unless she uses a breathing machine when she sleeps, follows a special diet and exercises more--”something which the parents have not been able or willing to do,” a state court affidavit said.

Martinez, 32, and Anamarie’s father, Miguel Regino, 54, have not been charged with any crime. They defend the care of their only child, who weighed 6 pounds, 13 ounces when she was born in April, 1997 but was up to 50 pounds less than a year later. Doctors say she is three times heavier and 50% taller than the average 3-year-old.

A custody hearing is scheduled for Tuesday.

“There’s obviously a lot of factual allegations in that affidavit. Some of them are true, some of them are not,” family attorney Troy Prichard said.

Deborah Hartz, the head of the state Department of Children, Youth and Families, would not comment specifically on the case but said the department removes children from their parents only in cases of abuse and neglect.

“The main issue is not weight, the main issue is safety,” she said.

Putting children in state custody because they are overweight is rare, said Thomas Morton, president of the Atlanta-based Child Welfare Institute, which guides agencies on training and development.

“This issue appears to be a form of medical neglect,” Morton said.

On Wednesday, Anamarie saw her parents for the first time since she was taken away.

“When I saw her, I did [cry]), but it was a lot better than I thought,” Martinez said. She was told that her daughter, who is at a local foster home, had lost four pounds.

Anamarie’s absence has taken its toll on the couple, who live in a low-income neighborhood in Albuquerque’s south valley.

Martinez, who works at an airport ticket counter, said her insurance doesn’t cover Anamarie’s medical bills.

The family relies on federal disability aid. Last year, Regino quit his job at a construction firm to keep the family’s income below the eligibility cap.

Regino didn’t speak and walked quietly through the house. “He’s been very antsy because it’s getting to him. He’s not used to people butting into our lives,” Martinez said.

Martinez said that though she is overweight now, she was skinny as a child. “My brother and sister were little butterballs . . . but they weren’t like Ana, [who] grew very tall,” she said.

Anamarie has spent much of her life in and out of hospitals and has seen about a dozen specialists. She begn walking only nine months ago.

The affidavit said Anamarie has been tested for a variety of conditions but doesn’t specify the cause of the weight gain and rapid growth. Papers provided by her parents show that doctors diagnosed her with morbid obesity.

“They ask, ‘Are you sure you’re watching what she eats?’ The poor girl. Ever since she was taken off her bottle, she was on her diet,” Martinez said. A typical meal for Anamarie had been green beans, a small low-fat yogurt and a piece of fruit, she said.

Earlier this year, doctors placed Anamarie on a 550-calorie-a-day liquid diet, the affidavit said, but the family put her “at grave risk” by repeatedly feeding her solid foods.

Martinez said Anamarie has been on the liquid diet since June 10, except for one time when an 8-year-old relative accidentally fed her solid food. According to the affidavit, that doctor who referred Anamarie’s case to the state said the girl may be a victim of Munchausen syndrome by proxy, a condition in which a caregiver harms a child to get attention.

Some pediatricians doubt that suggestion. Most Munchausen cases are caused when parents intentionally infect their children with a disease, they said.

“My imagining of this scenario is not that the parents are trying to get the child to eat all the time, but rather the child has some inherent tendency to gain weight genetically and is being allowed access to the food,” said Dr. Nancy Krebs, a professor of pediatrics at the University of Colorado. “The permissiveness could be harmful.”

Most cases of obesity are caused by overeating and lack of exercise, and not medical conditions, said Dr. Robert Schwartz, a pediatric endocrinologist at Wake Forest University.

Schwartz said Anamarie is an extreme example of a larger societal problem: 20% of children and 50% of adults in the United States are overweight.