Body image, or the impression you have of your physical appearance, is highly personal. For those with bipolar disorder, mood episodes and treatment side effects can magnify body image issues.
Bipolar disorder is a mental health condition that involves major shifts in mood and energy levels. You might alternate between “up” energy periods, ranging from agitation to euphoria (mania or hypomania), and “down” low-energy periods (depression).
But bipolar disorder affects more than your mind. It can change your body, too.
Nearly 70% of people who seek treatment for bipolar disorder are overweight or have obesity. Weight gain is a side effect of many medications that treat bipolar disorder.
Other factors related to having bipolar disorder, like depression and substance use, also can lead to excess eating and weight gain.
Managing the emotional ups and downs of bipolar disorder is incredibly important, as is maintaining a healthy body weight. Having excess weight can cause health complications and may also change brain chemistry in ways that could make bipolar disorder worse, according to a
The exact effects of bipolar disorder on body image aren’t known because there’s currently limited research on the subject.
But bipolar disorder symptoms and the possible weight gain related to treatment often affect body image.
For example, if you notice a major change in your body size after starting treatment, this might change the way you feel about or perceive your body. Obesity is linked to more body dissatisfaction, worse self-esteem, and greater rates of depression.
However, individuals with moderate body weight are affected by these things as well. Body size isn’t the only thing that determines body image.
In fact, the type of bipolar disorder someone has might also affect body image, according to one 2019 study that included 180 people with the condition.
Researchers found that:
- Body image concerns were higher in people with bipolar II disorder than in those with bipolar I disorder.
- People with bipolar II had higher rates of neuroticism and obsessive-compulsive disorder (OCD), which might explain why they were more affected by body image issues.
- People with bipolar I disorder tended to have higher self-esteem, which may explain why they had fewer body image issues.
According to some estimates, 1 in 3 people with bipolar disorder also has an eating disorder.
Despite being so common, eating disorders can look very different among individuals with bipolar disorder. Mania and depression can fuel various features of eating disorders, such as restrictive diets or overeating.
Binge eating disorder and bulimia may be more likely to coexist with bipolar disorder than anorexia nervosa.
A few examples of how bipolar disorder may contribute to disordered eating include:
- Some people overeat or undereat during depressive episodes as a way to manage overwhelming feelings of sadness and stress.
- Unfocused thoughts and a lack of planning during manic episodes may make it harder for someone to focus on eating. On the other hand, mania can also lead to increased appetite and less concern about body image issues.
- People with bipolar disorder may drink alcohol or use substances that affect their appetite.
- Worries over weight gain as a side effect of bipolar disorder medications may cause some people to skip their treatment. People may also try unhealthy strategies to avoid weight gain, like restrictive eating or purging.
An eating disorder can complicate bipolar disorder management. According to 2017 research, people who have both conditions have more day-to-day impairment and are more likely to attempt suicide.
Suicide prevention
If you’re experiencing suicidal thoughts, help is always available.
- Call the National Suicide Prevention Lifeline 24 hours a day at 988.
- Text “HOME” to the Crisis Text Line at 741741.
- Not in the U.S.? Find a helpline in your country with Befrienders Worldwide.
- If it’s an emergency, call or visit your nearest emergency room or psychiatric care center to speak with a mental health professional.
Treatment is essential for managing bipolar disorder, but body image issues can make it more complicated.
It’s possible that for some people, weight gain due to certain treatments may actually make body image issues worse.
A person may have a negative body image well before treatment for bipolar disorder is started, making it harder for them to stick with their treatment plans.
People with existing body image issues may be less likely to take their medication because they worry about weight gain as a side effect, according to a 2021 study. People who stop taking their bipolar disorder medication are more likely to need a hospital stay or die by suicide.
Not everyone has the same experience, though. For some, treatment may help a person reduce the effects of mood episodes and improve their body image issues that are related to their symptoms.
A mental health professional can help you understand and cope with bipolar disorder symptoms, your relationship with your body, and the overlap between them.
If you’re navigating body image issues, here are a few ways to quiet that negative inner voice and feel more positive about your body:
- Appreciate what’s good about you: Instead of focusing on the negative, embrace all the wonderful things there are to love about yourself, like your creativity or your beautiful eyes.
- Write words of affirmation: Think of these as little love notes to yourself. Post them in places where you’re sure to see them every day, like your bathroom mirror or fridge.
- Do things that make you feel good about yourself: If seeing all the hardbodies at the gym stresses you out, work out at home or with friends who think you’re beautiful no matter what. Wear clothes that boost your confidence rather than bring you down.
- Search out bodies that look like yours: Browse social media and you’ll find lots of people who resemble you and who love the shape they’re in. Let their stories inspire you.
Body image issues, disordered eating, and poor self-esteem are all common in people with bipolar disorder. Many bipolar disorder medications can cause weight gain, which might also worsen body image for some.
If you’re living with a body image issue or an eating disorder, you can find help. Though it can be scary to open up about these topics, therapy can help you feel better. It’s also very important to keep taking the medication you need to manage bipolar disorder.
You can learn more about body image and eating disorders from the National Eating Disorders Association and find in-person and virtual doctors who treat disordered eating here.