My home in Northwest Philadelphia, and street after street, neighborhood after neighborhood, were row houses, popular after World War II ended in 1945. Row houses were cheap for all the people returning from war.
At 3, I was old enough (I thought) to jump from the topmost step down to the pavement, all with one fell swoop, bypassing 4 other steps. Every row house had top step because the row houses were elevated. Sometimes, I banged my head on the concrete, or the brick walkway if I was a tad too confident, when I got to the bottom but didn’t say a word to my mother who was probably looking for an opportunity to yell pejoratively at me. I could’ve gotten a traumatic brain injury (TBI), I know now.
Anyway, stores sprung up, too, to meet the neighborhoods’ demands–pharmacies, delicatessens, bakeries, movie theaters, markets, and my favorite, Strawbridge’s Department Store since they carried Chubby-sized clothing.
Short, (Petite was what it would be called later), Regular, and Chubby (for fat girls soon to become Plus sizes as we know it today), and Chubby was what it was called then. Even my Brownie uniform came in Chubby sizes to meet my demands.Â
People were more honest in the days of the ’50s and ’60s and the first half of the ’70s. Political correctness was to blame and came into being the latter half of ’70s surrounding language, social justice, and cultural sensitivity. A lot of Brownie chapters and all Chubby sizes died since it became “uncomfortable” to say the truth about, or even allude to, your size or skin color.
“You’re fat. Get over it,” was a common expression, which is why, when high school came around, I dropped 40 pounds. Boys simply liked thin girls.Â
So I have experience. As a fat girl, I didn’t know any different until I was 14. “Thin was in,” not only in America but in England, too, with Twiggy in her mini-skirts plastered all over the news in the mid ’70s. If you’re too young to know who Twiggy was, Google it on your phone. It’s free.Â
Now that we’ve established that I was hugely overweight (I still think like a fat girl at home and in the market, but now, self control kicks in), brain damage and obesity together can create an ugly collaboration, magnifying risks for stroke or TBI with cognitive deterioration, emotional unsteadiness, and lackluster recovery.
Here are the reasons and there are many. First, having both obesity and brain damage can create demanding complications like medications to treat both simultaneously. Many medications used to treat brain damage can cause significant weight gain, too.Â
Rehabilitation goals may need to be changed to account for both obesity and brain injury. Each condition alone can strain the brain, but together, they often worsen cognitive decline, emotional regulation, physical disability, and utmost, recovery.
Obesity lowers BDNF (brain-derived neurotrophic factor), which helps the brain rewire after injury, making recovery after stroke or TBI more difficult. Also, obesity contributes to clogged arteries, high blood pressure, and diabetes, all of which harm the brain’s vascular system. This combination increases the risk of another stroke or more damage to previously injured areas for stroke survivors.
Furthermore, obesity elevates risks for conditions like diabetes and heart disease, which can mismanage brain injury recovery and long-term health. Also, brain damage may give poor judgment, motive to control what you put in your mouth, or memory, making it difficult to follow diet plans, make healthy food choices, or remember to take prescribed medications.Â
Obesity is linked to lethargic thinking, poorer memory, and a decrease to learn, work, build relationships, and manage daily life, especially in people who already had brain damage. Extra body weight can make rehab exercises harder and exhaustive, especially with one-sided weakness, spasticity, and fall risk.
Obesity diminishes the blood brain barrier (BBB), which is a negative process allowing toxic poisons and inflammatory molecules to access the brain more easily. There can be cognition decrease with obesity-related changes in the hippocampus and prefrontal cortex, areas tied to memory and decision-making which may worsen cognitive shortfalls post-injury.
Mood and behavior separation with obesity may alter serotonin and dopamine, which can increase depression, anxiety, and emotional state after the brain is traumatized. Obesity-related dopamine receptor points may reduce motivation and impulses, which has a negative effect on rehabilitation after brain damage.
One-handed challenges, brain fog, and memory loss can lead to poor food choices or missed meals. Limited exercise from fatigue leads to poor motivation or apathy, especially if the injury affects the frontal lobe.Â
So what helps? Anti-inflammatory diets like the Mediterranean or low-sugar diets can support brain healing and lessen oxidative stress. Early intervention may prevent long-term brain consequences. Coordinated care teams are there that address both issues simultaneously.
For people with physical limitations, adapted nutrition and exercise programs are designed. Don’t forget family and caregiver support systems can help. And talk with your doctor always about medications, supplements, and treatments that exist to provide safe solutions.
As Unknown once said, “I just need to change my taste buds to think broccoli is chocolate.”
Yeah, if it were so….
