The prevalence of obesity has increased continuously since 1980 and has even doubled in more than 70 countries [
Lifestyle interventions, dieting, pharmacology, and bariatric surgery have been named as the methods typically used today in the treatment of adults with overweight and obesity [
There is strong evidence for intensive lifestyle interventions which vary up to 6 months, for clinically significant weight loss (5–10% of initial weight, approximately 8 kg) [
Researchers point at the need for all health professionals to be upskilled for effective management of the “obesity epidemic” [
The current review followed Arksey and O’Malley’s five steps of scoping review procedure with the advantage of methodological improvements done by Davis et al., Levac et al., Colquhoun et al., Tricco et al., and Peters et al. These are (1) defining the research question; (2) identifying relevant studies; (3) study selection and inclusion; (4) data charting; and (5) collating, summarising, and reporting of the results [
What characterizes the interventions involving occupational therapists identified in the current evidence? Which significant improvements in lifestyle and health behavior were made by adults with overweight and obesity who participated in interventions involving occupational therapists?
The search strategy with inclusion and exclusion criteria was developed using the PCC model (population, concept, and context) [
A three-step literature search was performed from February to April 2017 (last search: 22 April 2017) to identify studies that reported outcomes of interventions for adults with overweight or obesity, where occupational therapists were involved. Firstly, an initial literature search was made in PubMed to identify relevant keywords, synonyms, word modifications, and thesaurus terms, according to the PCC criteria in this study [
Selection of articles eligible for inclusion was guided by inclusion and exclusion criteria according to the research questions. The articles were selected in agreement with the authors. The inclusion criteria were as follows: (i) interventions in all settings addressing lifestyle in overweight or obese adults > 18 years; (ii) identified occupational therapists’ involvement in the interventions; (iii) reported outcomes on the effectiveness of the interventions between participants before and after or between groups; and (iv) both articles published in peer-reviewed scientific journals and “grey literature,” e.g., treatment reports, evaluations, and public presentations. The exclusion criteria were as follows: (i) parents to children with overweight or obesity problems; (ii) pregnant women; (iii) articles written in languages other than English, Danish, Swedish, Norwegian, or German; and (iv) expert opinions, editorials, commentaries, interviews, conference thesis, lectures, periodicals, or abstracts.
A selection form was developed to reduce the risk of selecting bias and support the iterative approach to the selection process [
Selection form.
The data charting form was developed and pilot-tested on a sample of three of the included articles in terms of further justifications. The final data charting form included information on the first author, year of publication, country of origin, publication source, study design, methods, sample size, the participants’ age and gender, intervention’s duration and content, comparator, and the role and contributions of occupational therapy to outcomes. Descriptive statistics on study results and effects at baseline, post intervention, and follow-up (when available) and
Analysis of the extent, nature, and composition of the included studies was conducted. Infographics were applied to illustrate the results, supported by narrative comments. Nonnumerical findings were subject to qualitative thematic analysis. A tabular summary of the results across the reviewed studies was made in terms of mapping the evidence for answering the research question.
The process for literature search, assessment, and selection is specified in the flowchart [
Flowchart, according to PRISMA [
A total of 13 articles representing 11 studies describing interventions addressing adults with overweight and obesity, where occupational therapists were involved, were found eligible for this review.
The articles (
Three of the identified studies were RCT’s [
Data extraction form.
