Dangerous Association Noted Between Mental Illness and Obesity CME

Clinical Context

Obesity is common among patients with mental illness, occurring in up to 60% of patients with bipolar disorder, 70% of patients with schizophrenia, and 55% of patients with depression. A review by Taylor and colleagues in the current issue of the Canadian Journal of Psychiatry analyzes why mental illness is associated with higher rates of obesity. Although the use of psychoactive medications is an obvious reason for weight gain in this patient population, there is also evidence that disturbance of the sleep-wake cycle may promote a resistance to leptin, which promotes satiety, and higher levels of circulating ghrelin, which stimulates appetite. In addition, depression is associated with higher levels of circulating cortisol, which promotes weight gain. Finally, both mood disorders and obesity are marked by dopaminergic deficits. Continue reading