If you’re like half the population of the United States, you’ve been worried about your weight at some point recently. That stands to reason as 39% of adults in the U.S. are overweight and 13% are obese. I am one of those people. In fact, when I came across the research on bipolar disorder and obesity, I didn’t want to write about it. It’s too personal. I spend a lot of time worried about my weight. It’s not just vanity. Let’s be real, vanity is at least one factor for most of us who want to lose weight. I tell myself that if I were thinner people would respect me more, that my weight makes them think I have no self-control or self-worth. Well, the latter happens to be true sometimes because I have bipolar disorder; so there’s that. My focus is also on my health. I just want to feel better overall.

Let’s be clear. This will not be a list of excuses or accolades about accepting your own body. It will not be about fat-shaming. I will present the facts to you and you can do with them what you will, so let’s get to it.

The fact is, more than two-thirds of bipolar patients are overweight. That’s a serious increase over the general population and desperately needs to be addressed. Sadly, at least in my case, it’s not a topic that comes up often in treatment, whether with a physician or psychiatrist/therapist. We talk about mood. We talk about other symptoms. Doctors will give you the “P.S. This medication may make you gain weight,” but weight in general doesn’t seem to be something that automatically comes up. Other than the high population of overweight patients, why would it be important to discuss the link between weight and bipolar disorder? I can give you four reasons, though there are more that can be discussed.

1. Weight gain is linked to medications used to treat bipolar disorder.
I already mentioned this one, but it’s worth going into further. The vast majority of medications for any ailment come with side-effects. Just think of the commercials you see that spend half the time listing all of the horrible things that may happen to you if you take them. Medications for bipolar disorder are no different. It just so happens that one of those side-effects targets an already vulnerable population. Medications can lower metabolism, increase “bad” cholesterol levels and affect glucose levels, just to name a few things that are associated with weight gain. Surprisingly, patients who are not already overweight are more at risk of gaining weight with use of some medications. Of course, not all medications are created equal. Clozapine and olanzapine are among the top culprits with lithium and gabapentin less-so. Contrarily, lamotrigine, ziprasidone and carbamazepine do not seem to have much effect, if any on weight.

2. Bipolar patients are at greater risk for physical illnesses such as diabetes and heart disease.
This may be a bit of a chicken vs. egg argument. Correlation does not equal causation, but it is true that bipolar patients suffer from weight-related illnesses at a higher rate than the general population. This includes poor triglyceride and cholesterol levels, higher risk of hypertension, diabetes and metabolic syndrome. As if this weren’t enough, overweight patients tend to experience more frequent symptoms than normal-weight counterparts.

3. Atypical depression is especially common in bipolar disorder.
With atypical depression, instead of insomnia and weight loss, patients will actually sleep and eat more than they normally would during a euthymic phase. Since two-thirds of bipolar patients experience atypical depression, this could play a large part in why so many of us have weight problems.

4. Patients with bipolar disorder are more likely to have an eating disorder.
About nine percent of the U.S. population has an eating disorder. With bipolar disorder, that percentage increases to over 20%. While anorexia still makes a showing among bipolar patients, the most common eating disorders are bulimia nervosa and binge eating disorder. This could be associated more with the atypical depression, but nonetheless warrants attention. Again, an eating disorder is often something that is treated separately from bipolar disorder, when the two are inevitably intertwined.

Like it or not, the link between weight and bipolar disorder needs to be addressed. Knowing the link exists is the first step in addressing the problem. Knowledge is power, right? Instead of just being down on ourselves because we’re overweight, and, well, generally down on ourselves, we can start adding steps to our coping regimen to help ourselves out. You can bring up all of these things with your doctor. Find out whether or not you may have insulin resistance or cardiovascular issues. Then you can adjust your diet accordingly. Also, if you think you may have an eating disorder now is the time to start addressing it. Sometimes it can be hard to distinguish from what may seem like normal symptoms of atypical depression.

As always, do what you can for yourself. You deserve it.