Author (year), country [ref.], journal, purpose | Design, sample, age | Duration/frequency | Intervention/controls | OT role and contribution to outcomes | Outcomes | Results at discharge | Results at follow-up |
---|---|---|---|---|---|---|---|
Rynne & McKenna (1999), Australia [ |
Cohort |
3 mths in total |
IG (participants and their relatives/friends) (groups at max. 10): information on the basic physiology of diabetes; management of hypoglycemia and sick days; medications and blood glucose testing; dietary management; weight control; role of PA; foot care; motivation; Diabetes Australia services | OT as part of multidisciplinary team |
Diabetes knowledge | NS (unspec.) | NS (unspec.) |
Self-management behavior in diet | NS (unspec.) | NS (unspec.) | |||||
Self-management behavior in exercise | ( |
( | |||||
Perceptions of wellness | NS (unspec.) | NS (unspec.) | |||||
BMI | NS (unspec.) | NS (unspec.) | |||||
Metabolic control | NR | ( | |||||
Haber et al. (2000), USA [ |
Cohort |
9.75 mths in total |
IG: 40 min PA; heart rate/PA intensity calculation; information on nutrition and stress management; 20 min group discussion on social, cognitive, and behavioral issues; social skills and environmental control training; realistic and measurable health goal setting; listing health benefits and motivational inspiration; self-affirmations; linking new health behavior with existing habits; homework assignments to increase PA time and healthy nutrition; phone calls between sessions | OT as part of OT/PT undergraduate team |
Brisk walk exercises | ( |
NS (unspec.) |
Flexibility exercises | ( |
NS (unspec.) | |||||
Strength exercises | ( |
NS (unspec.) | |||||
Association for health behavior change vs the following: | |||||||
(i) Participants’ educational level |
NR |
NS (unspec.) | |||||
Regular PA (min. of 3 t./wk at ≥20 min) | NR | NS (unspec.) | |||||
Voruganti et al. (2006) |
Quasiexperiment |
20 mths in total |
IG: summer and winter modules with various outdoor activities. |
OTs as part of multidisciplinary team | [Maintenance phase] | ||
Weight loss | NR | ( | |||||
Self-esteem | ( |
( | |||||
Global functioning | ( |
Marginally improved | |||||
Self-appraised cognitive abilities | Marginally improved | NR | |||||
Brown et al. (2006), USA [ |
Quasiexperiment |
3 mths in total |
IG: weight loss and psychiatric rehabilitation principles; diet, frequent contact with professionals, dietary education, 30–45 min moderate PA 3–5 days/wk, goal setting, social and instrumental support, skill and transfer training (dining out), granted materials (calorie counts, cooking utensils etc.) |
OTs as part of multidisciplinary team |
Between-group diff.: | ||
(i) Weight |
( | ||||||
In-group diff. (IG): | |||||||
(i) Total lifestyle profile |
( | ||||||
Pendlebury et al. (2007), UK [ |
Quasiexperiment |
4 years in total |
IG (open drop-in program): measuring weight; group discussion on dietary experiences; group discussion on 8 informal rotational topics (to solve any actual issues on weight loss) | OTs as part of multidisciplinary team |
7% body weight and BMI change at 3–6–9 mths; 1–1, 5–2–3-4 y | ||
Normal BMI achieved | 23% [at the end of each patient episode] | NR | |||||
Weight loss | Sign. NRb | ||||||
Weight loss correlation with young age | ( |
NS (unspec.) | |||||
Weight loss correlation with adherence to the program | ( |
NS (unspec.) | |||||
Weight loss correlation with diagnosis | ( |
NS (unspec.) | |||||
Weight loss correlation with mono- or multimedication | NR | ( | |||||
McClure et al. (2010) |
RCT |
17 wks/4.25 mths in total |
IG (The Breast Cancer Recovery Program): of The FLOW video (McClure & Bittman, 2003) and relaxation techniques at home daily; verbal instructions and written educational material on lymphedema coping and relaxation techniques (deep diaphragmatic breathing, progressive muscle relaxation and facial massage); a question-and-answer component and group discussion at every session |
OTs as part of multidisciplinary team (team composition not declared) |
Bio-impedance z (arm swelling) | ( |
NR |
Arm flexibility | ( |
( | |||||
Volume | NS (unspec.) | NS (unspec.) | |||||
Weight loss | ( |
