Nutrition and exercise behavior among patients with bipolar disorder1


  • 1

    The authors of this paper warrant that they have no actual or perceived conflicts of interest, financial or non-financial in the procedures described in this manuscript.

Amy M Kilbourne, PhD, MPH, VA Ann Arbor Healthcare System Serious Mental Illness Treatment and Evaluation Center (11H), 2215 Fuller Road, Ann Arbor, MI 48105, USA. Fax: +1 734 761 2617; e-mail:


Objectives:  There have been few comprehensive studies of nutrition and exercise behaviors among patients with bipolar disorder (BPD). Based on a national sample of patients receiving care in the Veterans Affairs (VA) health care system, we compared nutrition and exercise behaviors among individuals diagnosed with BPD, others diagnosed with schizophrenia, and others who did not receive diagnoses of serious mental illness (SMI).

Methods:  We conducted a cross-sectional study of patients who completed the VA's Large Health Survey of Veteran Enrollees section on health and nutrition in fiscal year (FY) 1999 and who either received a diagnosis of BPD (n = 2,032) or schizophrenia (n = 1,895), or were included in a random sample of non-SMI VA patients (n = 3,065). We compared nutrition and exercise behaviors using multivariable logistic regression, controlling for patient socio-economic and clinical factors, and adjusting for patients clustered by site using generalized estimating equations.

Results:  Patients with BPD were more likely to report poor exercise habits, including infrequent walking (odds ratio, OR = 1.33, p < 0.001) or strength exercises (OR = 1.28, p < 0.001) than those with no SMI. They were also more likely to self-report suboptimal eating behaviors, including having fewer than two daily meals (OR = 1.32, p < 0.001) and having difficulty obtaining or cooking food (OR = 1.48, p < 0.001). Patients with BPD were also more likely to report having gained ≥10 pounds in the past 6 months (OR = 1.59, p < 0.001) and were the least likely to report that their health care provider discussed their eating habits (OR = 0.84, p < 0.05) or physical activity (OR = 0.81, p < 0.01).

Conclusions:  Greater efforts are needed to reduce the risk of poor nutrition and exercise habits among patients diagnosed with BPD.