Occupational Therapy in
Bariatric Care:
Joining Interprofessional Teams
An advocative and educative tool for bariatric teams,
occupational therapy practitioners & occupational therapy students
Person
People who have undergone bariatric surgery have increased psychiatric vulnerability; mood disorders, eating disorders, anxiety disorders, and substance use disorders ranged from 36.8-72.6% of this population (Sarwer & Heinberg, 2020).
Task
Individuals with bariatric needs have limited opportunities to participate in meaningful occupations; therefore, occupational disengagement and decreased quality of life is likely to occur (Vallis, 2016).
Context
The most frequently reported contextual barriers for this population included narrow chairs and seats, fear of looks or comments from others and social anxiety (Nossum et al., 2018).
Performance
Patients’ psychosocial concerns were not properly addressed prior to surgery; therefore, they were not appropriately equipped with strategies or follow-up care after surgery to promote weight loss (Kalarchian and Marcus, 2019).
Patient Experiences
People who have undergone bariatric surgery have increased psychiatric vulnerability; mood disorders, eating disorders, anxiety disorders, and substance use disorders ranging from 36.8-72.6% of this population (Sarwer & Heinberg, 2020).
Task Imbalances
Individuals with bariatric needs have limited opportunities to participate in meaningful occupations; therefore, occupational disengagement and decreased quality of life is likely to occur (Vallis, 2016).
Context: Barrier or Support?
The most frequently reported contextual barriers for this population included narrow chairs and seats, fear of looks or comments from others and social anxiety (Nossum et al., 2018).
Pre & Post-Surgery Performance
Patients’ psychosocial concerns are not properly addressed prior to surgery; therefore, are not appropriately equipped with strategies or follow-up care after surgery to promote weight loss (Kalarchian and Marcus, 2019).
Scope of Practice
Occupational therapy has many opportunities to assist within this scope of practice as OT practitioners are skilled in creating, modifying, and adapting institutional, contextual, and attitudinal barriers to enhance opportunities for meaningful engagement (Ellison et al., 2020).
Emerging Areas & Abilities
Within the profession, there are increasing opportunities to develop strong evidence-based strategies to implement with individuals and communities that are seeking bariatric surgery through a perspective of prevention and health promotion (AOTA, 2015; Pizzi, 2013).
Contextual Challenges
The sociocultural context of OT practitioners is often negative and biased towards clients who are seeking bariatric surgery (Forhan & Law, 2009; Vroman & Cote, 2011). The majority of OT students surveyed by Vroman and Cote (2011) held stereotypical and strong prejudicial beliefs towards these individuals.
Lost Utilization & Growth
Over 50% of the OT respondents thought weight management advice was not within OT’s scope of practice (Lang et al., 2013). Forty-four percent of the participants’ clients are at an unhealthy weight and the most popular form of intervention was a referral to dietitian services (Lang et al., 2013).
Our Goals
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Further inform current bariatric teams, occupational therapists, and occupational therapy students of the value that OT can bring to current bariatric interprofessional care teams.
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Provide easy-to-use resources to encourage advocacy efforts for the inclusion of OT to bariatric teams.
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Overall enhance bariatric patient outcomes through the interprofessional care team with the inclusion of OT to promote greater quality of life pre- and post-surgery.
OT Approach
Occupational therapy addresses both
physical and psychosocial health concerns as new habits and lifestyles are being adopted following bariatric surgery.
Other professions may focus on the client's:
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thoughts & emotions (psychiatry)
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nutritional intake (dietetics)
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functional mobility (physical therapy).
The attention to daily life occupations, roles, habits, routines, quality of life, and environmental impact is yet to be a focus.
About the authors
Rylee Skyberg, MOTS
Occupational Therapy Student
University of North Dakota Department of Occupational Therapy
Annabelle Tarnowski,
MOTS
Occupational Therapy Student
University of North Dakota Department of Occupational Therapy
Dr. Sclinda Janssen,
PhD, OTR/L, CLA
Occupational Therapy Professor
University of North Dakota Department of Occupational Therapy
Areas of Occupation Impacted
Sleep
Social
Self-Care
Work
Meal Prep
Leisure
(Ellison et al., 2020; Faccio et al., 2016; Vallis, 2016)
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It is essential to provide comprehensive treatment that addresses functional impacts of surgery and reintegration into daily life in addition to the surgical complications and nutritional restrictions
(Mata, Mikkola, Loveland, & Hallowell, 2015).
Special Considerations
Student Project:
This website was developed by Rylee Skyberg, MOTS, Annabelle Tarnowski, MOTS, and Sclinda Janssen, PhD, OTR/L, CLA (advisor) in partial fulfillment of graduation requirements for a master’s degree by the Department of Occupational Therapy, School of Medicine and Health Sciences, University of North Dakota. Although they were continuously under the academic and professional advisement of a licensed occupational therapist, at the time this website was created, the students had limited clinical experience. We acknowledge that the information on this website could be expanded upon and enriched by clinical experience. This should be considered when consuming the content of the website. All photos were used with permission.
Accreditation Statement:
ACCREDITATION: The UND Occupational Therapy program is accredited by the Accreditation Council for Occupational Therapy Education (ACOTE). For information regarding accreditation, contact the ACOTE at (301) 652-2682, or ACOTE, c/o Accreditation Department, 6116 Executive Boulevard, Suite 200, North Bethesda, MD 20852- 4929. The website is www.acoteonline.org. All basic professional programs must comply with the Standards for an Accredited Educational Program for the Occupational Therapist, 2011.