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 ] .
Reducing eating disorder onset in a very high risk sample with significant comorbid depression: A randomized controlled trial.
OBJECTIVE Eating disorders ( EDs ) are serious problems among college-age women and may be preventable . An indicated online eating disorder ( ED ) intervention , design ed to reduce ED and comorbid pathology , was evaluated . METHOD 206 women ( M age = 20 ± 1.8 years ; 51 % White/Caucasian , 11 % African American , 10 % Hispanic , 21 % Asian/Asian American , 7 % other ) at very high risk for ED onset ( i.e. , with high weight/shape concerns plus a history of being teased , current or lifetime depression , and /or non clinical levels of compensatory behaviors ) were r and omized to a 10-week , Internet-based , cognitive-behavioral intervention or waitlist control . Assessment s included the Eating Disorder Examination ( EDE , to assess ED onset ) , EDE- Question naire , Structured Clinical Interview for DSM Disorders , and Beck Depression Inventory-II . RESULTS ED attitudes and behaviors improved more in the intervention than control group ( p = .02 , d = 0.31 ) ; although ED onset rate was 27 % lower , this difference was not significant ( p = .28 , NNT = 15 ) . In the subgroup with highest shape concerns , ED onset rate was significantly lower in the intervention than control group ( 20 % vs. 42 % , p = .025 , NNT = 5 ) . For the 27 individuals with depression at baseline , depressive symptomatology improved more in the intervention than control group ( p = .016 , d = 0.96 ) ; although ED onset rate was lower in the intervention than control group , this difference was not significant ( 25 % vs. 57 % , NNT = 4 ) . CONCLUSIONS An inexpensive , easily disseminated intervention might reduce ED onset among those at highest risk . Low adoption rates need to be addressed in future research
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 ] .