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Weight cycling in bipolar disorder.

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Weight cycling in bipolar disorder (BD) is linked to more frequent mood episodes and higher inflammation. This may identify a subgroup at increased cardiovascular risk, aiding personalized BD treatment strategies.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Immunology

Background:

  • Excess weight and weight fluctuations are linked to cardiovascular issues.
  • Individuals with bipolar disorder (BD) experience higher rates of obesity and cardiovascular mortality.
  • Weight cycling (WCYC), defined as repetitive weight loss and gain, is a pattern observed in some individuals with BD.

Purpose of the Study:

  • To investigate the relationship between the course of illness in BD and WCYC.
  • To determine if WCYC in BD identifies a distinct biological subtype with a unique inflammatory profile.
  • To explore potential links between WCYC, illness severity, and cardiovascular risk in BD.

Main Methods:

  • Retrospective analysis of sociodemographic, clinical, and inflammatory markers in euthymic adults with BD (n=101) and healthy controls (n=48).
  • Assessment of history of weight cycling (WCYC) in relation to illness course and inflammatory markers.
  • Measurement of circulating inflammatory markers, including IL-6 concentrations.

Main Results:

  • Individuals with BD and a history of WCYC had more frequent manic and depressive episodes compared to non-WCYC BD individuals.
  • Elevated circulating IL-6 concentrations were observed in BD individuals with WCYC.
  • These associations remained significant after adjusting for BMI, age, and number of prior episodes.

Conclusions:

  • Adults with BD who are overweight are more prone to a relapse-prone illness course and WCYC.
  • Elevated pro-inflammatory cytokines in the WCYC subgroup suggest increased susceptibility to cardiovascular disease.
  • Stratifying BD patients based on anthropometrics and WCYC may aid in personalized cardiovascular risk assessment and prevention.