Assessment of adolescent obesity from the perspective of the Kawa (River) Model: a case report

Abstract

Introduction: Adolescent obesity adversely impacts participation in everyday life activities and limits occupational performance. Factors such as sedentary lifestyle, irregular sleep patterns, and social isolation further challenge adolescents’ ability to maintain a healthy and balanced life. Objective: This case report aims to explore the barriers and strengths experienced by an adolescent with obesity by examining physical, psychological, and environmental factors through the lens of the Kawa Model. Method: This single-case study explored the occupational participation of a 15-year-old adolescent diagnosed with obesity using the Kawa Model. Through the model’s process, the participant created a river diagram representing her life flow, which facilitated the identification of personal strengths, challenges, and environmental influences affecting her engagement in everyday activities. Results: The findings revealed imbalances in activities of daily living, poor sleep quality, and limited social skills. The Kawa Model analysis identified key factors affecting the participant’s life flow, including time-management difficulties, disrupted sleep patterns, reduced social engagement, family conflict, and peer bullying. Conclusion: This case report demonstrates how the Kawa Model can be applied to gain a holistic, client-centered understanding of the environmental, social, and personal factors influencing occupational engagement in an adolescent diagnosed with obesity. Although the findings reflect the experience of a single participant, they provide insights that may help inform individualized therapeutic planning in similar contexts.