The burden of obesity among adults with bipolar disorder in the United States

Abstract

Objectives Previous studies of clinical samples of adults with bipolar disorder (BD) suggest that there is increased prevalence of obesity and that obesity is associated with greater BD severity. We therefore examined this topic in a representative epidemiologic sample. Methods The 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions was used to determine whether the prevalence of obesity is elevated among subjects with lifetime BD, and whether obesity is associated with greater severity of BD. Results The age-, race-, and sex-adjusted prevalence of obesity was significantly greater among subjects with BD versus controls [odds ratio (OR) = 1.65, 95% confidence interval (CI): 1.45–1.89, p < 0.001]. Obesity among subjects with BD was significantly positively associated with greater age, female sex, comorbid anxiety and medical conditions, and depression-related treatment utilization, and significantly negatively associated with past-year substance use disorder (SUD). In multivariable analyses, obesity among adults with BD was positively associated with age, comorbid anxiety disorders, duration of depressive episodes, and history of hospitalization for depression, and negatively associated with past-year SUD. Conclusions The increased prevalence of obesity in BD and its association with illness severity, particularly in relation to depression, cannot be attributed to biases inherent in treatment-seeking samples. Future studies are needed to examine the direction of the observed associations and to develop preventive and treatment strategies seeking to mitigate the burden of obesity in BD.

Obesity and psychiatric disorders: Commonalities in dysregulated biological pathways and their implications for treatment

“…In a large, nationally representative sample, Goldstein et al (2011) found a nearly two-fold age-, race-, and sexadjusted increased risk of obesity among adults with bipolar disorder versus controls. Obese participants with bipolar disorder also had greater comorbidity with anxiety disorders, longer depressive episodes, and significantly poorer physical and mental health functioning compared to non-obese people with bipolar disorder.…”

Cardiovascular risk factors in outpatients with bipolar disorder: a report from the Brazilian Research Network in Bipolar Disorder

“…[3][4][5] Increased rates of obesity, 6,7 diabetes, 8 hypertension, 9 dyslipidemia, 10 and metabolic syndrome [11][12][13] have been reported in recent clinical and epidemiological studies. 14,15 In addition to being exposed to the weight gain effects of the pharmacological treatment, BD patients are more likely to have sedentary lifestyles and poor dietary habits, 16 which are well-established cardiovascular risk factors. 17 Most of the abovementioned data come from developed countries, which have somewhat distinct realities from the developing world.…”

Greater body mass index is associated with reduced frontal cortical volumes among adolescents with bipolar disorder

“…[1][2][3][4][5][6] Elevated body mass index (BMI) is associated with hypertension, diabetes, certain types of cancer and cardiovascular disease (CVD). [7][8][9] The latter is particularly concerning because CVD is excessively prevalent and occurs prematurely in individuals with BD, 4,10 recently leading the American Heart Association to position BD as an illness that predisposes youth to premature CVD and atherosclerosis. 11 In addition to its adverse physical health correlates, obesity has been associated with a more pernicious course of BD in adults, including increased frequency of mood episodes, increased treatment resistance, poor cognitive function and increased suicidality.…”