Determinants of Overweight and Obesity in Patients With Bipolar Disorder
J Clin Psychiatry 2001;62(6):486-491
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: To examine lifestyle-related
determinants of the excess adiposity observed in patients with
Method: Eighty-nine male and female patients
with DSM-IV bipolar disorder who were attending a specialist
bipolar clinic or another psychiatric outpatient clinic (19% with
body mass index [BMI] >= 30) and 445 age- and sex-matched
reference subjects (12% with BMI >= 30) participated in a
cross-sectional study of nutrient intake and physical activity.
Main outcome measures included macronutrient intakes (assessed
with 24-hour recall), percentage of energy derived from various
food sources, and physical activity levels (assessed with the
Life in New Zealand Questionnaire).
Results: Mean total energy intake was higher in
female patients than in reference subjects: 8468 kJ compared with
6980 kJ (95% confidence interval [CI] = 583 to 2392 kJ). Total
daily sucrose and percentage of energy from carbohydrate were
higher in patients than in reference subjects; for women, 73 g
and 49% (95% CI = 20 to 56 g, 3% to 10%) and for men, 89 g and
47% (95% CI = 15 to 59 g, 3% to 9%). Total fluid intake and
intake of sweetened drinks were higher in patients than in
reference subjects (ratio of geometric means: women, 1.2 and 2.3,
respectively [95% CI = 1.1 to 1.4, 1.9 to 2.8]; men, 1.1 and 2.1,
respectively [95% CI = 1.0 to 1.23, 1.8 to 2.4]). Patients
reported fewer episodes of low- to moderate-intensity and
high-intensity physical activity as compared with reference
subjects (p <= .05).
Conclusion: This study confirms that
drug-induced changes in food preference can lead to an excessive
energy intake largely as a result of a high intake of sucrose.
Dietary advice regarding the use of energy-rich beverages along
with encouragement to increase levels of physical activity may
help prevent weight gain in bipolar patients. The findings also
have some bearing on dietary advice aimed at avoiding overweight
and obesity in the general population.