Occupational therapists play a valuable role in helping an individual with an eating disorder recover and remain at work. Maxine Jones explains how OTs can work alongside occupational health practitioners.
Occupational therapy is a practice that looks holistically at an individual, their environment and daily tasks to evaluate their level of functioning and quality of life. Its focus is on purposeful activity and nurturing independence as someone works through a particular challenge.
Occupational therapy is an invaluable means of supporting someone with an eating disorder through recovery as part of a multi-disciplinary team of therapeutic, dietetic, and medical specialists.
Eating disorders are complex mental illnesses; they are not a lifestyle choice or a ‘phase’. They can cause significant emotional and physical distress for individuals and loved ones who bear witness to someone’s suffering.
Eating disorders
Managing eating disorders in the workplace
Importantly, there’s no ‘one way’ to suffer from an eating disorder. Not only are there multiple diagnoses (such as anorexia, bulimia, binge eating disorder or avoidant restrictive food intake disorder, or ARFID), but the way that someone experiences one of those diagnoses, and the support they need, will differ from person to person.
Eating disorders impact all aspects of someone’s life: from their relationship to others and self, to work, self-care practices, routines, food, and mealtimes. Whilst food behaviours can draw a lot of attention and concern, OTs are keen on understanding the function of the illness – we want to understand the purpose the behaviours serve to soothe emotional distress. Whilst it is about food, it’s also not just about food.
Supporting recovery
Occupational therapists work collaboratively with clients to rebuild daily structure and routines in a way that supports their recovery and moves them towards independence. To do this, they have to offer a tailored approach that puts the individual at the heart of their treatment. They’re keen on understanding someone’s motivation, reminding them of what was important to them in the past and where they want to move to. Therapists also support with pacing; ensuring that clients aren’t moving too quickly or slowly, as they make adjustments to their day-to-day routines.
In contrast to many other forms of psychotherapy, occupational therapy focuses on the here and now. This provides OTs with a unique opportunity to intervene in the moment, which differs from other therapeutic approaches which may explore the clients’ past and look retrospectively at feelings or events.
In this way, OTs support clients as they progress in recovery. Leaning into frequent ‘in-action’ work, OTs draw upon gentle exposure techniques to address specific challenges, such as body image issues or fear of certain foods. Whether it’s changing clothes, walking down the street, or engaging in self-care, clients are helped to break down activities into manageable steps to build independence and support long-term recovery.
OTs also seek to understand the impact of historical events on a client’s current functioning and take this into account when devising treatment.
The workplace can introduce a number of challenges to someone in recovery. For instance, they may find themselves dealing with negative body image and comparing themselves to others.”
How can OH and OTs work together?
Occupational therapists can work alongside occupational health professionals to ensure that a person with an eating disorder is receiving the support they need at work.
The workplace can introduce a number of challenges to someone in recovery. For instance, they may find themselves dealing with negative body image and comparing themselves to others. They might struggle with social eating – fearing judgement for eating certain foods or quantities – or attending social events and not knowing how to navigate having little control over the food and drink provided. Their relational dynamic may be very people-pleasing, with porous boundaries that mean they struggle to push back, delegate or say ‘no’.
OH and OTs can work together to support someone with these practical aspects of work by ensuring they are able to manage stress and anxiety, can be more assertive around their boundaries or perspectives, and have the right structure and routine in place to aid mealtimes.
They can also work together to promote awareness and understanding of eating disorders in the workplace, including the more nuanced symptoms that may otherwise go unnoticed and become entrenched. Examples could include team education events, resources, and signposting to support services.
OTs and OH can also collaborate on facilitating reasonable adjustments to help an employee with an eating disorder re-integrate into the workforce after time off. They can help understand what the right balance is for both the individual and the organisation.
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OTs and OH professionals should try to promote a wholly supportive workplace culture. They might work together to ensure that key team members feel equipped to have difficult conversations about eating disorders, for example.
By collaborating with occupational therapists, line managers and the individual, occupational health professionals can effectively support someone with an eating disorder to return, or remain in, work.
