A stroke can have a profound impact on a person’s health and daily life. One common but less-talked-about aftereffect of stroke is a change in appetite and eating habits. In this article, we’ll explore the link between stroke and increased hunger, why it happens, and tips for managing appetite after stroke.
Why Do Strokes Increase Appetite?
There are a few reasons why strokes can leave survivors feeling hungrier than usual:
- Injury to parts of the brain that regulate appetite and fullness signals. Strokes cause damage to brain tissue, which can impair normal hunger cues if areas like the hypothalamus are affected.
- Increased nutritional needs for recovery. Healing the brain after a stroke requires extra energy and nutrients. This can drive up appetite as the body seeks fuel for repairing itself.
- Medication side effects. Some post-stroke medications like steroids may increase appetite as a side effect.
- Depression. Strokes often lead to depression, which can manifest as overeating and craving carbohydrates.
- Reduced activity levels. Limited mobility after a stroke means the body burns fewer calories at rest, which can spur food cravings.
In many cases, post-stroke hyperphagia (excessive eating) is the body’s natural response to the increased metabolic demands of healing and recovery. But unchecked, it can lead to unhealthy weight gain and associated health risks.
How Common Is Post-Stroke Hyperphagia?
Estimates vary on how many stroke survivors experience increased hunger and overeating afterward:
- One study found up to 65% of stroke patients reported excessive appetite within one year of their stroke.
- Up to 60% of stroke survivors experience hyperphagia within 3 months post-stroke, per some research.
- Women may be more likely to overeat after a stroke, with one study reporting hyperphagia in 73% of female participants versus 48% of males.
While hyperphagia appears relatively widespread following strokes, it can be an under-recognized phenomenon. Patients and doctors may focus more treatment on restoring motor skills and speech rather than altered eating patterns. But identifying and managing hyperphagia is key for optimal recovery.
When Does Post-Stroke Hyperphagia Onset Occur?
Increased appetite after stroke can begin:
- Immediately – Some patients experience ravenous hunger right after their stroke, before hospital discharge.
- Weeks later – For many, hyperphagia kicks in after returning home as they regain appetite and mobility.
- Months later – It may take months for full hyperphagia symptoms to emerge.
Post-stroke hyperphagia seems to peak around six months after the stroke but can persist up to a year or more if uncontrolled. The onset timeline varies by individual though based on stroke severity and location.
What Are the Effects of Post-Stroke Hyperphagia?
Consistently overeating after stroke can lead to several nutritional and health consequences:
- Weight gain – Excess calorie intake typically results in rapid, significant weight gain, sometimes upwards of 20-30 pounds.
- Diminished recovery – Weight gain can hamper mobility, independence, and rehabilitation progress after stroke.
- Diabetes risk – Sugary, high-carb cravings can increase blood sugar and the chance of developing diabetes.
- Heart disease risk – Added weight stresses the cardiovascular system and boosts risk for heart attack and stroke.
Unchecked hyperphagia can essentially counteract the rehabilitative efforts and progress made after stroke. Consulting a dietician and addressing altered hunger signals is key for recovery.
What Foods Are Commonly Craved After Stroke?
The types of foods desired during post-stroke hyperphagia include:
- Starches – bread, pasta, potatoes
- Sweets – sugary snacks like cakes, cookies, candy, ice cream
- Fatty foods – pizza, burgers, fries, chips
- Salty snacks – pretzels, chips, crackers
- Sugary drinks – soda, fruit juice, sweet tea
In general, high-calorie comfort foods with plenty of carbohydrates and salt seem most appealing. More nutritious items like fruits, vegetables, and lean protein are often less desirable.
Why Are These Foods Craved?
There are a few reasons stroke survivors gravitate toward starchy, sugary, and salty foods:
- Brain circuits involving dopamine and reward pathways may drive cravings for indulgent comfort foods high in fat and sugar.
- Carbs may be sought out as an efficient source of energy for the recovering brain and body.
- High-calorie foods provide maximum energy density per bite compared to healthier items.
- Salt cravings help replenish sodium levels, which may be depleted after hospitalization.
While these cravings come naturally after stroke, giving in to them excessively can impede long-term health. Moderation and making healthier substitutions can help manage hunger while avoiding nutritional pitfalls.
Tips for Coping With Post-Stroke Hyperphagia
If stroke has left you frequently hungry and craving unhealthy fare, the following strategies may help:
Work With a Dietitian
Consult a registered dietitian or nutritionist. They can review your calorie needs, food intake, and weight changes to create a balanced eating plan for your condition.
Eat Regular, Substantial Meals
Don’t skip breakfast, lunch or dinner. Eating enough at meals prevents excessive snacking later. Include filling protein and fiber.
Limit Access to Problem Foods
Don’t keep trigger foods that lead to binges in the house. Out of sight can mean out of mind.
Portion Out Snacks
Pre-portion snacks like nuts or chips into individual baggies instead of eating straight from a jumbo package.
Load Up on Fruits and Vegetables
Keep washed, prepped veggies and cut fruit handy for easy grabbing when hunger strikes. They provide nutrients and bulk without excess calories.
Drink water regularly through the day. Thirst signals may get confused with hunger pangs.
Aim For Nutrient-Dense Foods
Choose options like eggs, yogurt, beans, fish, and nuts that pack nutrients into fewer calories compared to processed items.
Start a Food Diary
Journal meals and snacks to identify patterns involved with hyperphagia episodes. Note timing, triggers, foods, and portion sizes.
Exercise Each Day
As possible, stay active through walking, swimming, stretching, resistance bands, etc. Activity helps burn extra calories and regulates appetite.
Talk to Your Doctor About Medications
Certain drugs like bromocriptine may suppress appetite. Discuss options if cravings remain extremely difficult to control.
Seek Support From a Coach or Group
Enlist a health coach or join a support group to develop strategies for managing hyperphagia and achieving nutrition goals after stroke.
Get Therapy for Depression
Treat post-stroke depression with counseling and medication, since depression exacerbates poor eating habits.
Practice Mindful Eating
When eating, focus fully on the tastes, textures, smells of food. Pause halfway through for fullness cues before continuing.
Allow Occasional Indulgences
Completely restricting favorite foods can backfire. Have small servings of craved items occasionally in a careful, conscious way.
Stock Up on Frozen Fruits and Vegetables
Keep lots of frozen produce so healthy food is always available. Mix into meals, pasta sauces, smoothies, etc.
Increased appetite and uncontrolled food cravings are common after stroke. Hyperphagia likely stems from changes in hunger signaling pathways, medication effects, depression, and more. While it poses health risks if unchecked, keeping portion sizes reasonable, substituting nutritious options, and developing helpful eating strategies can help stroke survivors manage appetite changes for optimal recovery.