How Bipolar Disorder Affects Body Image

Bipolar disorder (BD) is a mental illness characterized by psychosis in which a person’s ability to recognize reality and emotional responses, thinking processes, judgment, and ability to communicate are so affected that their functioning is seriously impaired. Hallucinations and delusions are common features of psychosis.

Bipolar disorder caused extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). When people with BD (formerly called manic depression) become depressed, they may feel sad or hopeless and lose interest or pleasure in most activities. When their mood shifts to mania they may feel euphoric, full of energy, or irritable. These mood swings can affect sleep, energy, activity, judgment, behavior, and the ability to think clearly.

But bipolar disorder affects more than the psyche of the patient. People with BD also face elevated physical health risks. According to a study published last year in Psychosomatic Medicine, they are more likely than other people to experience a major adverse cardiac event, for example. Another common side effect of BD is weight gain.

“Nearly 70 percent of people who seek treatment for bipolar disorder are overweight or have obesity,” reported Stephanie Watson on PsychCentral in March. “Weight gain is a side effect of many medications that treat bipolar disorder. Other factors related to having bipolar disorder, like depression and substance use, also can lead to excess eating and weight gain.”

Managing the psychiatric symptoms of bipolar disorder with appropriate medications is very important, of course, but so is maintaining a healthy body weight. A 2017 study indicated that an elevated body mass index (BMI) may impact brain chemistry in ways that could worsen bipolar disorder symptoms.

And it may have a negative effect on body image, i.e. the impression a person has of their physical appearance. BD “symptoms and the possible weight gain related to treatment often affect body image,” Watson wrote. “For example, if you notice a major change in your body size after starting treatment, this might change the way you feel about or perceive your body. Obesity is linked to more body dissatisfaction, worse self-esteem, and greater rates of depression.”

Which in turn does not exactly help to counteract the symptoms of bipolar disorder. Body dissatisfaction is a major driver of eating disorders and many BD patients also have an eating disorder. As Watson explained in her article, “eating disorders can look very different among individuals with bipolar disorder. Mania and depression can fuel various features of eating disorders, such as restrictive diets or overeating. Binge eating disorder and bulimia may be more likely to coexist with bipolar disorder than anorexia nervosa.”

An eating disorder can obviously complicate BD management and should be addressed as part of a comprehensive treatment plan. The Colorado Recovery treatment model created by our founder Richard Warner is based on a warmer and more human familial setting, as well as  comprehensive levels of care that result in a path of self-reliance, improved self-esteem, and community engagement for connection and a feeling of contribution.

Since Dr. Warner’s passing in 2015, we have continued to innovate based on these core principles. It is our mission to help adults with serious mental health issues stabilize their illness, minimize symptoms, improve functioning, and enhance each person’s social inclusion, quality of life, and sense of meaning in life.

If you have questions about our recovery model or our services to treat schizophrenia, bipolar disorder, and similar mental illnesses, call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.