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By addressing disrupted areas of occupational performance, practitioners can provide a unique approach for people with this mental illness.
Reports of eating disorders and disordered eating appear throughout medical journals around the world. Previously thought to be a disorder that primarily affects young Caucasian women of upper socio-economic status, it is now widely accepted that this is not the case. Eating disorders are prevalent in countries throughout the world, in both genders, across cultures and age groups.1 The Academy for Eating Disorders recently issued a position paper stating that both anorexia nervosa and bulimia nervosa are
biologically based, serious mental illnesses that warrant the same level and breadth of health care coverage as conditions currently categorized in this way?eating disorders are significantly heritable, influenced by alterations of brain function; significantly impair cognitive function, judgment, and emotional stability; and restrict the life activities of persons afflicted with these illnesses (p. 97).2
People with eating disorders experience difficulty in all areas of occupational performance.3 These difficulties include problems in the areas of self-care, work, and leisure, as well as excessively high self-expectations, decreased interest in social and vocational activities, poor social skills, and diminished pursuit of occupations that have purpose or meaning.4 Shopping, meal preparation and cleanup, and health management and maintenance are instrumental activities of daily living (IADL) that can be severely disrupted by an eating disorder. It is important to note that even the thought of these IADL can trigger a strong emotional response.
For example, clients [with eating disorders] often find the necessary regular trip to the supermarket a frightening experience. They may feel that everyone around them believes that they are greedy and disgusting simply for buying food. They may agonize over choosing the correct size of baking potato, become obsessed with checking labels on everything they buy, or experience extreme anxiety symptoms. For many clients, the eating disorder has taken over their lives. The need for secrecy to conceal disturbed eating can lead to isolation from friends or family. Work or school may have become impossible owing to impaired concentration or the need for hospital admission. Interests and socializing may have been abandoned and energy redirected into sustaining the punishing demands of the eating disorder (p. 326).5
This article highlights the...