Determinants of Overweight and Obesity in Patients With Bipolar Disorder

Objective: To examine lifestyle-relateddeterminants of the excess adiposity observed in patients withbipolar disorder.

Method: Eighty-nine male and female patientswith DSM-IV bipolar disorder who were attending a specialistbipolar clinic or another psychiatric outpatient clinic (19% withbody mass index [BMI] >= 30) and 445 age- and sex-matchedreference subjects (12% with BMI >= 30) participated in across-sectional study of nutrient intake and physical activity.Main outcome measures included macronutrient intakes (assessedwith 24-hour recall), percentage of energy derived from variousfood sources, and physical activity levels (assessed with theLife in New Zealand Questionnaire).

Results: Mean total energy intake was higher infemale patients than in reference subjects: 8468 kJ compared with6980 kJ (95% confidence interval [CI] = 583 to 2392 kJ). Totaldaily sucrose and percentage of energy from carbohydrate werehigher in patients than in reference subjects; for women, 73 gand 49% (95% CI = 20 to 56 g, 3% to 10%) and for men, 89 g and47% (95% CI = 15 to 59 g, 3% to 9%). Total fluid intake andintake of sweetened drinks were higher in patients than inreference 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]). Patientsreported fewer episodes of low- to moderate-intensity andhigh-intensity physical activity as compared with referencesubjects (p <= .05).

Conclusion: This study confirms thatdrug-induced changes in food preference can lead to an excessiveenergy intake largely as a result of a high intake of sucrose.Dietary advice regarding the use of energy-rich beverages alongwith encouragement to increase levels of physical activity mayhelp prevent weight gain in bipolar patients. The findings alsohave some bearing on dietary advice aimed at avoiding overweightand obesity in the general population.