Furthering the Mind/Body Connection: Secondary Eating Disorders From Traumatic Brain Injury
As the field of traumatic brain injury (TBI) research continues to flourish, scientists have worked to identify the complex relationship between brain injury and the development of secondary mental illnesses. According to landmark research from the National Institutes of Health, about 1 in 5 people who sustain a TBI will experience new symptoms of a mental health disorder within 6 months of injury. These symptoms typically align with signs of post-traumatic stress disorder (PTSD), depression, or anxiety. However, neuroscientists recognize that altered neural pathways following TBI may lead to the development of other disorders that can further reduce a person’s quality of life following injury.
Among these are eating disorders, which are defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as “a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food, and that significantly impairs physical health or psychosocial functioning.”2 Eating disorders comprise a diverse array of behaviors and symptoms, but all types of eating disorders are associated with significant mental and physical consequences.
Research suggests that TBI can damage regions of the brain that regulate impulse control and disinhibition, which may lead to loss of control over eating.4 This, in turn, can lead to binge eating disorder (BED), a type of eating disorder characterized by eating large quantities of food in a short period of time with loss of control over the amount of food consumed.2 Disruptions to neural pathways that regulate food intake can also lead to development of atypical forms of anorexia and bulimia.5,6
Lifestyle changes that occur after TBI can also cause weight- or appearance-related concerns that may trigger an eating disorder.5 For example, a person who has sustained TBI may need to take a break from their normal exercise routine during recovery or may gain weight as a result of new medications. Coupled with potential damage to brain regions associated with food intake, these sudden changes in appearance or weight may increase a person’s risk of developing unhealthy food-related behaviors that may eventually become an eating disorder.
Given the potential for developing an eating disorder following TBI, loved ones of people who have recently sustained a head injury should remain aware of the primary warning signs of an eating disorder. Some emotional and physical symptoms of eating disorders include:
- Preoccupation with weight, food, calories, or content/quality of food
- Withdrawal from typical activities or social relationships
- Behaviors and attitudes fixated on weight loss, dieting, and control over food
- Frequent checking in the mirror for perceived flaws in appearance
- Dizziness, especially upon standing
- Noticeable weight fluctuations, both up and down
- Difficulty concentrating
- Cuts and calluses across the top of finger joints (caused by induced vomiting)
A more comprehensive list of signs and symptoms, a screening tool, and other important resources are available online. Early intervention for eating disorders is associated with better long-term outcomes, and proper nutrition is essential for brain healing after TBI. As a result, it is critical to identify and seek help for these behaviors as soon as they occur.