These ethical considerations regarding developmental capacity to give assent and consent suggest that intensive treatments should focus on older children and adolescents and that all decision-makers (parent, child, and physician) need to reach a consensus before beginning intensive treatment. Additionally there is concern over insurance coverage that is often unavailable or inadequate for obesity services, even if recommended by professional and governmental organizations. This issue raises questions of distributive justice, since barriers preventing payment may intensify existing socio-demographic disparities in obesity (Cuttler et al.,
