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Brain Injury Survivors Who Become Obese Face Greater Risk for Chronic Illness

Being overweight or obese is linked to a greater risk for chronic diseases among survivors of moderate to severe traumatic brain injury (TBI), particularly over time, according to a new study published in the Journal of Head Trauma Rehabilitation (JHTR).

The findings emphasize the need for a proactive approach to managing weight and related health conditions in long-term TBI survivors.

“Being obese or overweight presents a health risk in the years following rehabilitation for TBI,” write the researchers, led by Laura E. Dreer, Ph.D., of The University of Alabama at Birmingham.

During the early recovery period, patients often lose weight due to increased metabolic rate and other physical effects of TBI. In the later phases, however, weight gain may occur due to a wide range of factors including medical conditions, medications, cognitive or behavioral changes, physical limitations, and lack of transportation or other resources.

“Achieving and maintaining a healthy diet and engaging in regular physical activity following a TBI are critical goals for recovery,” the researchers write.

The study involved 7,287 adults with TBI who had undergone inpatient acute rehabilitation which consisted of intensive therapy provided by a team of specialists and designed to improve physical and mental functioning.

About three-fourths of the patients were men with an average age of 46 years. The associations between body weight and functional and health outcomes were evaluated between one and 25 years after TBI. At the most recent follow-up, 23 percent of TBI survivors were classified as obese, 36 percent as overweight, 39 percent as normal weight, and three percent as underweight.

Being overweight or obese was less likely among patients under age 30, as well as those aged 80 years or older. While the percentage of overweight patients was relatively stable, the obesity rate increased over time — especially five years or longer after TBI.

Being overweight or obese was strongly linked to several chronic health conditions, including high blood pressure, heart failure, and diabetes. Overweight/obese patients also rated themselves as having poorer general health. The frequency of seizures — a common problem among TBI survivors — was also related to differences in body weight and health status.

The overall prevalence of overweight/obesity in the TBI patients (59 percent) was lower than reported in the general U.S. population (over 70 percent). This may be attributed to several reasons in need of further research; for example, a higher rate of health complications, rehospitalizations, medication side effects, or death among individuals who were already obese at the time of TBI and thus were excluded from the follow-up study.

The new study confirms that being overweight or obese is associated with significant health problems for survivors of moderate to severe TBI who require acute rehabilitation. The researchers note some important limitations of their study, including the lack of information on the timing of weight problems and associated health conditions.

“However, these findings do highlight the potential importance of surveillance, prevention, and management of weight and related health conditions during the years postinjury,” said Dreer and colleagues.

“Lifestyle and health behaviors related to weight gain will need to be a component of any proactive approach to managing TBI as a chronic health condition.”

Source: Wolters Kluwer

 



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