By Ed Roth
It’s widely accepted that brain injuries can cause mental health issues such as depression and anxiety. But what about eating disorders? Anecdotal evidence would suggest so, but are anorexia, bingeing, and purging related to brain trauma?
The answer is, well, complicated.
A recent 38-month study of 107 traumatic brain injury (TBI) survivors found that 42% gained and 29% lost weight. While much could be attributed to changes in behavior, these results strongly indicated a common denominator was recognizing the importance of providing specific nutritional care.
Others suggest something more is going on. A well-documented study of four patients with severe TBI concluded that eating disorders among people with TBI don’t resemble typical forms of anorexia and bulimia. Various factors affecting changes in eating patterns were noted, including reduction in physical disorders and use of psychotropic drugs.
One patient in this study was admitted to the clinic with a gastrostomy catheter due to his refusal to eat. Upon discharge 14 months later, he was apathetic, obsessive, and refused to eat, claiming he wasn’t hungry.
All patients presented a wide range of appetite disorders, from reduction to total anorexia. There were also changes in food preference and taste, a condition many have reported during the pandemic.
So, since COVID-19 is known to affect the brain – one of the primary indicators is loss of taste and smell — could this virus reveal a key to this mystery?
Dr. Lesley Williams, Family Medicine Physician at Mayo Clinic, is a member of the international Academy for Eating Disorders. She believes the correlation can be found between malnutrition and the brain.
“With severe malnutrition, a body can’t function appropriately, including cognition and memory. In chronic cases of anorexia, brain scans reveal evidence of atrophy. The brain actually ages at a more rapid pace.
“Most younger people who are treated will improve.” Dr. Williams recalls a nurse who had restored her weight, but not the nutrition. As a result, her brain was smaller than was age appropriate. What’s worse is that it was irreversible, and she couldn’t return to her career as a nurse.
“Eating disorders can starve the brain. With bulimia, you can see an electrolyte imbalance. Losing phosphorus can translate into difficulties with cognition, putting a person at higher risk for seizure or heart attack.
“I realize it’s difficult when someone can’t see potential risks and reasons for the disorder, and their health is secondary. Many have the vision, ‘I’ll be successful at dealing with my eating disorder or will die.’ And they’re fine with that.”
Dr. Williams says the most common complaints heard by psychologists are those of cognition, including mood, memory loss, inattention. The first sign is they usually have trouble focusing. “It’s often hard to see damage if someone was successful beforehand,” because they have more cognitive wiggle room. “The A student with an eating disorder who is now getting A’s and B’s doesn’t fire off alarms. You have to be aware of baseline functioning before seeing the difference.”
Phoenix public relations executive Elizabeth Lowney can vouch for a link between brain injury and a change in her eating habits. She has had five concussions, each of which brought about a range of manifestations, including amnesia and brain fog. But her most recent brain injury two years ago was different.
“I never put the two together, but for the past two years, I don’t get hungry until dinner,” she recalls. “The concussion may have affected my central nervous system, slowing down my metabolism. The effects of brain injury are just so random.”
Malnutrition plays a key role in people of all shapes, sizes, and economic status, but the causes vary. It occurs more often in lower household incomes due to limited access to nutritious food, while those with higher incomes have access to it, but restrict themselves.
Misperceptions are also partially to blame. “In the general media, carbs are bad. But that’s not true. Without them, you can’t fire on all cylinders. However, they’re necessary for better energy levels, sleep, concentration, and reduction of irritability, even if there’s no weight change.”
What’s more, the pandemic has had a tremendous impact on the general population around the world, especially with traditional coping mechanisms removed. “There was so much media focus on access to food, and that if you’re overweight, you’ll die unless you stay in your house. It’s no wonder anxiety and eating disorders shot through the roof.”
Dr. Williams believes the decline in COVID-19 cases represents an opportunity for people to reevaluate their relationship with food. “We should cut ourselves a break and stop obsessing after gaining ‘the COVID 15’. We got through this and should celebrate.
“Think about it, from an emotional standpoint, we’ve survived something that has impacted the world. This is a triumph. If 15 or 20 pounds is what I have show for survival, I should be proud.”
“We should realize that with smart eating and dealing honestly with potential eating disorders, our bodies will take of this on their own.”
“This is true whether you’ve had a brain injury or not.”
USE YOUR BRAIN TO FEED YOUR BRAIN
While there’s no such thing as a magic brain food, there are dietary choices are superior to others. Incorporating these is smart way to promote brain health:
- Green veggies. Kale, spinach, collards, and broccoli are full of vitamin K and Lutein to help slow cognitive decline.
- Fatty fish. These are great sources for omega-3 fatty acids, which lower blood levels of the protein that lead to Alzheimer’
- Flavonoids, which give them color, help improve memory.
- Dark chocolate. This, too, contains flavonoids, which also improve blood flow to the brain.
- Tea and coffee. This should come as no surprise to anyone who thinks clearer after a cup or two in the morning.
- An excellent source of protein and healthy fats, they may help improve memory.
- Many herbs and spices. Turmeric, ginger, and ginger are chock full of antioxidants.
- Red wine. The resveratrol found in the skin of red grapes may protect against the development of destructive plaque in the brain. Of course, moderation is the key.
- Whole grains. Oats, barley, and quinoa are rich with B vitamins, which are believed to preserve memory.
- They have protein, vitamins B, D, and E, as well as yolks to help improve memory. Cholesterol can be kept to a minimum by eating in moderation.
Ed Roth was raised in Chicago and has had a long and diverse career in the entertainment and media industries. He is the Communications Director for the Brain Injury Alliance of Arizona. He currently resides with his family in Scottsdale, Arizona, where he eats well and enjoys playing tennis all year long.