A Michigan couple has been charged with second-degree murder, torture, and child abuse in the death of their 7-year-old son, Casper O'Brien, who weighed 255 pounds at the time of his death. Casper died on November 4, 2025, in Flint Township, Michigan, from dilated cardiomyopathy, with morbid obesity listed as a contributing factor, according to the Genesee County Medical Examiner.
Damien O'Brien, 40, and Jessica O'Brien, 41, were charged in June. Investigators were told by Casper's mother that his daily diet included a large bag of potato chips, french fries, carbonated water, and apple juice. She also stated that she bathed him with baby wipes because he disliked water. By the time of his death, Casper was nonverbal, bedridden, and had severe bed sores.
Casper had last seen a medical provider in February 2024, 21 months before his death, weighing 104 pounds. He was referred to a pediatric endocrinologist, but his parents never scheduled an appointment.
This case is being prosecuted after the landscape for adolescent obesity treatment has been altered by the introduction of GLP-1 drugs. Medications like Wegovy, approved by the FDA for adolescents aged 12 and older in December 2022, and Saxenda, approved two years earlier, have changed treatment options. Prescribing of these obesity medications among adolescents aged 12 to 17 with obesity rose from 0.1% in 2020 to 0.5% in 2023, according to CDC data. However, these treatments are not approved for children as young as Casper.
Dr. Fatima Cody Stanford, an obesity medicine physician at Massachusetts General Hospital, emphasized that for younger children, treatment focuses on intensive, family-based care including nutrition, physical activity, behavioral support, and close medical follow-up. Medications and bariatric surgery are not standard care for this age group.
Courts in at least six states have previously considered whether morbid obesity in a child constitutes medical neglect. A 2009 South Carolina case involved a mother charged with criminal mistreatment after her 14-year-old son reached 555 pounds. In 2007, a New York case involving a 261-pound teenage girl resulted in court-ordered nutritional counseling rather than criminal charges.
Elizabeth Bartholet, a professor of law emeritus at Harvard Law School, argues that child welfare law is often too deferential to parental rights and should intervene more readily when parents fail to provide necessary medical treatment. She believes that extreme obesity cases should not be treated with less protection for children.
The O'Brien case is notable for the severity of the outcome and the decision to pursue murder charges, framing a child's dangerous weight as potentially meeting the threshold for criminal neglect. Experts suggest that medical neglect in cases of childhood obesity should be considered only in extreme situations where a child is at imminent risk of serious harm and family engagement efforts have failed.