Eating disorders are common in people with bipolar disorder, especially binge eating disorder and bulimia. We look at the reasons why.

Nutrition is crucial to your overall health, especially if you’re living with bipolar disorder — but it can be difficult to get the nutrition that you need when you’re dealing with mood shifts.

Bipolar disorder affects not only your mood, but also your appetite, weight, and food intake. This is partly due to mood episodes. Bipolar disorder medication side effects can also contribute.

The result can be the development of a true eating disorder like binge eating disorder or bulimia. If you think you may have an eating disorder, consider talking with a mental health professional to find appropriate treatment.

If you have bipolar disorder, it’s common to also have an eating disorder.

A systematic review from 2019 reported that eating disorders affect up to a third of people with bipolar disorder (33%). By comparison, the lifetime prevalence of eating disorders in the general United States population is 9%.

Eating disorders may occur more frequently in bipolar disorder because of the symptoms of depression, mania, and hypomania — all of which can affect your appetite and eating habits.

Depression, for example, can lead to either increased or decreased appetite. Similarly, impulsivity during mania can cause you to eat more or less than usual.

Eating disorders involve a preoccupation with your body weight, shape, or diet, which impacts your well-being. Low mood and a negative perception of yourself are common in bipolar disorder and can contribute to disordered eating.

Bipolar disorder and eating disorders share some features, including:

  • impulsivity
  • emotional reactivity
  • changes in appetite
  • difficulties with self-esteem
  • a negative opinion of yourself
  • changes in physical activity

Overall, it seems that the nature of bipolar disorder plays a role in developing eating disorders. Changes in mood and cognitive function can affect your appetite and weight.

According to 2021 research, the most prevalent eating disorders in bipolar disorder are the following:

Among these, binge eating disorder is the most common. This is when you consistently eat an excessive amount of food for one or more days per week for at least 3 months. You will usually also:

  • eat rapidly
  • eat regardless of hunger
  • eat alone due to feelings of shame
  • have negative feelings about yourself after binging

Bulimia nervosa is also characterized by episodes of binge eating, but the episodes are typically followed by self-induced vomiting. Bulimia is the second most common eating disorder in bipolar and may also include:

  • throat pain
  • fatigue or muscular pain
  • severe self-criticism
  • abdominal pain or bloating

Anorexia nervosa is defined by the severe restriction of food and resulting weight loss. It’s the third most common eating disorder in bipolar. Anorexia symptoms may also include:

  • fear of weight gain
  • absence of menstrual cycle
  • body image distortion
  • low body weight

Bipolar disorder medications are known to cause changes in metabolism and appetite, among other effects, which can affect your eating patterns.

Medications that treat bipolar disorder can lead to weight gain, which can be challenging for people with a history of eating disorders. This can prevent people from taking their medication. In these cases, it’s best to speak with a mental health professional to find a treatment option that works best for you.

Research from 2020 reports that commonly prescribed medications such as lithium and quetiapine may cause weight gain after about 6 months of use. But this doesn’t mean that they directly contribute to eating disorders — rather, their effects seem to influence metabolism.

On the other hand, the effect of antidepressant medications can either increase or decrease your appetite. Antidepressants are sometimes prescribed to manage bulimia nervosa, however.

Bipolar disorder can complicate the treatment of eating disorders, especially because bipolar disorder medications can have unpredictable effects on your appetite.

It may help to talk with a mental health professional about finding the right medication and dose that helps to keep your mood, energy, and appetite relatively stable.

A 2019 review noted that managing eating disorders in bipolar disorder is a relatively new topic that needs more research. The review advocated for using psychotherapies, such as cognitive behavioral therapy (CBT), as one means to treat eating disorders in people with bipolar disorder.

You can learn more about treatment and coping tips at Psych Central’s eating disorder resource hub.

If you think that you may have an eating disorder, you can work with a professional to help improve your eating habits. They’ll be able to provide you with advice and strategies to help get you back on track.

Want to learn more? The following resources may help: