You have to tackle the problem when the child is young, and it's often the parents that have to be managed too. But it's a new thing. One of my consultants has a patient who is very large but is doing nothing about it despite several different services offering appts and is actually using it as a way to control the family situation which is quite chaotic. That the patient got that big at a young age is a wasted issue, there's no point in dealing with that now as the problem is now that the patient is that big and what the patient is doing to help or not help thier own situation. So you can throw all the services at the problem, including social services, but you still can't make a patient, at an age where they're entitled to an opinion, do what is necessary for their health. It's incredibly difficult. This girl is in the same situation, a massive amount of help thrown at her which she just will not accept, and I don think that this is more to do with her mental health than lazy-itis. Although I do admit to personally finding it incredibly difficult to emphasise with people with eating disorders, be they overeating or annorexia. BUt my lack of empathy doesn't change the fact that eating disorders are essentially a mental health problem and not just a 'get off your lardy arse and do some exercise, it's all your own fault' situation. (There are cases like that too, but when they're this big, it's clearly something else going on too).
I once read something that said that some of the obese toddlers are actually as malnourished as children in third world countries because what they're eating provides them with nothing to aid their development. So if we consider deliberately starving a child as child abuse, then surely deliberately depriving them of nutrients is also child abuse in the form of neglect. But you then have to prove that you have offered every education and service possible and that the family have still continued to not engage before social services can act to put them on a child protection plan, or indeed in extreme cases remove them from their home. But I definitely think that at young ages, we should be looking at over-feeding your children crap as a child in need with the potential to prosecure and remove children should after everything failing, the parents still refuse to act.
Blimey... that was damn long winded of me for a saturday morning!