An eight-year-old boy who weighs more than 200 pounds is now in foster care.
Social workers the Department of Children and Family Services in Cuyahoga County, Ohio, took the child from school in October.
"This child's problem was so severe that we had to take custody," department spokeswoman Mary Louise Madigan said.
Madigan said after working with his mother for more than a year and seeing little progress, the Juvenile Court agreed to removing him from his home.
Government growth charts show most boys who are eight-years-old should weigh around 60 pounds. Severely overweight children are at risk to develop diabetes and high blood pressure.
The case, however, is fueling the debate on whether parents should lose custody if their child is severely obese.
"There's no easy answer when it comes to determining who's to blame in such obesity cases," said Dr. Naim Alkhouri, who works with overweight children and their families at Cleveland Clinic Children's Hospital.
"It's not only the parents or the child," he said. "Obesity is an epidemic in the United States. As a society we're all responsible."