Bipolar Disorder and Obesity: Contributing Factors, Impact on Clinical Course, and the Role of Bariatric Surgery

Abstract

Purpose of review: Bipolar disorder (BD) is a severe, common, and chronic affective disorder. This review highlights the BD and obesity connection and the role of treatments for obesity in this population.

Recent findings: Patients with BD are at a significantly increased risk for obesity, as compared to those without BD, with obesity serving as a proxy for severity and predictor of poorer outcome. BD is characterized by substantial medical burden, with obesity-related conditions contributing to premature mortality. Pharmacotherapy for BD can cause weight gain and may be moderated by binge eating behavior. Bariatric surgery may be the most robust intervention for weight loss in patients with stable BD, but access may be limited. There is a greater need for interventions to prevent weight gain in BD, the development weight-neutral medications for BD, and more research into the role of bariatric surgery for patients with BD.

Keywords: Bariatric surgery; Binge eating disorder; Bipolar disorder; Comorbidity; Medical burden; Medications; Obesity; Pharmacotherapy; Psychotropic weight gain.