By: Rebecca Archer
Epilepsy, a common neurological disorder, is characterized by repeated seizures, but it rarely stands alone. In fact, more than 50% of individuals with epilepsy are reported to have one or several comorbid conditions. While these comorbidities can have a different pathophysiology compared to epilepsy, they can still affect the treatment and outcomes of epilepsy itself and the patient’s overall quality of life.
Among the comorbidities identified through research is obesity, a chronic condition involving abnormal or excessive body fat accumulation. Although the study linked above identifies it as a resultant comorbidity — a consequence of seizure activity or epilepsy treatments — the relationship between obesity and epilepsy is much more complex. Below, we discuss how obesity and epilepsy affect each other and how individuals diagnosed with both conditions can manage them effectively.
Obesity is typically classified as a health consequence of epilepsy since anti-seizure medications (ASMs) have emergent adverse effects, including weight gain. Studies have also pointed out that epileptic seizures can disrupt ghrelin, leptin, and adiponectin serum levels. Since these hormones are associated with appetite, satiety, and metabolism, hormonal changes can ultimately lead to weight gain and obesity.
However, as previously mentioned, the relationship between obesity and epilepsy goes beyond a direct cause and effect. 2022 research published in the journal Frontiers in Neurology identifies obesity as a risk factor for epilepsy and its subtypes. Specifically, findings indicate that increased hip and waist circumference elevates the risk of myoclonic epilepsy, while a high body mass index (BMI) is associated with childhood absence epilepsy.
One of the proposed pathways through which obesity affects the risk of epilepsy is how excess adiposity increases the secretion of inflammatory markers. When neural circuits are inflamed, it can initiate or lead to the progression of epilepsy. Despite this complex link that may cause a vicious cycle of weight gain and seizure frequency, there are ways to manage weight and epilepsy at once, some of which will be discussed below.
Lifestyle change remains the foundation for weight management, and you can start by adopting a healthier diet. The good news is that the dietary choices that help you lose weight are the same ones that can serve as naturopathic treatments for epilepsy.
For instance, the low-glycemic index diet is based on the association between blood sugar levels and seizure frequency, thus emphasizing complex carbohydrates like fruits, vegetables, and whole grains over simple sugars. Aside from causing fewer blood sugar spikes, these foods are also known to be low-calorie and nutrient-dense, therefore supporting weight loss.
Losing weight may not be as simple and straightforward as expected when you have a serious, debilitating condition like epilepsy. However, having a BMI of 30 or 27 or more with a weight-related comorbidity like hypertension — can qualify you to use GLP-1 for weight loss. With FDA-approved semaglutide and liraglutide as examples, these GLP-1 agonists mimic a gut hormone called glucagon-like peptide to reduce food cravings and boost feelings of fullness—ultimately leading to as much as 15% of weight reduction.
GLP-1 agonists can also be particularly helpful for your epilepsy treatment. While abnormal blood sugar levels have been linked to seizure frequency, these diabetes-turned-obesity medications can help regulate insulin and glucose control to reduce the number of seizures.
A healthy diet and weight loss plan are usually complemented by other lifestyle factors like exercise for effective and long-term weight management. However, keep in mind that seizures may limit the type of calorie-burning exercises you can do. If you plan on lifting weights or using exercise equipment to lose weight, use a buddy system to ensure safety in case of uncontrolled seizures. Overall, support from family and friends can go a long way in tackling the complexities of both obesity and epilepsy. If you are in search of additional information and resources on living with epilepsy, make sure to check out the rest of the blog posts by the Defeating Epilepsy Foundation.
Ben-Menachem E. (2007). Weight issues for people with epilepsy–a review. Epilepsia, 48 Suppl 9, 42–45. https://doi.org/10.1111/j.1528-1167.2007.01402.x
Jallon, P., & Picard, F. (2001). Bodyweight gain and anticonvulsants: a comparative review. Drug safety, 24(13), 969–978. https://doi.org/10.2165/00002018-200124130-00004
Marco Mula (2020) The comorbidities of epilepsy explained, Expert Review of Neurotherapeutics, 20:12, 1207-1209, DOI: 10.1080/14737175.2020.1840979
This post was prepared by Rebecca Archer