Associate Professor John Dixon, of the Baker IDI Heart and Diabetes Institute, said he expected more such cases, but that they would not become common. ''I would not want parents out there with overweight or obese children to in any way feel that it's through their negligence that we have a growing obesity issue in children today,'' Associate Professor Dixon said. ''That would be very wrong indeed … This is a community problem, an Australia-wide, a global problem that we're not addressing very well at the moment. ''We shouldn't be blaming the parents for our environment. The parents and the children who are obese are really victims of the environment.'' In the teenage girl's case, experts stressed to the department that her weight problem needed urgent attention.

She had gained 30 kilograms in 18 months and was described by a Children's Court magistrate as ''incredibly unhealthy … To hear that her waist measurement is greater than her height is so concerning.'' The court was told it would be impossible for her to reduce her weight to a healthy range within a year and a more realistic goal was to lose 15 to 20 kilograms and keep it off. Doctors had concluded that the weight gain was not genetic and had to have come from eating. The girl's mother told the court that she wanted her daughter returned home or placed in residential care. The department said foster care was not an option because there were no families available who could help with her needs. The magistrate ordered the girl remain legally in the care of the state. She and her mother had had a breakdown in their relationship that had led to the girl not living at home. In the case of the pre-teenage boy who weighed 110 kilograms, another magistrate ordered that he be removed from his mother's care and put into a ''therapeutic setting''.

The boy had been referred for medical intervention but it had no effect and he had been sitting in his room, eating and inactive. The department said it could not work with the boy's mother until he was removed from her care. A spokesman for the department told The Age that obesity was not of itself grounds for child protection workers to become involved with a family. But he said ''obesity may be a symptom of other issues that could place a child at risk or harm that would warrant child-protection involvement''. Some of Victoria's most obese children are referred to the Weight Management Clinic at the Royal Children's Hospital.

But The Age understands that the clinic is struggling with a lack of resources to deal with families where there are several obese children who need intervention. Non-urgent referrals to the clinic face a wait of between nine months and a year, but the clinic warns that in some cases, the delay could be longer. A smaller clinic operates at Melton. Associate Professor Dixon said there were many determinants of obesity in children and adolescents but parental neglect was not usually considered to be one. ''Severely obese adolescents and their parents are under enormous stress and there are often other issues in the family,'' he said. ''It wouldn't only be obesity that would lead to a child being removed.'' He said any cases where extremely obese children were removed from their families should be seen as rare.

Associate Professor Tim Gill, of Sydney University's Boden Institute of Obesity, Nutrition, Exercise and Eating, said if the only reason for removing a child from their parents was weight, it was not appropriate. ''There are a whole range of issues which drive weight gain, particularly in children,'' Associate Professor Gill said. ''We are going to see more children in that [extreme] weight category and in some ways, yes, it's a failure of parents, but it also reflects a failure of society - that we could create a circumstance that would allow and encourage kids to overeat and under-exercise to such an extent that they get to that weight.''