Maintained sign. (unspec.) | |||||
Quality of life in norm-based physical function | ( |
NR | |||||
Quality of life in general health | ( |
NR | |||||
Quality of life in vitality | ( |
NR | |||||
Mood | ( |
( | |||||
Jacobs et al. (2011), UK [ |
Cohort |
3 mths | IG 1: the solo Wii group ( |
OTs as main interventionists |
Weight: | ||
(i) IG1 |
( | ||||||
BMI: | |||||||
(i) IG1 |
( | ||||||
Motivation for PA: | |||||||
(i) IG1 |
NS, sugg. Improved | ||||||
PA level: | |||||||
(i) IG1 |
NS, remained moderate | ||||||
Bacon et al. (2012), Australia [ |
Pre-exp. explorative |
8 wks | IG: Wii Fit in individual or group sessions | OTs as main interventionists |
Total daily PA time | NS, increased | |
More positive attitudes towards PA | |||||||
Attitudes towards PA | |||||||
Increased PA, provided meaningful occupation and showed potential use of the technology | |||||||
Use of Wii Fit | |||||||
Christensen et al. (2011), DK [ |
Cluster RCT |
12 mths in total |
IG: individually dietary plan with energy deficit of 1200 kcal/day (15 min/hr); strengthening exercises (15 min/hr) and CBT (30 min/hr); leisure time aerobic fitness: 2 hr/wk; additional reducing of energy intake; 15 min circuit training during the 6th–9th mth of intervention; local sport activities and jogging outdoor during the 9th–12th mth of intervention; motivation to use training log books for home exercises; composition of one’s own diet; setting realistic easy-to-implement goals based on participants’ preferences and perception of meaningfulness; coping with cravings and practicing the intervention principles in everyday life |
OTs as part of multidisciplinary team | [Maintenance phase] | ||
Body weight | ( |
( | |||||
BMI | ( |
( | |||||
Body fat percentage | ( |
( | |||||
Waist circumference | ( |
( | |||||
BP | ( |
( | |||||
Musculoskeletal pain | NS (unspec.) | NS (unspec.) | |||||
Maximal oxygen uptake | NS (unspec.) | NS (unspec.) | |||||
Isometric maximal muscle strength of 3 body regions | NS (unspec.) | NS (unspec.) | |||||
Brown et al. (2011), USA [ |
RCT |
12 mths in total |
IG (RENEW): energy intake reduction min. 500 kcal/day; education on nutrition; PA min. of 30 min/day; individualized goal setting; eating together; 2 meal replacements a day; weekly phone support in maintenance phase, no contact in support phase |
OTs as part of multidisciplinary team |
Weight loss 5% (clinically sign.) at 3 mths | (p = .01) ∗e | NR |
Weight loss 10% (weight loss maintenance) at 6 mths | (p = .22) f | NR | |||||
Weight regain | (p = .47) g | ||||||
Differences by weight changes by site | At 3 vs 6 months: |
At 12 months: | |||||
Brown et al. (2015), USA [ |
Cohort |
6 mths in total |
IG: Education; PA (20–30 min. Moderate intensity); healthy meals; provided printed materials (recipes and books with guidelines for eating out) and exercise bands | OTs as main interventionists |
An average weight loss | ( |
( |
Increased knowledge about nutrition | ( |
NR | |||||
Increased PA | ( |
NR | |||||
Association between attendance and body weight | NS (but tended towards significance) | NR |
BP = blood pressure; CBT = cognitive behavioral therapy; CG = control group; hr = hour; diff. = difference; IG = intervention group;
Over the half of the included studies (
Interventions’ phases and length.
The extent of occupational therapy involvement varied across the identified interventions. Two studies were solely occupational therapist-led [
Various attempts to promote the healthy lifestyle and health behavior changes in overweight and obese adults were described in the identified studies. Several studies from the sample did not declare any specific occupational therapy role and contribution. However, the studies operated with methods relevant to occupational therapy. Intervention components (as focus fields in an intervention) and intervention strategies (as methods of impact on the focus fields) across the studies were synthesized and differentiated according to the level of transparency in the declaration of the occupational therapy role and contribution (Table
Intervention components (a) and intervention strategies (b) presented in the included studies.
