Overweight and
obesity are highly
prevalent in patients with
bipolar disorder, and
metabolic disorders also affect a significant portion of this population.
Obesity and
metabolic disorders cause significant economic burden and impair quality of life in both the general population and patients with
bipolar disorder. This review examines the relationship between
bipolar disorder and the
metabolic syndrome, and the associated economic impact.The
metabolic syndrome and
bipolar disorder appear to share common
risk factors, including
endocrine disturbances,
dysregulation of the
sympathetic nervous system, and behaviour patterns, such as physical inactivity and
overeating. In addition, many of the commonly used
pharmacological treatments for
bipolar disorder may intensify the medical burden in bipolar patients by causing weight
gain and
metabolic disturbances, including alterations in
lipid and
glucose metabolism, which can result in an increased risk for
diabetes mellitus,
hypertension,
dyslipidaemia,
cardiovascular disease and the
metabolic syndrome. These medical co-morbidities and
obesity have been associated with a worse disease course and likely contribute to the premature mortality observed in bipolar patients. Weight
gain is also a major cause of treatment noncompliance, increased use of outpatient and inpatient services and, consequently, higher healthcare costs. Prevention of weight
gain and
metabolic disturbances or early intervention when these are present in
bipolar disorder could result in significant health and economic benefits.
