These have been of limited long-term effectiveness , though early intervention post-first episode psychosis appears to be more promising [ 6 ] .
Hence , the effectiveness of Cognitive Behaviour Therapy ( CBT ) or
Background Eating disorders are understood to no longer be the remit of lean adolescent girls alone [ 1 ] , whatever pop culture offerings such as Netflix ’s To The Bone might continue to present .
Rather , people with eating disorders are much more diverse , often undiagnosed and often suffering in silence .
One patient population with a unique but poorly understood vulnerability to eating disorders , as well as obesity and poor physical health , is people with bipolar disorder .
Bipolar disorder is a complex , serious mental illness that confers significant functional impairment , primarily due to time spent in manic , depressed , or mixed state episodes , difficulty eliminating subthreshold depressive symptoms , and the financial , social and emotional sequelae of illness episodes .
One significant contributor to disability is physical ill health , with the average life expectancy of someone with bipolar disorder notably reduced due to cardiometabolic illnesses like heart disease and type two diabetes mellitus .
Furthermore , poorer physical health is associated with poorer mental health in this group , such as higher risk of depressive relapse [ 2 , 3 ] .
The past two decades has seen increased focus on preserving and improving the physical health of people with bipolar disorder , who are often prescribed long-term medication known to be conducive to weight gain [ 4 ] .
Trials of a number of interventions have attempted to implement lifestyle interventions to promote healthy eating , physical activity , and social connectedness , in order to prevent or reduce the adverse impact of obesity and improve physical health and psycho-social functioning [ 5 ] .
The role of disordered eating in contributing to physical and mental health outcomes among individuals with bipolar disorder has rarely been considered , despite the fact that approximately one in three people with bipolar disorder also meet criteria for binge eating disorder , bulimia nervosa , or variants of these disorders [ 7 , 8 ] .
Alongside studies question ing the impact of medication on weight gain in bipolar disorder [ 9 ] , identifying the role of weight-cycling in higher cardiovascular risk [ 10 ] , and showing that obesity risk pre- date s medication [ 11 ] , are reports of a link between eating disorders and high Body Mass Index ( BMI , kg/m ) [ 12 ] and evidence that baseline binge eating predicts medication-associated weight gain [ 13 ] .
With these recent developments in mind , the authors were curious about what novel interventions for eating disorders and weight disorder in bipolar disorder exist , and conducted a systematic review about their effectiveness .
In this search no treatments targeting eating disorders specifically were found to exist [ 14 ] , despite the movement of this area into the spotlight over 10 years ago [ 15 ] .
Evaluating an individualized lifestyle and life skills intervention to prevent antipsychotic-induced weight gain in first-episode psychosis.
AIM Initiating antipsychotic medication frequently induces rapid , clinical ly significant weight gain . We aim ed to evaluate the effectiveness of a lifestyle and life skills intervention , delivered within 4 weeks of antipsychotic medication initiation , in attenuating weight gain in youth aged 14 - 25 years with first-episode psychosis ( FEP ) . METHODS We undertook a prospect i ve , controlled study in two early psychosis community services . Intervention participants ( n = 16 ) received a 12-week individualized intervention delivered by specialist clinical staff ( nurse , dietician and exercise physiologist ) and youth peer wellness coaches , in addition to st and ard care . A comparison group was recruited from a similar service and received st and ard care  ( n = 12 ) . RESULTS The intervention group experienced significantly less weight gain at 12 weeks compared to st and ard care ( 1.8 kg , 95 % CI -0.4 to 2.8 vs. 7.8 kg , 4.8 - 10.7 , P < 0.001 ) . Thirteen per cent ( 2/16 ) of the intervention group experienced clinical ly significant weight gain ( greater than 7 % of baseline weight ) , while 75 % ( 9/12 ) of the st and ard care group experienced this level of weight gain . Similar positive effects of the intervention were observed for waist circumference . CONCLUSIONS A lifestyle and life skills intervention delivered as part of st and ard care attenuated antipsychotic-induced weight gain in young people with FEP . The intervention was acceptable to the young people referred to the service . Such interventions may prevent the seeding of future disease risk and in the long-term help reduce the life expectancy gap for people living with serious mental illness
These have been of limited long-term effectiveness , though early intervention post-first episode psychosis appears to be more promising [ 6 ] .
Hence , the effectiveness of Cognitive Behaviour Therapy ( CBT ) or
Background Eating disorders are understood to no longer be the remit of lean adolescent girls alone [ 1 ] , whatever pop culture offerings such as Netflix ’s To The Bone might continue to present .
Rather , people with eating disorders are much more diverse , often undiagnosed and often suffering in silence .
One patient population with a unique but poorly understood vulnerability to eating disorders , as well as obesity and poor physical health , is people with bipolar disorder .
Bipolar disorder is a complex , serious mental illness that confers significant functional impairment , primarily due to time spent in manic , depressed , or mixed state episodes , difficulty eliminating subthreshold depressive symptoms , and the financial , social and emotional sequelae of illness episodes .
One significant contributor to disability is physical ill health , with the average life expectancy of someone with bipolar disorder notably reduced due to cardiometabolic illnesses like heart disease and type two diabetes mellitus .
Furthermore , poorer physical health is associated with poorer mental health in this group , such as higher risk of depressive relapse [ 2 , 3 ] .
The past two decades has seen increased focus on preserving and improving the physical health of people with bipolar disorder , who are often prescribed long-term medication known to be conducive to weight gain [ 4 ] .
Trials of a number of interventions have attempted to implement lifestyle interventions to promote healthy eating , physical activity , and social connectedness , in order to prevent or reduce the adverse impact of obesity and improve physical health and psycho-social functioning [ 5 ] .
The role of disordered eating in contributing to physical and mental health outcomes among individuals with bipolar disorder has rarely been considered , despite the fact that approximately one in three people with bipolar disorder also meet criteria for binge eating disorder , bulimia nervosa , or variants of these disorders [ 7 , 8 ] .
Alongside studies question ing the impact of medication on weight gain in bipolar disorder [ 9 ] , identifying the role of weight-cycling in higher cardiovascular risk [ 10 ] , and showing that obesity risk pre- date s medication [ 11 ] , are reports of a link between eating disorders and high Body Mass Index ( BMI , kg/m ) [ 12 ] and evidence that baseline binge eating predicts medication-associated weight gain [ 13 ] .
With these recent developments in mind , the authors were curious about what novel interventions for eating disorders and weight disorder in bipolar disorder exist , and conducted a systematic review about their effectiveness .
In this search no treatments targeting eating disorders specifically were found to exist [ 14 ] , despite the movement of this area into the spotlight over 10 years ago [ 15 ] .