Clinical, Economic, and Humanistic Outcomes Associated With Obesity Among Adults With Bipolar I Disorder: Analysis of National Health and Wellness Survey Data

Abstract: Background: People living with bipolar I disorder (BD-I) have a higher risk of obesity than the general population. While outcomes associated with obesity are well documented in general, less is known about the burden of obesity among adults with BD-I. Objective: This study examined relationships between obesity and clinical, humanistic, and economic outcomes among adults with BD-I. Methods: Data are from the 2016 and 2020 US National Health and Wellness Survey (nationally representative, cross-sectional survey). Participants who self-reported a physician diagnosis of BD-I were categorized by body mass index (BMI). Study outcomes were adjusted for demographic (eg, age, sex) and health (eg, exercise, smoking status) characteristics. Results: Of 1,853 participants, most were female (65%), White (62%), and unemployed (54%), with an average age of 34 years. A total of 30% were underweight/normal weight (BMI 25), 25% were overweight (BMI ≥25 to 30), and 45% were obese (BMI≥30). Compared to underweight/normal-weight or overweight participants, those with obesity reported the highest prevalence of high blood pressure and cholesterol, type 2 diabetes, and heart attacks/strokes, among other comorbidities. Participants with obesity reported the lowest scores of physical health and highest scores of activity impairment. Participants with obesity had the highest average numbers of hospitalizations and emergency room visits, in addition to highest direct costs. Employed participants with obesity had the highest indirect costs due to loss of work productivity. Conclusions: In BD-I, obesity may be associated with an increased risk for comorbidities, reduced quality of life, and healthcare burden due to direct costs.Short Description: This study examined relationships between obesity and clinical, humanistic, and economic outcomes among adults with bipolar I disorder (BD-I). Data from the 2016 and 2020 US National Health and Wellness Survey were analyzed. Among 1,853 participants, 30% were underweight/normal weight, 25% were overweight, and 45% were obese. Participants with obesity reported the highest prevalence of comorbidities, highest average healthcare resource use and activity impairment, greatest indirect and direct costs, and lowest health-related quality of life.Name of Sponsoring Organization(s): Alkermes, Inc.