What’s the connection between eating disorders and brain injury? A lot!!!

The linkage between eating disorders and the brain-injured is extraordinary and can involve a variety of behavioral, psychological, and neurological effects. Traumatic brain injuries (TBIs), strokes, and other types of brain damage can affect the brain regions responsible for regulating cognition, emotions, impulse control, and general body feelings.

Here are some of the essential ways in which eating disorders and brain injury are often related.

1. Emotional and Psychological 

Brain-injured people can often have changes in emotional stability, like depression or anxiety. Psychological effects can trigger chaotic eating behaviors, serving as a way to cope for misery.

• Individuals who have heightened emotional sensitivity after a brain injury can opt to food for comfort, leading to binge eating or passionate overeating.
• Brain injuries can change perceptions, leading to preoccupation with how much the scale says, resulting in eating disorders like anorexia nervosa or bulimia nervosa.

2. Appetite and Eating Behavior 

Regions of the brain play a critical role in regulating hunger and impulse control related to eating like the frontal lobe, hypothalamus, and insula cortex damage. 

• Damage to the frontal lobe can result in changes in impulse control and decision-making. Detriments can affect self-regulation, elevating the risk of binge eating, for example.
• The hypothalamus region helps restrain hungriness. Damage to this area can break up signals, potentially leading to overeating (hyperphagia) or poor appetite (anorexia), which are most often seen in individuals with injuries to the brain.
• The insular cortex region is necessary for body awareness. If this area is damaged, individuals can misread body signs, such as near-starving or overeating.

3. Cognitive and Behavioral 

Cognitive loss, like problems with attention and memory, are common among the brain-injured. Those difficulties make it hard for people to stick to good eating habits leading survivors who may struggle with meal planning and/or preparation.

• Binge eating involved in impulse control, such as damage to the frontal lobe, may experience binge eating disorder or bulimia, where binge eating is followed by purging.
• Obsessive-compulsive behaviors might lead to preoccupation with calories and body image or restrictive eating, like only eating in a certain time-centered window every day.

4. Environmental and Social

Changes brought by brain injury often affect environment and social life, which can affect eating behaviors.

• Survivors who are brain-injured may rely on caregivers, and go off-center about the times they eat or the contents of the meal if the caregivers quit or take a leave of absence, resulting in eating as a way to assert control over some aspect of their lives.
• Brain injury survivors may use social isolation as a result of physical impairments, communication blunders, or emotional struggles. Invoking isolation may lead to overeating for soothing contentment or not taking enough food, leading to refusing any social dining.

5. Taste and Smell Changes

Cranial nerves or orbitofrontal cortex regions can alter the taste and smell in brain injuries, leading to appetite and/or food preferences.

• Loss of taste or smell might diminish the pleasure of eating, resulting in loss of interest in food or those who stop eating altogether, which contribute to malnutrition.
• On the other hand, brain injury may cause overeating as a way to compensate for the diminished taste which could contribute to overeating or binge eating.

6. Side Effects from Medications 

Brain injury survivors very often have medications that could affect appetite and weight, like antidepressants, epileptic drugs, or steroids that can have side effects. 

• Medications may cause a loss of appetite, such as in the form of nausea or stomach upset.
• Medications can also cause weight gain or increased appetite, like steroids, leading to overeating or binge eating.

There’s a lot going on with brain-injured individuals, and a lot of it isn’t good, or even fair.

As Julia Zakrzewski, RD, Registered Dietitian and Lead Nutrition Editor for Nourish, says, “Close your eyes and try to relax by doing some deep breathing—take a long breath in for three seconds and exhale for three counts. Repeat this until you feel calm, then imagine a version of yourself in the future that has recovered from an eating disorder.”

Damn. She’s right. But brain cells don’t regenerate. Enter neuroplasticity to help you find new pathways! (https://talesofastrokesurvivor.blog/what-is-neuroplasticity-anyway-you-might-be-surprised/)