The Burden of Obesity Among Adults With Bipolar I Disorder

Researchers collected data from the 2016 and 2020 National Health Interview Survey to examine the relationships between obesity and clinical, humanistic, and economic outcomes among patients who self-reported a diagnosis of bipolar I disorder. Results from the study were highlighted at a poster presentation at the 2022 Neuroscience Education Institute Congress.

In this exclusive MedPage Today video, lead researcher Michael J. Doane, PhD, the associate director of Health Economics and Outcomes Research at Alkermes, discusses the results of the study.

Following is a transcript of his remarks:

My name is Michael Doane. My role at Alkermes is as a health economics and outcomes researcher. And so part of what we try to do is really to highlight the patient experience. And since Alkermes is dedicated to treating patients with serious mental illness, we’ve tried to conduct a series of studies to just understand and capture the patient perspective, and to understand what matters to the patients outside of the clinical trial programs that we conduct.

And so related to this study, one of the things that we’ve seen over time is that the rates of obesity have been increasing just in general in the United States. And another thing that we’ve seen in the literature, though, is that the rates of obesity for patients with bipolar I disorder specifically are even higher. They’re at an added risk of obesity compared to the general population.

And so we just wanted to understand and kind of dig a little bit more into obesity among this patient population and the potential outcomes that are associated with obesity among those living with bipolar I disorder.

And so, this study was looking at survey data direct from patients. So we had just over 1,800 people with bipolar I disorder complete the survey. And we looked at a broad range of different outcomes, things from clinical outcomes like comorbidities, to humanistic outcomes, so health-related quality of life, and also economic outcomes, so looking at healthcare resource use and medical costs, for example.

And there are a couple of key things that we found in the study. We found, for example, that about half of respondents with bipolar I disorder were considered obese, and another quarter of respondents were overweight and at risk of developing obesity. And when it comes to comorbidities, respondents with obesity had the highest risk or the highest prevalence of many different comorbidities that we assessed. So, some of the common ones, you know, cardiometabolic comorbidities like high cholesterol, type 2 diabetes, high blood pressure. But those patients were also much more likely to have had a heart attack or stroke in the past as well.

But there were other comorbidities that we looked at that looked to be associated with obesity — so things like asthma, osteoarthritis, and sleep conditions, things like insomnia and sleep apnea. But beyond the clinical comorbidities and those clinical characteristics that we looked at, there were a lot of other outcomes that were linked to obesity.

So there were a lot of patient-reported outcome assessments that we captured in the survey, which really showed the highest overall burden of those with obesity. So, for example, the lowest physical health and perceptions of physical health, and also the highest overall physical impairment in terms of being able to just complete daily activities.

And then lastly, we looked at healthcare resource use and medical costs. And we found that those patients with obesity had the highest average number of hospitalizations. They also had the highest average visits to the emergency room as well. And given those high rates of healthcare resource use among those with obesity, they also had the highest direct medical costs as well.

I think when thinking about the study results, it’s important for clinicians to think about patients in terms of their whole health — so not just focusing on their mental health, but also thinking about their physical health. And that can include things like comorbidities that they’re currently living with, or the potential risk of developing new comorbidities, or having a worsening of existing comorbidities.

In the study we found that a pretty high rate of different comorbidities among these patients, which could be driven in part by obesity. And so it’s important to take that more holistic approach to treating patients with bipolar I disorder — again, keeping in mind both mental as well as physical aspects.