Intervention component categories | Intervention component modalities | Declared OT role in the sample [ref.] | The roles not specifically assigned to OT in the sample [ref.] |
---|---|---|---|
Physical activity (PA) | Interventionist-led | Promoting participation in moderate exercise [ |
Promoting participation in PA [ |
In leisure time/self-managed | Providing access to exercise, e.g., with elastic bands [ |
Encouraging continued strengthening exercises and initiating aerobic exercises at home [ | |
Relaxation techniques | Interventionist-led | Practicing progressive muscle relaxation [ |
Use of relaxation techniques [ |
In leisure time | Encouraging home relaxation practice [ | ||
Nutrition | Dieting | Encouraging behavior changes by self-assessment of additional fruit and vegetable consumption [ |
Encouraging calorie reduction [ |
Meal replacement and meal preparation | In combination with identification of food preferences and ideas to preparation of favorite foods in a healthy way, moving from meal replacement to purchasing food at the grocery store [ | ||
Social eating | Providing healthy meal experience as part of group sessions [ |
Providing experiences in eating together [ | |
Cognitive techniques | CBT elements | Encouraging positive cognition [ |
Using CBT elements in promoting health behavior changes at workplace, encouraging positive thinking [ |
Coping | Reflecting dysfunctional attitudes and coping behaviors [ | ||
Memory support | Guidance in improving memory function with social support [ |
Teaching compensatory strategies for cognitive impairments [ | |
Motivational support | Guidance in using social support to motivation, listing health benefits and motivational inspiration, repeating affirmations to oneself, and environment modifications [ |
Using simplification of material, active learning, repetition, flexible methods of presenting information, visual aids and reinforces [ | |
Disease-specific topics | Mood and quality of life monitoring in postsurgical breast cancer survivors [ |
Diabetes management in relation to hypoglycemia, sick days, medication, blood glucose testing, foot care, and psychological issues [ |
Intervention strategies | Intervention strategy modalities | Declared OT role in the sample [ref.] | The roles not specifically assigned to OT in the sample [ref.] |
---|---|---|---|
Assessment | Supervising the assessors and guiding the assessment process [ | ||
Education | On nutrition | Instructing in nutrition [ | |
On exercise | Providing exercise recommendations based on clinical guidelines (USA) within a multidisciplinary intervention [ |
Recommending moderate PA 3–5 times a week [ | |
On the role of activity | Education on the role of activity [ |
Teaching the importance of daily activity scheduling [ | |
On disease | Teaching self-management of diabetes [ | ||
On stress management | Providing information and experiential learning on stress management [ | ||
Unspecified | Having focus on active learning [ |
Providing information on various rotational topics in relation to healthy lifestyle [ | |
Individual goal setting | Promoting individual choice and assistance in setting daily and weekly goals [ |
Help in setting individualized goals [ | |
Group discussion | Interventionist-led | Providing supervised discussion in small groups [ |
Building up team spirit to prevent dropout [ |
Phone call support | Providing encouragement and support to health behavior changes [ |
Weekly phone calls during maintenance phase aimed problem solving and goal setting, monthly phone calls in follow-up phase to promote sustainability [ | |
Instrumental support | Printed/written materials | Supporting behavioral changes with recipes and guidelines for eating out [ |
Providing disease-related printed materials [ |
Video guiding | Video guide for self-monitoring of disease-related health issues in breast cancer survivors [ | ||
Exercise tools | Promoting accessibility to exercise through providing elastic bands [ |
Providing training tools, e.g., pedometers, weights, stretch bands, heart rate monitors, and workout videotapes [ | |
