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Obesity and Bipolar Disorder: Synergistic Neurotoxic Effects?

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Abstract

Bipolar disorder (BD) is a disabling and chronic neuropsychiatric disorder that is typified by a complex illness presentation, episode recurrence and by its frequent association with psychiatric and medical comorbidities. Over the past decade, obesity has emerged as one of many comorbidities generating substantial concern in the BD population due to important prognostic implications. This comprehensive review details the bidirectional relationship between obesity and BD as evidenced by alterations in the structure and function of the central nervous system, in addition to greater depressive recurrence, cognitive dysfunction and risk of suicidality. Drawing on current research results, this article presents several putative mechanisms underlying the synergistic toxic effects and provides a framework for future treatment options for the obesity–BD comorbidity. There is a need for more large-scale prospective studies to investigate the bidirectional relationships between obesity and BD.

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Acknowledgments

The authors would like to acknowledge D. Cha, J. Soczynska L.A. Gallaugher, H. Woldeyohannes, and B. DeFreitas from the Mood Disorders Psychopharmacology Unit. No funding or sponsorship was received for the publication of this article. Celina Liu is the guarantor for this article, and takes responsibility for the integrity of the work as a whole.

Conflict of interest

Roger S. McIntyre has received research grants from Stanley Medical Research Institute, National Alliance for Research on Schizophrenia and Depression (NARSAD), National Institutes of Mental Health, Eli Lilly, Janssen-Ortho, Shire, Astra-Zeneca, Pfizer, Lundbeck, Forest, Sepracor, and BMS; has served on advisory boards for Astra-Zeneca, Bristol-Myers Squibb, Janssen-Ortho, Eli Lilly, Lundbeck, Pfizer, Shire, Merck, Sepracor and Otsuka; has served on speakers bureaus for Janssen-Ortho, Astra Zeneca, Eli Lilly, Lundbeck, Merck, Pfizer, and Otsuka; and CME activities for Astra Zeneca, Bristol-Myers Squibb, Physicians’ Postgraduate Press, CME Outfitters, Merck, Eli Lilly, Pfizer, Lundbeck and Otsuka. Andre F. Carvalho had received speakers’ honoraria from Abbott, Libbs Farmaceutica, GSK and Lundbeck. Celina S. Liu declares no conflict of interest. Rodrigo B. Mansur declares no conflict of interest.

Compliance with ethics guidelines

This article is based on previously conducted studies, and does not involve any new studies of human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Human Biology, University of Toronto, Toronto, ON, Canada

    Celina S. Liu

  2. Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, Toronto, ON, Canada

    Celina S. Liu, Rodrigo B. Mansur & Roger S. McIntyre

  3. Psychiatric Research Group, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil

    André F. Carvalho

  4. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Rodrigo B. Mansur & Roger S. McIntyre

  5. Department of Pharmacology, University of Toronto, Toronto, ON, Canada

    Roger S. McIntyre

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  1. Celina S. Liu
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  2. André F. Carvalho
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  3. Rodrigo B. Mansur
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  4. Roger S. McIntyre
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Correspondence to Roger S. McIntyre.

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Liu, C.S., Carvalho, A.F., Mansur, R.B. et al. Obesity and Bipolar Disorder: Synergistic Neurotoxic Effects?. Adv Ther 30, 987–1006 (2013). https://doi.org/10.1007/s12325-013-0067-7

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