A Heavy Burden: Bipolar Disorder and Obesity

How did patients with BDI and obesity fare in new research looking at quality of life issues?


What effect does obesity have on patients with bipolar disorder? Results from a new study were highlighted at a poster presentation at the 2022 NEI Congress.1

Michael J. Doane, PhD, and colleagues collected data from the 2016 and 2020 US National Health and Wellness Survey to examine the relationships between obesity and clinical, humanistic, and economic outcomes among patients who self-reported a diagnosis of bipolar I disorder (BDI). As part of the retrospective, cross-sectional analysis, participants (N=1853) were categorized as underweight or normal weight if their BMI was less than 25 kg/m2, overweight if their BMI fell between 25 and 30 kg/m2, and obese if their BMI was at least 30 kg/m2.

Doane et al used the 36-item Short Form Version 2 and EuroQol EQ-5D health surveys to measure health related quality of life. The Work Productivity and Activity Impairment questionnaire was used to measure work productivity and absenteeism as well as work and activity impairment. The investigators also leveraged the Medical Expenditure Panel Survey and US Bureau of Labor Statistics to ascertain direct and indirect costs.

The mean age of all participants was 34.1 years old, with patients in underweight/normal grouping tending to be younger than their peers in the overweight and obese groups. There were more females (65%) among the participants, and women were fairly evenly distributed among the BMI groups. Similarly, more than half (62%) of participants were white. Less than half of the participants were married (45%). The overall mean for being employed was 46%, and the percentage decreased as BMI increased. More than half of the overweight patients and obese were trying to lose weight and had exercised in the past month.

In addition to having the highest rates of high blood pressure, increased cholesterol, and type 2 diabetes, participants who were categorized with obesity were more likely to have asthma, cancer, osteoarthritis, sleep apnea, and other comorbidities. They also reported the highest levels of activity impairment as well as the most number of hospitalizations and emergency department visits in the previous 6 months. Interestingly, when compared with the obesity group, the underweight/normal weight group had slightly higher levels of absenteeism (37.1 vs 36.4), and overall work impairment (64.3 vs 64.2). Not surprisingly, the highest direct and indirect costs were found in the obese group.

Doane et al acknowledged that individuals with BDI have an increased risk of obesity compared with the general population, which may be due to genetic, lifestyle, and treatment-related factors (ie, weight liability of medications used to treat BDI).

“[The] study results highlight important clinical, humanistic, and economic burdens associated with obesity in adults living with BD-I,” the researchers concluded. “These outcomes are important to consider in terms of a holistic treatment approach.”

Do you have tips for your colleagues on how to address obesity in patients with BDI? Share your success stories—or challenges—with us at PTEditor@mjhlifesciences.com.


1. Doane MJ, Thompson J, Jauregui A, et al. Humanistic outcomes associated with obesity among adults with bipolar I disorder: analysis of National Health and Wellness Survey Data. Supported by Alkermes, Inc. Poster presented at: 2022 NEI Congress. November 2022; Colorado.