Weight Gain During Treatment of Bipolar Disorder (BD)—Facts and Therapeutic Options

Mangge, Harald; Bengesser, Susanne; Dalkner, Nina; Birner, Armin; Fellendorf, Frederike T.; Platzer, Martina; Queissner, Robert; Pilz, René; Maget, Alexander; Reininghaus, Bernd; Hamm, Carlo; Bauer, Konstantin; Rieger, Alexandra; Zelzer, Sieglinde; Fuchs, Dietmar; Reininghaus, Eva

doi:10.3389/fnut.2019.00076

Cited by 14 publications

(12 citation statements)

References 90 publications

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“…Whether weight loss alone could lead to a reduction in symptoms of depression, bipolar disorder ( 64 ), and/or psychosis remains a largely unanswered question. In people with type 2 diabetes treated with a KD, improvement in depression symptoms was not correlated with weight loss ( 38 ).…”

Section: Discussionmentioning

confidence: 99%

The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients

et al. 2022

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Background and HypothesisThe robust evidence base supporting the therapeutic benefit of ketogenic diets in epilepsy and other neurological conditions suggests this same metabolic approach may also benefit psychiatric conditions.Study DesignIn this retrospective analysis of clinical care, 31 adults with severe, persistent mental illness (major depressive disorder, bipolar disorder, and schizoaffective disorder) whose symptoms were poorly controlled despite intensive psychiatric management were admitted to a psychiatric hospital and placed on a ketogenic diet restricted to a maximum of 20 grams of carbohydrate per day as an adjunct to conventional inpatient care. The duration of the intervention ranged from 6 to 248 days.Study ResultsThree patients were unable to adhere to the diet for >14 days and were excluded from the final analysis. Among included participants, means and standard deviations (SDs) improved for the Hamilton Depression Rating Scale scores from 25.4 (6.3) to 7.7 (4.2), P < 0.001 and the Montgomery-Åsberg Depression Rating Scale from 29.6 (7.8) to 10.1 (6.5), P < 0.001. Among the 10 patients with schizoaffective illness, mean (SD) of the Positive and Negative Syndrome Scale (PANSS) scores improved from 91.4 (15.3) to 49.3 (6.9), P < 0.001. Significant improvements were also observed in metabolic health measures including weight, blood pressure, blood glucose, and triglycerides.ConclusionsThe administration of a ketogenic diet in this semi-controlled setting to patients with treatment-refractory mental illness was feasible, well-tolerated, and associated with significant and substantial improvements in depression and psychosis symptoms and multiple markers of metabolic health.

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Section: Discussionmentioning

confidence: 99%

The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients

et al. 2022

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“…Amenorrhea might be an adverse effect of stress, depression, and affective disorders (Facchinetti et al, 1993). Furthermore, as described previously, BD is also associated with overweight and obesity due to polygenetic disposition, biological processes such as inflammation, and unhealthy lifestyle (Mangge et al, 2019). It is therefore not surprising that there is also a higher rate of symptoms related to "sexuality and body weight" in BD.…”

Section: Discussionmentioning

confidence: 82%

Eating Habits and Eating Disorder Associated Behavior in Bipolar Disorder

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et al. 2022

J Nerv Ment Dis

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A relevant comorbidity of bipolar disorder (BD) is eating disorders (EDs). Crossed vulnerability factors as eating disorder–specific symptoms (EDSSs) may trigger the onset of both disorders in either direction. The Structured Inventory for Anorexic and Bulimic Eating Disorders for Self-Report was used to examine the occurrence of EDs in euthymic/subsyndromal individuals with BD (n = 86) and healthy controls (n = 86) matched for age and sex. Furthermore, we explored EDSSs with the subscales “general psychopathology and social integration,” “bulimic symptoms,” “body image and slimness ideal,” “sexuality and body weight,” “counteract,” and “atypical binge.” Higher rates of all EDSSs were reported in BD. Younger individuals with BD showed higher expression in “bulimic symptoms,” “body image and slimness ideal,” and “atypical binge” subscales. No participants fulfilled ED diagnosis. The findings show a link between EDSS and BD. Clinicians should pay attention to a multimodal intervention, considering risk factors, investigating eating habits and ED associated behaviors.

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“…Similarly, anti-sense apo-B oligonucleotides and MTTP (Microsomal triglyceride transfer protein) inhibitors employed in managing lipid disorders can cause the ectopic deposition of fat, especially in the liver, and changes the fat distribution in the body [ 12 ]. It is well established that antidepressants, atypical antipsychotics, and mood-stabilizing agents induce weight gain by increasing appetite [ 13 ]. A UK study in 136,762 men and 157,957 women demonstrated that the use of antidepressants was associated with weight gain at the population level and suggested that the risk for weight gain must be considered during the antidepressant treatment [ 14 ].…”

Section: Drugs-induced Obesitymentioning

confidence: 99%

Pharmacological Treatments and Natural Biocompounds in Weight Management

et al. 2023

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The obesity pandemic is one of society’s most urgent public health concerns. One-third of the global adult population may fall under obese or overweight by 2025, suggesting a rising demand for medical care and an exorbitant cost of healthcare expenditure in the coming years. Generally, the treatment strategy for obese patients is largely patient-centric and needs dietary, behavioral, pharmacological, and sometimes even surgical interventions. Given that obesity cases are rising in adults and children and lifestyle modifications have failed to produce the desired results, the need for medical therapy adjunct to lifestyle modifications is vital for better managing obesity. Most existing or past drugs for obesity treatment target satiety or monoamine pathways and induce a feeling of fullness in patients, while drugs such as orlistat are targeted against intestinal lipases. However, many medications targeted against neurotransmitters showed adverse events in patients, thus being withdrawn from the market. Alternatively, the combination of some drugs has been successfully tested in obesity management. However, the demand for novel, safer, and more efficacious pharmaceutical medicines for weight management does exist. The present review elucidates the current understanding of the available anti-obesity medicines of synthetic and natural origin, their main mechanisms of action, and the shortcomings associated with current weight management drugs.

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Weight Gain During Treatment of Bipolar Disorder (BD)—Facts and Therapeutic Options

Cited by 14 publications

References 90 publications

The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients

The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients

Eating Habits and Eating Disorder Associated Behavior in Bipolar Disorder

Pharmacological Treatments and Natural Biocompounds in Weight Management

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