This blog began as a journal of a Winston Churchill Memorial Trust Travel Award visit to the USA to study how Lifestyle Redesign could be used in Occupational Therapy to improve the hospital/home interface for older people. It has continued to record developments and inspiration gained from that experience since returning from Los Angeles early in 2012.

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Be Inspired-
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Saturday, 11 February 2012

Lifestyle Redesign Class- The End of Overeating

This week's class was explicitly about the issue of over eating and obesity.   
Center for Occupation & Lifestyle Redesign

Lifestyle Redesign Class at 'the Center"

 The Lifestyle Redesign methodology has 4 key components originally developed in the Well Elderly study.
  • didactic material
  • peer support (often group work)
  • occupational self analysis
  • direct experience
I am fortunate to be  following a Weight Management Lifestyle Redesign group for 8 weeks. The other students are all having the opportunity to sit in with one session. We reported back on our experiences, how we have observed the 4 components above in practice and how the OT's skills were used to ensure that the process occurs.

Some clients begin the process having repeatedly failed to lose weight in the past and are pessimistic about their prospect of doing any better this time. The intervention aims to allow them to develop a sense of self efficacy initially, often in small stages, so that they can continue to set clear, progressive goals. Others attend as a requirement of their insurance company in preparation for having bariatric surgery and may have low motivation as they believe that surgery will provide a 'magic solution', or even fear that if they lose weight they may be refused surgery. Here the OT takes an educational approach, to allow clients to understand that even with the surgery they will need modified eating habits to ensure a successful outcome in the longer term and to cope with the very restricted regime for the first few months post surgery.

Camille referred to a paper we will be looking at in more detail later that investigates the elements of successful weight loss. There are complex issues involved that are linked to behaviours developed over a lifetime and therefore closely entwined in daily occupation. If weight loss interventions are situated in the context of the complexities of daily life routines - OT's area of expertise- this can help to ensure successful and sustained weight loss. In this model the keys to success are:
  • habit training
  • occupational self analysis, or considering the link between 'doing' and eating
  • healthier habits are embedded into the real fabric of everyday life 
 In the group I am observing and form the feedback form other students, it is evident that this approach is motivating the participants.
Feed back from The End of Overeating...

We covered a large amount of readings for this class and divided these up to give a 5 minute synopsis each. I had 6 chapters from a book I would highly recommend:

Kessler, David.  (2009). The end of overeating: Taking control of the insatiable American appetite.  NY: Rodale.

It's fascinating. It talks about what the food industry does to make food highly palatable and constantly available, how this has changed the way we respond to it, and how we can regain control.

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