Bipolar and Obesity: Link and Treatment

  • 1 January 2016
  • Petra_1

obese woman

With more research being underway, the awareness regarding Bipolar Disorder is finally increasing to the point that pharmaceutical companies are taking an active interest in developing proper medications with fewer side effects. We are quite fortunate that we are living in the age when the bipolar issue has been accepted as an actual problem, instead of being pooh-poohed away as a dramatic pretense of patients who are looking for attention. I remember that when I was quite young and suffered from severe depression, my neighbors would often comment negatively on my behavior in front of my mother. Needless to say, it only made other neighbors and their kids see me as weird and this further increased the pressure I felt while being in public places.

I remember very well that when other kids wouldn't talk to me, I would come back home and sit in front of the T.V and binge eat. Lunch time at school was a nightmare. It did not matter that my mother packed healthy items for lunch: an apple, a toast and a cupcake. I was always ridiculed when I ate because I was 'fat'. It did not help when the doctor diagnosed me as a bipolar and put me on a bunch of medicines which further added to my weight gain.

While the doctor had warned us that this side effect would happen, I was still not ready to accept the consequences. I literally gained about 15 pounds in a month and by the end of it I almost gave up on therapy. I would stop taking medicines and ignored warning signs. I thought that if the medicines were making me fat, I ought to cut them away from my life.

I was wrong. I learnt from my mistakes the hard way. The better way—the only way—to deal with Bipolar Disorder is to learn more about it. It is about using knowledge as the ultimate weapon to fight back. Ignoring issues and stopping medications and therapy are as ineffective as a car without brakes. From the start, it is destined to crash.

What is Bipolar Disorder, and what are its symptoms?

Bipolar Disorder is a type of mental illness whereby your feelings alternate between euphoria and despair. This illness causes extreme reactions in the human brain. You know how chocolates make us happy because they release this 'Happy chemical' in our brain called serotonin? Every reaction or feeling is created with the help of hormones which get released in our body. Bipolar Disorder affects this chemical process. Our brain functions with the help of brain chemicals called neurotransmitters. The three main brain chemicals are dopamine, noradrenaline and serotonin. While an imbalance in dopamine is related to schizophrenia, the chemical imbalance in noradrenaline and serotonin are seen as underlying causes of depression and Bipolar Disorder. The imbalance in the levels of these neurotransmitters in brain can lead to problematic behavioral symptoms like:

  • Elated highs followed by horrible depression
  • Aggressive speech
  • Hypersexuality
  • Outburst of energy followed by excessive fatigue
  • Self-injury
  • Suicidal inclinations
  • Weight gain
  • Alternations periods between hypersomnia and insomnia.

There are other effects like aggravated ego, feelings of invincibility, guilt and others, but one comorbid symptom that really makes a complete recovery almost impossible is obesity.

Bipolar and Obesity: Link and Treatment

Bipolar Disorder and Obesity is a horrible combination of two conditions that often occur together. They are seen as comorbid situations where one is the cause of the other. According to recent observations, about 35% of people with Bipolar Disorder suffer from obesity. This percentage is much higher than in case of other psychiatric illnesses. The paper "Bipolar disorder, obesity, and pharmacotherapy-associated weight gain" was written based on the findings of several studies that tested the prevalence of weight gain and obesity in case of bipolar conditions. It concluded that patients with this psychiatric condition are more susceptible to weight gain than the general population. There are several reasons why:

  • Bipolar medications like lithium and valproate etc cause a high rate of weight gain in patients.
  • Depression usually motivates patients to binge-eat or stress-eat, and this becomes a self-defeating act.
  • During the “mental low” experienced by bipolar patients, the body becomes fatigued. People hardly find the motivation to go outside and exercise. This causes low physical activity and high weight gain.

Being overweight is quite a challenge for mentally ill patients who are trying hard to turn their life around for the better. Sometimes, patients become so demotivated and disillusioned that they become opposed to receiving further treatment and try to stop taking their medicines. They end up refusing therapy, and this is exactly the path I had chosen for myself.

But the situation took a turn for the worse when I had my ultimate meltdown. I ran out of my university campus and took an overnight ride back home. I remember ending up as a sobbing mess in my mother's arms and my parents did everything they could to make me feel secure and safe. It was an uphill battle from then on, and I started visiting my psychiatrist more often; and took my prescribed medications on time. However, this time my psychiatrist did something different.

She suggested that I join different physical programs at the psychiatrist rehabilitation centers which included light aerobic exercises and sports activities. She helped my moderate my food intake. My dietician recommended Nutrisystem for me, which is a pre-packaged meal delivery system that puts subscribers on a portion controlled diet. I got to like this diet program after I read a number of other people's  Nutrisystem success stories. This way, whenever I felt too stressed out, I was given vegetables or fruits to eat. My meal plans were micromanaged and I had no choice but stick to the plan. My physical activities were regulated effectively. And by the end of two months, I was already a few pounds lighter and more self-confident than before.

Treatment methods

This therapy is based on a behavioral intervention that focuses on regulating the activities of bipolar patients. Specialized attention is given to the mental and physical effort made by the patients to reduce weight gain. These interventions are designed around the patient's health and lifestyle and this personalized care actually helps to give them the support they would need to believe that a positive change is possible.

Also, treatments focus on certain medicines which are known to cause minimal weight gains in patients like Lamotrigine and Carbamazepine.

Additional Sources:
http://www.ncbi.nlm.nih.gov/pubmed/18221634