Division of Research, Kaiser Permanente, Oakland, CA 94612, USA.
Adv Ther. 2011 May;28(5):389-400. doi: 10.1007/s12325-011-0015-3. Epub 2011 Apr 4.
Persons with bipolar disorder (BD) have an increased risk of obesity and associated diseases. Success of current behavioral treatment for obesity in patients with BD is inadequate.
Existing literature on bariatric surgery outcomes in populations with BD were reviewed, and needed areas of research were identified.
Knowledge about bariatric surgery outcomes among patients with BD is limited. Available evidence indicates that bariatric surgery is a uniquely effective intervention for achieving and sustaining significant weight loss and improving metabolic parameters. Notwithstanding the benefits of bariatric surgery in nonpsychiatric samples, individuals with BD (and other serious and persistent mental illnesses) have decreased access to this intervention. Areas of needed research include: (1) current practice patterns; (2) metabolic course after bariatric surgery; (3) psychiatric course after bariatric surgery; and (4) mechanisms of psychiatric effect.
The considerable hazards posed by obesity in BD, as measured by illness complexity and premature mortality, provide the basis for hypothesizing that bariatric surgery may prevent and improve morbidity in this patient population. In addition to physical health benefits, bariatric surgery may exert a robust and favorable effect on the course and outcome of BD and reduce obesity-associated morbidity, the most frequent cause of premature mortality in this patient population.
双相情感障碍（BD）患者肥胖和相关疾病的风险增加。目前针对 BD 患者肥胖的行为治疗效果并不理想。
综述了 BD 患者接受减重手术结果的现有文献，并确定了需要研究的领域。
BD 患者接受减重手术结果的相关知识有限。现有证据表明，减重手术是一种独特有效的干预措施，可实现并维持显著的体重减轻和改善代谢参数。尽管减重手术在非精神科样本中具有益处，但 BD 患者（和其他严重和持续的精神疾病患者）接受这种干预的机会减少。需要研究的领域包括：（1）当前的实践模式；（2）减重手术后的代谢过程；（3）减重手术后的精神科病程；（4）精神科效应的机制。
肥胖对 BD 造成的严重危害，如疾病复杂性和过早死亡，为假设减重手术可能预防和改善该患者群体的发病率提供了依据。除了对身体健康有益之外，减重手术可能对 BD 的病程和结果产生强大而有利的影响，并减少肥胖相关的发病率，这是该患者群体过早死亡的最常见原因。
