Being Obese Can Complicate Recovery from TBI

September 20, 2018, Kitchener, Ontario

Posted by: Robert Deutschmann, Personal Injury Lawyer

New studies show that being obese may complicate the already difficult recovery faced by victims of TBI. It appears that obesity compounds the health challenges that survivors face during the years after their injury.

Research conducted by Dr. Laura Dreer and her colleagues at the University of Alabama’s Nutrition Obesity Research Centre concluded that “"Achieving and maintaining a healthy diet and engaging in regular physical activity following a traumatic brain injury (TBI) are critical goals for recovery".

“Obesity and Overweight Problems Among Individuals 1 to 25 Years Following Acute Rehabilitation for Traumatic Brain Injury: A NIDILRR Traumatic Brain Injury Model Systems Study”

Dreer, Laura E., PhD; Ketchum, Jessica M., PhD; Novack, Thomas A.; Bogner, Jennifer, PhD; Felix, Elizabeth R., PhD; Corrigan, John D., PhD; Johnson-Greene, Doug, PhD; Hammond, Flora M., MD, FACRM, FAAPMR Section Editor(s): Bushnik, Tamara PhD The Journal of Head Trauma Rehabilitation: July/August 2018 - Volume 33 - Issue 4 - p 246–256 doi: 10.1097/HTR.0000000000000408

Being obese or overweight presents a health risk in the years following rehabilitation for TBI. The findings support the need for longitudinal studies and highlight the advisability of monitoring weight and promoting healthy lifestyle behaviors over time in survivors of TBI.

 

OBESITY IN THE UNITED STATES has become a significant public health problem.¹ Being overweight or obese is associated with greater health risks such as cardiovascular diseases, type 2 diabetes, hyperlipidemia, hypertension, cerebral vascular accidents, sleep apnea, respiratory problems, depression, some forms of cancer, lowered cognition, and even mortality.^2, 3 In general, people with disabilities are more vulnerable to problems with weight management. According to the Behavioral Health Risk Factor Surveillance System, obesity rates for adults with disabilities are 58% higher than for adults without disabilities, with annual health care costs estimated at approximately $44 billion.⁴ Secondary health conditions associated with obesity/overweight among adults with disabilities can compromise recovery and limit opportunities for community engagement in work, leisure, and physical activity.⁵

Adults with a moderate or severe traumatic brain injury (TBI) often experience changes in neurocognitive functioning, emotional well-being, sleep/fatigue, pain, motor functioning, balance, and/or seizures that can negatively affect weight and participation in weightmanagement behaviors (eg, physical activity; healthy diet).^6 , 7 Other factors may also limit physical functioning (eg, orthopedic injuries; surgeries) and dietary intake (eg, medications; dysphagia; hypothalamic disorder compromising endocrine control),^8 , 9 thereby affecting weight.

Achieving and maintaining a healthy diet and engaging in regular physical activity following a TBI are critical goals for recovery.¹⁰ Immediately after injury, nutrition and level of physical activity often drastically change,^11 , 12 influenced in part by disruption of anatomical, biochemical, and endocrine pathways in the central nervous system.^{8 , 9 , 13 , 14} Early in recovery, weight loss is often evident related to hypermetabolism, hypercatabolism, reduced caloric intake, and/or altered gastrointestinal function.¹⁴ In later phases of recovery, increased oral intake and calories, coupled with reduced mobility and physical activity, promote weightgain. This trend may continue over the course of long-term recovery, given problems with sleep, pain, sedentary lifestyles, depression, medication side effects, and limited transportation. Thus, it is reasonable to suspect that people experiencing TBI are at risk for unhealthy weight gain and associated health problems. However, research examining weight/obesity issues among persons with TBI is scarce. Of the few studies to date, findings indicate greater complications and mortality among patients with TBI who are obese at the time of injury,^{7 , 15 , 16} higher prevalence of obesity at the time of inpatient rehabilitation (13.2%),⁶ and initial weight loss/gain over the first year post-TBI.^14 , 17 Further research is needed to better understand problematic weight among patients with TBI. Therefore, the purpose of this study was to assess the relations between the prevalence of weight classifications (obesity, overweight, normal, underweight) at postinjury years 1, 2, 5, 10, 15, 20, and 25 and demographic and injury characteristics, as well as functional, life satisfaction, and health outcomes using a large-scale database of TBI survivors.

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Deutschmann Law serves South-Western Ontario with offices in Kitchener-Waterloo, Cambridge, Woodstock, Brantford, Stratford and Ayr. The law practice of Robert Deutschmann focuses almost exclusively in personal injury and disability insurance matters. For more information, please visit www.deutschmannlaw.com or call us at 1-519-742-7774.

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