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High prevalence of obesity in patients with bipolar I disorder
The prevalence of obesity is increasing and represents a major public health concern, particularly in the United States. A tendency for patients suffering from bipolar disorder to be overweight has been noticed.
A retrospective report examined the prevalence of overweight (body mass index (BMI) = 25.0 - 29.9) and obesity (BMI = or > 30.0) in 50 patients with bipolar disorder (according to DSM-IV), and assessed weight change during acute treatment and the first 12 months of maintenance therapy.
At baseline, 34 of the 50 patients were obese or overweight. Sixteen subjects were obese, 18 were overweight, 15 were normal weight, and 1 was underweight. Being overweight or obese at study entry appeared to be linked with the number of previous depressive episodes. Significant weight gain occurred in the normal weight and overweight groups during acute treatment, whereas only the normal-weight group gained a significant amount of weight during maintenance treatment. During acute treatment, the increase of BMI was positively associated with the score on the Hamilton Rating Scale for Depression and negatively associated with the score on the Bech-Rafaelsen Mania Scale. During both acute and maintenance treatment there was a negative relationship between BMI and the tendency to gain weight.
In view of the high prevalence of obesity in patients with bipolar disorder, specific strategies of treatment and for weight control are highly recommended. The link between depressive episodes and weight gain, and the minimal weight gain during the maintenance phase which may facilitate the acceptance for loosing weight, should favour the practice of maintenance therapy.
J Clin Psychiat 63: 528-533, 2002

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