Treating Eating Disorders: An Occupational Therapy Approach

At the age of thirteen, I was diagnosed with anorexia nervosa. Without proper support, understanding, or resources it took me ten years to receive the appropriate treatment I needed to recover. A year into recovery, I began my journey pursuing my master’s degree in occupational therapy. Having personal experiences with mental illness, I was interested in focusing my learning on occupational therapy and mental health (specifically eating disorders).

Toward the end of my education, I was searching for a setting to complete three-months of clinical fieldwork. With a desire to learn more about eating disorders from an occupational therapist’s point of view, I reached out to several eating disorder clinics in the surrounding area, asking to temporarily join their team as an occupational therapy student. Kindly, all eating disorder clinics declined my request stating, “We cannot justify a position for occupational therapy as part of the eating disorder treatment team at this time.” Um, excuse me? What? Their responses caught me off guard and left me at a loss.

An occupational therapist is known as the ‘functional’ therapist. In other words, the goal of an occupational therapist is to return an individual to their original occupation-based quality of life, with as much independence as possible. In the midst of an eating disorder, occupations such as work, school, faith, social activities, meal preparation, eating, and hygiene can be severely impaired. After reflecting my own occupation-based deficiencies and decline of life quality due to my eating disorder, the feedback I received motivated me to prove a point: occupational therapists are not only important but critical when treating individuals with eating disorders. 

From there, I selected my master’s project based on effective and skilled-based interventions occupational therapists provide to individuals diagnosed with eating disorders. After researching, organizing, and constructing a year-long systematic review, I was able to conclude that occupation therapy is indeed beneficial to those seeking treatment for eating disorders. I identified the most influential treatment interventions and categorized them into three groups: dissonance based, mindfulness based, and psychoeducational based interventions. 

• Dissonance based. A treatment approach that challenges society’s norms or ideals. An example? The Body Project! NEDA’s group-based intervention that confronts ‘thin idealization’ and other negative societal influences. 
• Mindfulness based. A treatment approach that explores healthy coping skills. Examples include practices such as journaling, meditation, and visualization.
• Psychoeducational based. A treatment approach that educates the individual and individual’s support group on the effects, prognosis, and resources for eating disorders. 

An eating disorder strips you from experiencing a meaningful life. My eating disorder delayed me from going to graduate school, forced me to go on medical leave at work, deprived me of social gatherings, sabotaged my relationships, and left me questioning my faith. School, work ethic, family, friends, and faith are all meaningful occupations to me—and were stolen because of a disease. Had an occupational therapist been on my treatment team, they could have used skilled tools such as empathy, motivational interviewing, active listening, and evidence-based research to encourage volition or opportunities reintroducing me to meaningful aspects of life and reminding me I am so much more than an eating disorder.

Moving forward, it is the obligation of the occupational therapy community to continue to research and advocate our field’s importance in treating eating disorders. It is the obligation of the person affected by an eating disorder—the individual, families, and friends—to ask questions: Has your physician or treatment team informed you of the benefits of occupational therapy to make sure you are receiving the best care possible? 

As for me? My obligation is to provide education, advocacy, and resources so others do not have to suffer as long as I did. 

Carry on, warriors!

 

Maddie Mescher is an occupational therapist who graduated from Spalding University in Louisville, KY. She has also been a committee member of Louisville’s NEDA Walk the last two years and was trained as a Body Project leader in December. Maddie and her fiancé look forward to moving to Cincinnati where she will pursue researching and advocating occupational therapy in the realm of mental health.