Bipolar Disorder with Binge Eating Disorder

Up to 4% of Americans have some form of bipolar illness, and nearly 10% of these patients also have binge-eating disorder (BED). Bipolar disorder evolves differently in patients who also binge-eat, according to results of a recent study at the Mayo Clinic, Rochester, MN, the Lindner Center of HOPE, Cincinnati, OH, and the University of Minnesota, Minneapolis (J Affective Disord. 2013. June 3 ([Epub ahead of print]).

Dr. Susan L. McElroy, Chief Research Officer at the Lindner Center, and researchers at the Mayo Clinic and the University of Minnesota, used data from 717 patients with bipolar disorder included in the Mayo Clinic Bipolar Biobank to search for a genetic link to BED among patients with bipolar disease. According to the authors, patients with bipolar disease who also binge-eat are more likely to have other mental health problems, such as suicidal thoughts, psychosis, anxiety disorders and substance abuse. Persons with bipolar disease who are obese but do not binge eat are more likely to have serious physical problems such as arthritis, diabetes, hypertension, and heart disease. 

The authors found that 9.5% of the patients with bipolar disorder had a clinical diagnosis of BED and 42.8% were obese. After controlling for obesity, BED was associated with suicidality, psychosis, mood instability, anxiety disorder comorbidity, and substance abuse comorbidity. After controlling for BED status, obesity was associated with greater general medical comorbidity, but lower substance abuse comorbidity. There were no significant interaction effects between obesity and BED, or BMI and BED, on any illness burden outcome. The authors also found that it was more common for women than for men to binge-eat or to be obese.

Dr. McElroy and coauthors point out that their findings underscore the importance of identifying this more severely ill subgroup of patients. They hope doing so will lead to more effective and personalized treatment for these very ill patients.