Binge eating, weight gain and psychosocial adjustment in patients with bipolar disorder.

Binge Eating (BE) is a common eating pattern in patients with Bipolar Disorder (BD). BE may confer an increased risk for obesity, morbidity, mortality and poorer quality of life. We assessed the presence of BE and its impact on body weight, body image and self-esteem in 50 patients with BD and 50 age- and gender-matched controls. The presence and severity of BE was assessed with the Binge Eating Scale (BES). The Body Image and Self-Esteem Evaluation Scale (B-WISE) was used to assess the psychosocial impact of weight gain. Body Mass Index (BMI) was calculated. Nine (18%) patients had a score >27, indicating a likely diagnosis of BE. None of the control subjects had a BES score >17. No association between BES score and the medications was found. Patients had a significantly higher BES score, significantly higher BMI, waist circumference and fasting blood glucose. Although the B-Wise score was higher in the controls, the difference was not statistically significant. This study suggests that BE is prevalent in patients with BD. The presence of BE eating is a predictor of higher BMI, indicating that the disruption of eating behavior may be a pathway to weight gain.

Measured and expected resting energy expenditure in patients with bipolar disorder on maintenance treatment.

OBJECTIVES: Patients with bipolar disorder (BD) on long-term maintenance treatment represent a clinical population with peculiar characteristics, for which available equations to estimate resting energy expenditure (REE) are not suitable. The aim of this study was to measure REE by means of indirect calorimetry in bipolar patients on maintenance treatment and in controls, and to estimate the agreement between measured and predicted REE in both groups. METHODS: Patients diagnosed with BD I and healthy controls were assessed for height, weight and body mass index (BMI). Predicted REE was calculated using Harris-Benedict, Schofield, Recommended Nutrients Assumption Levels (LARN), and OUR equations; measurements of REE were performed using a portable indirect calorimeter. RESULTS: Results for our sample show the most commonly used formulas give a systematic overestimation of REE with respect to measured basal metabolic rate in the patient group. The mean bias was considerably greater for bipolar subjects than for controls. CONCLUSIONS: These results suggest that patients with severe mental illness on long-term psychopharmacologic treatment may have reduced basal energy expenditure that may be a cause of weight gain.

Effects of an educational intervention on weight gain in patients treated with antipsychotics.

BACKGROUND: Increasing numbers of reports have raised concerns about significant increases in weight and adiposity over both short- and long-term treatment in patients treated with antipsychotics (APs). The management of overweight and obesity in patients treated with APs has included pharmacological interventions, dietary suggestions, and behavioral strategies. Nevertheless, current evidence does not support the use of pharmacological management of this specific type of obesity, and only a limited number of studies have been published regarding prevention and treatment of weight gain with other strategies. OBJECTIVE: The aim of this study was to evaluate the effectiveness of an educational intervention (EI) that combines low-calorie diet with increased physical activity to prevent and treat weight gain in patients treated with APs. METHOD: Data were from 53 subjects whose body mass index (BMI) had increased by more than 7% after starting an AP therapy and who consented to participate in a 12-week educational intervention study aimed at preventing further weight gain and, when possible, at inducing a weight loss. Weight and BMI were measured at baseline (at each of the monthly follow-up visits) and at study completion 12 weeks from entry in the study. RESULTS: Twenty-six patients completed the 12-week program. Completers showed a significant mean body weight decrease of 3.15 kg, with a mean BMI reduction of 1.2 (kg/m) at the end of the 3-month period. CONCLUSIONS: Educational intervention can be an important tool for the management of weight increase in patients treated with APs. A larger prospective and controlled study is now needed to confirm our findings.

Nutrition knowledge and dietary composition in Italian adolescent female athletes and non-athletes.

This study aims to investigate dietary composition and nutrition knowledge of 60 athlete and 59 non-athlete adolescent females (age, 14-18 years), using a 3-day food recall and a questionnaire on nutrition. The reported daily energy intake was similar in athletes and non-athletes, but less than the recommended and the estimated requirements. In the athletes, the energy supply from breakfast was higher than in the non-athletes (18.5 +/- 6.6 vs. 15.0 +/- 8.2%, p < .005). Energy intake from carbohydrates was higher (53.6 +/- 6.2 vs. 49.8 +/- 6.3%, p < .05) and that from lipids was lower (30.4 +/- 5.5 vs. 34.2 +/- 5.2%, p < .001) in athletes than in non-athletes. Athletes also showed higher fiber (20.0 +/- 5.8 vs. 14.1 +/- 4.3 g/day, p < .001), iron (10.6 +/- 5.1 vs. 7.5 +/- 2.1 mg/day, p < .001) and vitamin A (804 +/- 500 vs. 612 +/- 456 micrograms/day, p < .05) reported intake than non-athletes. Calcium, iron, and zinc intake were less than 100% RDA in both groups. Athletes gave a slightly higher rate of correct answers on the nutrition knowledge questionnaire (77.6 vs. 71.6%, p < .01) than non-athletes. In conclusion, the overall recalled dietary intake and nutrition knowledge of the studied adolescent females show some misconceptions and nutrient deficiencies, but the results in athletes are quite better than in non-athletes, suggesting a favorable role of sport practice on dietary habits and nutrition knowledge.