Cooking utensils | Providing cooking utensils to promote proper nutrition [ | ||
Unspecified | Instrumental support given/unclear [ | ||
Skill training | Weight control | Training in managing weight control [ | |
Exercise self-management | Teaching to estimate own training intensity and heart-rate [ | ||
Relaxation techniques | Teaching progressive muscle relaxation [ |
Instruction in relaxation techniques [ | |
One’s own diet composition | Co-operating with dietitians in helping clients to calculate an individual diet [ | ||
Use of technology | Instructing in use of VR technology in exercise [ | ||
Self-control for sustainable health behavior changes | Planning daily behaviors that can impact weight with focus on small changes [ |
Focusing on transferring behavioral changes into habit patterns in maintenance phase, identifying small successes and issues in daily living [ | |
Social skills | Improvement of social skills [ | ||
Homework assignments | On exercises | Encouraging behavior changes by self-assessment [ |
Encouraging positive thinking with homework between sessions [ |
On nutrition | Encouraging behavior changes by self-assessment [ |
Nutrition log [ | |
Community involvement | Patient organisation | Promoting co-operation with community services [ |
Co-operating with a community support program to provide support between group sessions [ |
Family and friends | Prompting systemic and holistic rehabilitation process [ | ||
Local sport and leisure facilities | Encouraging using local sport facilities to increase daily PA [ |
BP = blood pressure; CBT = cognitive behavioral therapy; OT = occupational therapy; PA = physical activity.
Regarding the major components of lifestyle interventions in obesity treatment described in the international guidelines in treatment of overweight and obesity, one-component (physical activity,
All the studies aimed at making an impact on body weight in populations with obesity and/or risk of metabolic complications. Six studies (55%) were directly addressing weight change, while the rest focused on change in overall health behavior (
Summary of the reported outcomes.
Outcomes reported | Significant at discharge, studies ( |
Significant at follow-up, studies ( |
Nonsignificant at discharge, studies ( |
Nonsignificant at follow-up, studies ( | |
---|---|---|---|---|---|
Anthropometrics | Weight loss | 6 | 4 | 3 | 1 |
Weight regain | — | — | — | 1 | |
BMI | 3 | 1 | 3 | 1 | |
Body fat percentage | 1 | 1 | — | — | |
Waist circumference | 2 | 1 | — | — | |
Biochemical and physical | Blood pressure | 1 | 1 | 1 | — |
Metabolic control measure | — | 1 | — | — | |
Max oxygen uptake | — | — | 1 | 1 | |
Isometric max muscle strength | — | — | 1 | 1 | |
Flexibility, arm | — | — | 1 | 1 | |
Bio-impedance z (arm swelling) | 1 | — | — | — | |
Increased physical activity (alone or in small, or bigger groups) | — | — | 3 | 1 | |
Brisk walk | 1 | — | — | 1 | |
Flexibility | 1 | — | — | 1 | |
Strength | 1 | — | — | 1 | |
Lifestyle profile, physical activity subscale (between groups) | 1 | — | — | — | |
Lifestyle profile, physical activity subscale (in-group) | 1 | — | — | — | |
Lifestyle profile, nutrition subscale (in-group) | 1 | — | — | — | |
Lifestyle profile, nutrition subscale (between groups) | — | — | 1 | — | |
Musculoskeletal pain | — | — | 1 | 1 | |
Psychosocial | Global functioning | 1 | — | — | 1 |
Quality of life, in norm-based physical function | 1 | — | — | — | |
Quality of life, in general health | 1 | — | — | — | |
Quality of life, in vitality | 1 | — | — | — | |
Mood | 1 | 1 | — | — | |
Motivation | — | — | 1 | — | |
Self-esteem | 1 | 1 | — | — | |
Perception of wellness | — | — | 1 | 1 | |
Self-management behavior in exercise | 1 | 1 | — | — | |
Attitudes towards exercise | — | — | 1 | — | |
Increased knowledge about nutrition | 1 | — | — | — | |
Energy intake (in-group) | 1 | — | — | — | |
Energy intake (between groups) | — | — | 1 | — | |
Fat intake (in-group) | 1 | — | — | — | |
Self-management behavior in diet | — | — | 1 | 1 | |
Diabetes knowledge | — | — | 1 | 1 | |
Differences by weight changes by site | 1 | — | — | 1 |
Not identified outcome reports are marked with “—.”
