Wednesday, July 20, 2011

Bipolar and Obesity

Bipolar and obesity connection
  Many patients present with both bipolar and obesity. Obesity is a common comorbid (occurs together) condition which complicates the assessment and management of bipolar.

  Bipolar is a disorder of behavioral extremes and during manic episodes excesses in many areas including calorie intake is not uncommon.

  A significant contributory factor to the tendency to obesity in bipolar individuals is the weight gain directly attributable to the medication involved in the long term management of the disorder. This undesirable side effect may well self perpetuate the problem. The patient is less inclined to take the medication required to stabilize the mood swings and curb the compulsion to eat eat eat.

  It is natural for anyone to turn to food when under stress and since bipolar and stress do not mix well the potential to turn to food for comfort is more probable.

  A diagnosis of bipolar disorder generally occurs many years after the onset of the symptoms. Many do not realize or will not accept that their behavior is unusual so will not seek help and of those who do seek help some initially will be misdiagnosed. There will always be a number of individuals in the pipeline whose destructive eating habits are developing with time and who are already well on the way to obesity before the diagnosis occurs.

  With obesity comes the increased risk of type II diabetes which is also one of the more common general medical comorbidities of Bipolar disorder. Not surprisingly the food consumed is usually the feel good stuff laden with the carbohydrates causing overloading of the insulin production process leading to insulin resistance or type II diabetes. The good news is that this form of diabetes is a result of diet and corrected by diet changes.

  Both bipolar and obesity can be medically controlled and with help available there is no reason not to seek all the help you can get.

When are you considered obese?
  Obesity today is classified as a BMI of 30 kg/m2 or greater. What's that in plain English? Well if you take your weight in kg and divide it by your height in meters squared and get an answer of 30 or more you are obese.

eg height 1.65m weight 100kg
BMI = 100/ (1.65*1.65) = 100/ 2.72 = 36.76 = Obese
or height 5' 4" (64") weight 120 pounds
BMI = [120/(64*64) ]*703= 20.59 = Healthy

  For adults a BMI between 18 and 25 is in the healthy range, 25 to 30 is the overweight range and 30 plus indicates obesity.

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