Obesity and Metabolic Syndrome in Bipolar Disorder

Metabolic syndrome and related conditions such as obesity, diabetes, dyslipidemia, and hypertension are significantly more prevalent in individuals with bipolar disorder compared to the general population. This chapter reviews the epidemiology, pathophysiology, and clinical implications of metabolic abnormalities in bipolar patients. Shared mechanisms include medication effects, unhealthy lifestyle behaviors, inflammation, neuroendocrine dysregulation, and genetic vulnerability. The presence of metabolic syndrome adversely affects the course, prognosis, and cognitive outcomes of bipolar disorder, particularly during depressive phases. Treatment strategies emphasize early screening, lifestyle modifications, and selection of psychotropic medications with minimal metabolic burden. Additionally, adjunctive pharmacologic interventions such as metformin or glucagon-like peptide-1 (GLP-1) receptor agonists may be considered. Greater clinical attention to metabolic health is essential to improve both psychiatric and physical outcomes in this population.