Traumatic Brain Injury: Increased appetite and weight gain

Posted by dstauffer63 @dstauffer63, Nov 20, 2022

My niece (36) suffered a traumatic brain injury in February of this year. She had a right subdural hematoma and required surgery to stop bleeding. She was in a coma for 2 months and then transferred to rehab hospital in Gardner, Ks in May, 2022. She was just discharged to my home November 2. She just recently was cleared to be able to eat mechanical soft foods and thin liquids. Since returning home she wants food constantly and says she is never full and always feels hungry. I have tried high protein meals to help to keep her stomach feeling full, yet she is still hungry even after a big meal. In the hospital when she was getting peg tube feedings she constantly complained of being hungry. She is also on 1000 mg Depakote and I know this causes increased appetite and weight gain. Since being home she has gained 15 lbs in 2 weeks. Could it be the part of her brain that regulates hunger was affected or could it be the medication or a combination? I am worried that the weight gain will hinder her progress as she continues with therapy and is able to ambulate short distances with a walker. Any ideas?

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Jennifer, Volunteer Mentor | @jenniferhunter | Nov 20, 2022

@dstauffer63 Hello and welcome to Connect. Bless you for wanting to help your niece. My dad had a traumatic brain injury and a long term hospital stay. I would direct your question to the doctors because very fast weight gain may cause other problems and if your niece also needs assistance in transferring or with balance, being very overweight will increase injury risk to her and her caregivers and therapists. My dad did not have an appetite increase because of a head injury, but he did have diabetes and heart disease which can do that. He had a skull fracture and had to learn how to swallow again, and how to use language. He used to make up words and tell me I was wrong that these were real words and they were not. H also had a quicker temper after the injury which is kind of a normal change for patients with this type of injury. What is Depakote prescribed to treat?

ellisa | @ellisaa | Nov 21, 2022

My TBI in 2008 accompanied, or was the result of a widowmaker heart attack. I was in a comma for 2 weeks, then to an advanced rehab facility, then a longer, rehab training. That took another 10 days in patient and 2 months OP. I had to learn to talk, and walked and double vision. A real pain. Finally, 3 months later i returned to work part. I finally retired im 2018 and am really enjoying that. Still have bad memory issues, and depression plus alzheimer's disease. Intresting, yet frustatrating TOO. One day at a time, i know. Just really hard to do things that used to br very easy i have to keep working on that. My awesome Wife got me a subscription to BrainHQ. It is the only scientfically proven brain game that actually, HELPS!!

Helen, Volunteer Mentor | @naturegirl5 | Nov 21, 2022

@dstauffer63 Your niece has had such a difficult year and she is so fortunate to have you at her side.

May I ask if she was in the ICU and in a Rehab unit before she came to you? What was her baseline weight before the TBI and did she lose a lot of body weight while she was hospitalized?

There are medications that can increase a person's craving for food. We might look at it as hunger but in fact the person could be well nourished but has cravings nonetheless. This is a question for your niece's brain trauma team which I hope includes a neurologist.

It's also possible that the TBI has affected her brain in such a way that she is craving more food than she needs. Hunger is regulated by the hypothalamus which connects the endocrine system with the central nervous system. The connections to and from that area of brain are complex but basically it is the hypothalamus that inhibits (stops) and releases hormones that affect hunger.

-- https://digitaleditions.library.dal.ca/intropsychneuro/chapter/hunger-and-eating/

Would you like to contact your niece's neurologist and ask questions about what is affecting her craving for food? I hope your niece's doctor will critically think about question and help you to problem solve. Other professionals on your nieces TBI team may also be helpful such as occupational therapy.

Does this help? Will you let me know when you contact your niece's neurologist what the advice is?

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