1. Obesity and Healthy Occupation CAOT Professional Issue Forum June 14, 2008 Mary Forhan, PhD candidate McMaster University, Hamilton ON

2. Meeting Objectives ► Understand the health status, cultural, social and political issues related to obesity and opportunities for healthy occupation ► Understand the impact of limited access to occupational therapy services for populations with obesity issues ► Identify issues that impede access to occupational therapy services ► Identify strategies to facilitate access to opportunities for participation in healthy occupations ► Inform the development of a position statement and strategic plan to improve access to occupational therapy services for populations with obesity issues

3. Functional Implications ► Limited mobility ► Fatigue ► Decreased range of motion ► ADL limitations

4. Implications for Occupational Performance Self-careProductivityLeisure ► Mobility in home and community ► Challenges with personal care ► Decrease stamina for meal prep & physical activity ► Increased disability days ► Hiring bias ► Education bias ► Reports of challenges for caregiving, household chores ► Social isolation ► Limited access to recreation environments

5. Sources of influence on occupational performance ► Personal ► Social ► Environment ► Political ► Media

6. Opportunities for healthy occupation ► Prevention Initiatives that promote healthy eating and active living ► Evidence based obesity treatment

7. Prevention Strategies -Healthy eating & active living guides -ParticipACTION -Child fitness credits -Access to food and recreation Public Opinion Access to Evidence Political Environment Factors that drive prevention strategies

8. Access to OT services Type of Service OT Role Setting Health Promotion ConsultantEducatorAdvocateResearcherOut-patientIn-patientCommunitySchoolPost-secondaryIndustry Obesity Treatment ConsultantEducatorAdvocateResearcherOut-patientIn-patient Private sector CommunityIndustry

9. Issues that impede access to OT services ► Limited knowledge about obesity by OTs ► Lack of awareness of potential of OT contributions to prevention, treatment and management of obesity ► Limited value to supporting obese persons to participate in occupations ► Funding for OT not identified on team grants to include OT

10. Compensation Work around the obesity -use technology -use mechanics -modify treatment approaches -gather supports Remediation Reduce or eliminate obesity -participate in evidence based weight Loss strategies Adaptation To the built environment -room configurations -transportation -places where we work, play, learn and live Advocacy For the rights of obese persons -enable occupation -to be included in research -access to evidence based treatment Interventions Contributions of OT for Obesity

11. Occupational therapy is the art and science of enabling engagement in everyday living, through occupation; of enabling people to perform the occupations that foster health and wellbeing; and of enabling a just and inclusive society so that all people may participate to their potential in the daily occupations of life. Ref. Polatajko, Davis, Stewart, Cantin, Amoroso et al., 2007 p. 27 Positioning occupational therapy and obesity