How can OT help with obesity?

Nielsen, S. S., & Christensen, J. R. (2018). Occupational Therapy for Adults with Overweight and Obesity: Mapping Interventions Involving Occupational Therapists. Occupational Therapy International, 2018. Read the open access article here.

Intro:

Obesity is a problem that continues to grow around the world.  Most health concerns of excess weight go without saying - but less obvious problems are associated disability and occupational issues.

Typical frontline treatment of obesity is diet modification, behaviour change and exercise (lifestyle modification). As with so many other populations, occupational therapists are “well positioned” in theory to support people who live with obesity, but our application has been limited and evidence is lacking.

No systematic review of occupational therapy intervention in obesity has been done yet, but there have been a few studies that explore the role (see below). Could obesity be an area of untapped OT potential?

The Study:

The authors looked into the effectiveness of interventions that involve OTs in the treatment of adults with overweight and obesity.

This was a scoping review, to answer two research questions:

  1. What characterizes the interventions that involve occupational therapists (as identified in the current evidence)?

  2. Which significant improvements in lifestyle and health behavior were made by adults with overweight and obesity who participated in interventions involving occupational therapists?

Key Takeaways:

  • Effective:

    • Three-component lifestyle modification is most effective: (diet, physical activity and CBT-elements)

    • Client-centeredness, promotion of active participation, realistic goal setting, and the use of meaningful occupations make interventions more effective.

    • Diet modification with exercise is more effective than either alone

  • Ineffective:

    • Education alone is ineffective for weight loss

    • Interventions need to be long term (>1 year) to promote maintenance of effect

  • OT specific:

    • OT intervention might be effective for improving weight loss in addition to reducing disability or impairment.

    • OT given as a mono-service can have benefit, but multidisciplinary service is superior

    • OT intervention was poorly defined by the studies reviewed, probably because we “may operate with a broader understanding of lifestyle, not limited to the presence of the three components (physical activity, nutrition, and cognitive treatment)”

  • Areas for OT to shine could include:

    • education on the role of activity,

    • focus on enjoyment from being active

    • involving family and friends

    • meal preparation as a therapeutic tool

    • Coping strategies, e.g. strengthening self-efficacy

    • Putting needed healthy behaviors/habits into action

Want more? Check these papers out:

Three other sources were referenced by this study, and shed more light on the topic:

  1. Forhan, M., & Gill, S. (2013). Cross-border contributions to obesity research and interventions: a review of Canadian and American occupational therapy contributions. Occupational therapy in health care, 27(2), 129-141.

  2. Haracz, K., Ryan, S., Hazelton, M., & James, C. (2013). Occupational therapy and obesity: An integrative literature review. Australian Occupational Therapy Journal, 60(5), 356-365.

  3. Reingold & Jordan (2013). Obesity and occupational therapy. The American Journal of Occupational Therapy, 67(6), S39.