Bipolar disorder Mental health

Medication & weight management for people with bipolar disorder

Lacing up running shoes
[dropcap]F[/dropcap]or many people with bipolar disorder, long-term treatment with anti-manic medications comprises the backbone of treatment. Unfortunately, weight gain is a common and bothersome side effect of most treatments that are effective against mania. This is particularly true for youth, who appear to be exquisitely sensitive to the weight-promoting effects of these medications. This adds insult to injury, because aspects of bipolar disorder itself can give rise to weight gain, including stress, sleep disruption and carbohydrate craving associated with depression.

What can people living with bipolar disorder do to minimize weight gain, or even lose weight that has already been gained? Simplicity is of the essence, because people with bipolar disorder often already juggle multiple competing demands, and they rarely have the luxury or opportunity to engage in a time-consuming intervention focusing specifically on weight.

Colleagues in the field of pediatrics have identified a “Big 5” list of modifiable risk factors for obesity among the general population of youth, and as you can see, most of these strategies could equally apply for adults:

  1. Limit sweetened beverage intake (including juice, soft drinks) to one serving per day.
  2. Limit television and other screen time to 2 hours per day.
  3. Limit fast food intake to one meal per week.
  4. Strive for 60 minutes of moderately vigorous physical activity most days of the week.
  5. Strive to eat meals as a family as much as possible.

Whether using the above strategies or other approaches, it is advisable to focus on dietary intake and physical activity before weight gain has occurred. When starting a medication, much of the excessive weight gain occurs in the first 12 weeks. Efforts aimed at limiting weight gain are especially important in these early weeks of treatment. Preventing excessive weight gain is not only beneficial from a medical perspective, but it can also help ensure that people continue to take their medication on a regular basis so as to derive the greatest possible benefit. 

For more info on childhood obesity, visit the American Family Physician website.

About the author

Dr. Ben Goldstein

Dr. Ben Goldstein

Dr. Ben Goldstein is a psychiatrist and Director of the Centre for Youth Bipolar Disorder at Sunnybrook.

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