Difficulties in Dieting

This blog is mostly going to cover the experiences I have working with traumatic brain injury patients and their specific health and psychological issues.  Each week I will try and base my topic on an event that has happened at work that week and has some aspect of health psychology involved. 

With TBI, we often see clients who are overweight and some who are obese.  This is often a direct result from the brain injury, sometimes from a lack of exercise due to physical limitations, sometimes from a neurological problem, or perhaps even an emotional problem.  My goal, as a facilitator, is to help our clients stay healthy and encourage them to make the proper nutritional choices.  A few of our clients are on special diets, which can certainly complicate dinnertime.  In addition, as part of the rehab process, we will take our clients out to eat at their favorite restaurants.  

I should probably take a moment to explain that, if it's not well known in the real world, TBI patients are usually a bit different than the rest of the population.  Characteristics can include social disinhibition, memory loss, emotional outbursts, psychological disorders, and a general "wearing of the emotions on the sleeve," among many other things.  Our clients can be quite frank with us, and they will never hide their true feelings and frustrations.  

Special diets with TBI patients can be particularly tricky because of some of these traits.  When going out to a restaurant with a client on a low-carb diet who doesn't really enjoy low-carb food items, it can be a challenge to keep them happy and have them stick to their diet.  It's also a delicate balance between suggesting healthy food items and not just telling them what they are "not allowed" to order, as we aren't able to stop them if they make a bad decision, just guide them in their choices.  However, clients will often be defensive about our suggestions and become easily frustrated that they "can't" order what they want.  Outbursts are typical in a situation like this, and can escalate quickly.  

Dieting can be such a complicated and involved process for individuals with TBI, it's no surprise to me that so many struggle to lose weight or just give up altogether.  Those who do lose weight have to work just as hard to keep it off.  The benefits of losing weight are worth the struggle for some clients, though.  Not only the health benefits, but just being more comfortable sitting in a wheelchair, or being able to fit in an specialized airplane seat so that they can finally go visit their family.