Weight Gain in Bipolar Disorder: Causes and Treatments

Bipolar disorder is associated with a high incidence of significant obesity, much of which is likely iatrogenic and caused by mood-stabilizing medications. This obesity produces a significant psychosocial burden, increases the risk for a range of comorbid medical disorders, and leads to higher rates of medication noncompliance and clinical relapse. Fortunately, the range of mood-stabilizing agents is expanding and several of the newer agents have a lower tendency to promote weight gain. Also, a greater focus on medication-associated weight gain has increased the data available to aid in medication selection. This article summarizes epidemiologic data relating obesity to bipolar illness, describe the associations between specific mood stabilizers and weight gain, and provide practical approaches to the management of weight gain in bipolar patients.