Prevalence of Obesity and Weight Change During Treatment in Patients With Bipolar I Disorder
J Clin Psychiatry 2002;63(6):528-533
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Obesity is a major public
health concern in the United States and its prevalence is
increasing. Individuals with bipolar disorder tend to be
overweight, and their treatment may exacerbate obesity and
increase the risk of concurrent medical disease in this
Method: This retrospective report from
the Pittsburgh Study of Maintenance Therapies in Bipolar Disorder
examines the prevalence of overweight (body mass index
[BMI]=25.0-29.9) and obesity (BMI >= 30.0) in 50 consecutive
subjects with bipolar I disorder (DSM-IV) and evaluates weight
change during acute treatment and the first year of maintenance
Results: At entry into the study, 34
(68%) of the patients in this sample with bipolar disorder were
obese or overweight. The prevalence of obesity was high (16 [32%]
of the 50 patients in our sample). The number of previous
depressive episodes contributed to the likelihood of being
overweight or obese at study entry. During the trial, most of the
weight gain occurred during acute treatment rather than during
maintenance treatment. During acute treatment, the amount of
increase of BMI was positively related to the score on the
Hamilton Rating Scale for Depression and negatively related to
the score on Bech-Rafaelsen Mania Scale. There was a negative
relationship between BMI and tendency to gain weight, during both
acute and maintenance treatment.
Conclusion: The high prevalence of
obesity in subjects with bipolar disorder emphasizes the need for
specific treatment strategies and programs for weight control for
these individuals. The minimal weight gain during the maintenance
phase, the relationship of acute depressive episodes to weight
gain, and the fact that stabilization on maintenance medication
may facilitate the participation in specific interventions for
weight loss provide additional support for the practice of