Bipolar disorder takes different path in patients who binge eat, study suggests

July 25, 2013, Mayo Clinic

Bipolar disorder evolves differently in patients who also binge eat, a study by Mayo Clinic, the Lindner Center of HOPE and the University of Minnesota found. Binge eating and obesity often are present among bipolar patients, but the mood disorder appears to take a different path in those who binge eat than it does in obese bipolar patients who do not, the researchers discovered. The findings are published online in the Journal of Affective Disorders.

Up to 4 percent of Americans have some form of bipolar illness, and of those, just under 10 percent also have binge —a higher rate of binge eating than seen in the general population, says co-author Mark Frye, M.D., a psychiatrist and chair of the Department of Psychiatry/Psychology at Mayo Clinic in Rochester. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) update released this spring recognizes binge eating disorder as a distinct condition, he noted.

Bipolar patients who binge eat are more likely to have other such as suicidal thoughts, psychosis, and substance abuse, the study found. People with bipolar disorder who are obese but do not binge eat are more likely to have serious physical problems such as arthritis, diabetes, high blood pressure and heart disease.

It was more common for women than men with bipolar disorder to binge eat or to be obese, the study showed.

"The illness is more complicated, and then by definition how you would conceptualize how best to individualize treatment is more complicated," Dr. Frye says. "It really underscores the importance of trying to stabilize mood, because we know when people are symptomatic of their bipolar illness their binge frequency is likely to increase. We want to work with treatments that can be helpful but not have weight gain as a significant side effect."

The researchers used the Mayo Clinic Bipolar Biobank, a collaborative effort by Mayo Clinic, the Lindner Center of HOPE, University of Minnesota and Mayo Clinic Health System. More research is planned to see whether there is a genetic link to binge eating disorder in bipolar disease.

"Patients with bipolar disorder and appear to represent a more severely ill population of bipolar patients. Identification of this subgroup of patients will help determine the underlying causes of and lead to more effective and personalized treatments," says co-author Susan McElroy, M.D., chief research officer at the Lindner Center of HOPE.

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