Eight studies from the sample used weight loss to evaluate the intervention effect, and all found improvements [
BMI was assessed in five of the included in this research studies [
A significant effect on waist circumference was experienced by the participants in two studies, one RCT and one quasiexperiment [
Most studies used multiple outcome measures, such as a combination of objective anthropometric, biochemical, and physical variables and self-reported psychosocial variables. Both significant and nonsignificant findings were represented.
The current study aimed at examining the evidence from studies evaluating the effectiveness of interventions involving occupational therapists in the treatment of adults with overweight and obesity. The most reviewed interventions were composed as multicomponent and multidisciplinary, involved graduated health professionals, offered frequent client contacts, and used elevated daily physical activity combined with better nutrition control, as recommended by the evidence on managing lifestyle changes in overweight and obese adults [
Comprehensive lifestyle interventions having an impact on physical activity, diet, and behavior are recognized in other evidence as the most effective treatment aimed at weight loss in overweight and obese adults [
The current research found no significant improvement in weight from education as the only intervention form, which partly supports the importance of the comprehensive approach [
The long-term (>1 year) effect on weight loss was found in two one-component interventions from the sample [
Only three interventions operated with the clinically significant weight loss measure (≥5% of the initial body weight) [
The little focus on clinically significant weight loss in the identified interventions could be the consequence of the paucity in quantitative research on the topic, particularly RCTs, in the field of occupational therapy. We suppose that attention to clinically significant weight loss in occupational therapy interventions will become more common, as soon as further investigations of strong methodology emerge in the field, urging higher comparability of the results.
One study from the sample (an RCT with active treatment period = 6 months) showed nonsignificant weight regain in the intervention group at follow-up (12 months post recruitment/6 months post intervention) [
Lifestyle interventions longer than 1 year were associated with weight regain [
While our findings supported the evidence, no interventions from the sample assessed the effect at 5 years post intervention. However, the two studies with the longest treatment durations (20–48 months) proved to achieve sufficient weight maintenance at the final assessment showing occupational therapy potentially capable of weight maintenance up to 4 years of treatment [
From the above-named treatment elements important for weight maintenance, the two studies had their regularity, continued contact with occupational therapists, and environmental support (during the treatment sessions) in common. The presence of the other elements seemed more uncertain. Prolonged contacts with occupational therapists and supportive in-treatment environments might build up the sense of belonging through occupation in the participants and thus support weight maintenance after the initial weight loss. The positive correlation between belonging and well-being was found previously [
BMI is a commonly used and recommended variable in weight loss interventions [
Similar to the sample studies, measuring of waist circumference was rather rare in other lifestyle interventions for adults with overweight and obesity [
As seen in the previous evidence, the identified interventions involving occupational therapists belonged to the secondary and tertiary health promotions, i.e., addressing adults in the risk of impairments or with present diagnoses [
We experienced that the current occupational therapy involvement was not comprehensively explicated and transparent in the reviewed interventions. The occupational therapy role and approach to treatment were reflected in a few articles from the sample. At the same time, the intervention components and strategies described in the articles with less transparency of occupational therapy involvement were close to those with clearly declared occupational therapy involvement, independently of mono- or multidisciplinary intervention character. Both types of interventions named above had similar components, e.g., physical activity practice, nutrition adjustments, relaxation techniques, cognitive techniques, and disease-specific elements. Both used collaborating with clients, education, setting individual goals, delivering instrumental, and social support, promoting active learning and sharing experiences, and supporting skill transfer to everyday life. However, education on the role of activity, focus on enjoyment from being active, and holistic approach to rehabilitation involving family and friends were only mentioned in the articles that delivered more comprehensive descriptions of occupational therapy contribution. Those qualities may be highlighted as the professional occupational therapy contribution in the interventions for overweight and obese adults. Additionally, occupational therapists contributed to the outcomes with a more rigorous use of VR (virtual reality) technology for exercise. Surprisingly, meal preparation and coping were only mentioned in the articles with no reports on a defined occupational therapy role. Meal preparation as a therapeutic tool would often be considered by occupational therapists in treatment planning [
