A startling Public Service Announcement from Children’s Healthcare of Atlanta has a harsh message for moms: if your child is fat, it’s your fault, even if he’s not a child anymore.

The video starts with a 32-year-old, 300-lb man, Jim, on the operating table after he’s just had a heart attack as life flashes backwards before his eyes. It’s a series of unhealthy choices, like ordering fast food and sitting on the couch, interspersed with warnings from doctors about his weight getting out of control. But as the flashbacks go further and further back, more of the blame gets shifted onto his mother– she took him to get fast food, she let him drink sugary juice, she even fed him french fries when he was a baby. “It’s the only thing that’ll make him stop [crying,]” she responds when her skeptical friend says “I still can’t believe you give this child french fries.”

The PSA ends with the text: “Your child’s future doesn’t have to look like this,” placing the blame for the adult man’s weight squarely on his mom.

While there are points where the mom does seem to be encouraging unhealthy behavior, like feeding a baby french fries, she also appears to care about his excessive weight gain. She buys him a treadmill, takes him to the doctor, and does other things to help him slim down. The organization even included a fake diary, called “Confessions of Jim’s Mom,” in which she describes how difficult it is to make healthy choices for her son. It includes “confessions” like:

I’m a little concerned about an article I read about juice being bad because it’s full of sugar. But if I take away the sippy, Jimmy throws an even bigger fit. What’s a tired mama to do? (I say, give the boy his juice. What’s a little extra sugar when it makes him so happy—and keeps me sane!?)

And:

I love my son with all my heart and I want him to be healthy. But I honestly don’t know how or where to start. Deep down, I wonder if I’m to blame for his weight problem. But if I force him to eat food he dislikes and do activities he hates (while the jocks tease him even more), he’ll resent me. I just want my boy to be happy.

On the one hand, numerous studies have shown that parents influence everything about their child’s weight, from their genetic makeup to their eating habits. But isn’t a 32-year old man responsible for himself at a certain point? Is it really fair to blame the mom entirely for something that an adult man has the power to change?

Children’s Healthcare of Atlanta seems to acknowledge that this PSA could cause a lot of guilt. “As parents (and humans), we’ve all made decisions that didn’t look too good in hindsight,” they say on their website. “But today, right now, we have an opportunity for a life changing do-over. It’s true. We can rewind the future by doing something differently today, and literally change our story’s ending.”

But is it too late for moms of obese adults? Is it really all their fault?

Write to Charlotte Alter at charlotte.alter@time.com.