Clinical phenotype of bipolar disorder with comorbid binge eating disorder

Susan L. McElroy*, Scott Crow, Joanna M. Biernacka, Stacey Winham, Jennifer Geske, Alfredo B.Cuellar Barboza, Miguel L. Prieto, Mohit Chauhan, Lisa R. Seymour, Nicole Mori, Mark A. Frye

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

57 Scopus citations


Background: To explore the relationship between binge eating disorder (BED) and obesity in patients with bipolar disorder (BP). Methods: 717 patients participating in the Mayo Clinic Bipolar Biobank completed structured diagnostic interviews and questionnaires for demographic and illness-related variables. They also had weight and height measured to determine body mass index (BMI). The effects of BED and obesity (BMI>30 kg/m2), as well as their interaction, were assessed on one measure of general medical burden and six proxies of psychiatric illness burden. Results: 9.5% of patients received a clinical diagnosis of BED and 42.8% were obese. BED was associated with a significantly elevated BMI. Both BED and obesity were associated with greater psychiatric and general illness burden, but illness burden profiles differed. After controlling for obesity, BED was associated with suicidality, psychosis, mood instability, anxiety disorder comorbidity, and substance abuse comorbidity. After controlling for BED status, obesity was associated with greater general medical comorbidity, but lower substance abuse comorbidity. There were no significant interaction effects between obesity and BED, or BMI and BED, on any illness burden outcome. Limitations: There may have been insufficient power to detect interactions between BED and obesity. Conclusions: Among patients with BP, BED and obesity are highly prevalent and correlated, but associated with different profiles of enhanced illness burden. As the association of BED with greater psychiatric illness burden remained significant even after accounting for the effect of obesity, BP with BED may represent a clinically important sub-phenotype.

Original languageEnglish
Pages (from-to)981-986
Number of pages6
JournalJournal of Affective Disorders
Issue number3
StatePublished - 25 Sep 2013

Bibliographical note

Funding Information:
Dr. Crow has received research grants from Shire, Alkermes, and Phillips Respironics.

Funding Information:
Dr. McElroy is a consultant to or member of the scientific advisory boards of Alkermes, Bracket, Corcept, MedAvante, Shire, and Teva. She is a principal or co-investigator on studies sponsored by the Agency for Healthcare Research and Quality (AHRQ), Alkermes, AstraZeneca, Cephalon, Eli Lilly and Company, Forest, Marriott Foundation, National Institute of Mental Health, Orexigen Therapeutics, Inc., Pfizer, Shire, Takeda Pharmaceutical Company Ltd., and Transcept Pharmaceutical, Inc. She is also an inventor on United States Patent no. 6,323,236 B2, Use of Sulfamate Derivatives for Treating Impulse Control Disorders, and along with the patent's assignee, University of Cincinnati, Cincinnati, Ohio, has received payments from Johnson & Johnson, which has exclusive rights under the patent.


  • Binge eating disorder
  • Bipolar disorder
  • Obesity


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