On the basis of the identified intervention components and strategies, all the reviewed studies could to a certain extent be linked to the previously outlined occupational therapy focus domains (e.g., “health promotion and prevention, increasing physical activity participation, modifying dietary intake, and reducing the impact of obesity”) and strategies (e.g., “assessment, modifying the environment, education, and introducing and adapting occupations”) [
The identified interventions link to occupational therapy also due to their focus on implementing of the new healthy lifestyle and sustainable changes in everyday practice related to physical activity, nutrition, and cognition, rather than only on weight-related outcomes. The evidence has described the occupational therapy role in lifestyle approaches as the mediator between some new wanted and needed healthy behaviors and an individual’s habitual conditions [
Occupational therapy contributed to the outcomes in the reviewed interventions with a holistic approach, sharing knowledge on the role of activity in people’s life, supporting the new exercise routines with technology and encouraging enjoyment from being active. Further explication of the occupational therapy role and contribution in overweight and obesity treatment would deepen the understanding of occupational therapy potential in the field and let occupational therapists be involved in the future interventions for overweight and obese individuals at all levels of health promotion. For example, the use of assessment tools and indicators for changes in lifestyle and health behavior that are relevant for occupational therapy would open the door for more comprehensive descriptions of occupational therapy impact in future overweight and obesity interventions involving occupational therapists. We hope that the current review will inspire occupational therapy researchers to improve the quality and transparency of the evidence on the topic.
Limitation of the methodological approach in this study is that scoping reviews provide an in-breadth overview on the topic, and not in-depth. This scoping review was not aimed to map all the literature on occupational therapy in the field of overweight and obesity but only focused on experimental studies from selected databases and with the identifiable involvement of occupational therapists. The selection strategy included keywords assigned by authors and may cause some of the relevant studies to be missing. Both primary and secondary articles usually are in focus of scoping reviews [
The current review suggested that the interventions involving occupational therapists may help overweight and obese adults to achieve a significant change in weight loss in the short-term. Additional studies are still needed to confirm the suggestion. Whether occupational therapy can help the achievement of clinical significant intermediate- and long-term weight loss is still to be investigated.
This study found a little improvement in the evidence quality since Haracz et al. underscored insufficiency of the evidence in this field of research in 2013–14. A few randomized controlled blinded trials were identified in this study, which was indicating ongoing development in this area of practice and research. The review showed occupational therapists being competent actors in different parts of the intervention process in both the mono- and multidisciplinary overweight and obesity interventions. We found that occupational therapists contributed to the intervention outcomes with a holistic approach, providing knowledge on the role of activity in humans, supporting changes in health behavior with technology and promoting the enjoyment from being active.
We recommend the initiation of further comprehensive lifestyle interventions, e.g., randomized clinical trials, with the involvement of occupational therapists in the treatment of overweight and obese adults in all settings. The international clinical recommendations in the field, the OT-relevant assessment methods, and long-term follow-up phases ought to be considered for inclusion in the future interventions. Further evaluations of the effectiveness of the overweight and obesity interventions for adults involving occupational therapists together with a more comprehensive explication of the OT role and contributions to the intervention outcomes will improve the current evidence in this area.
The authors are responsible for the content and writing of this paper.
The authors declare no conflicts of interest.