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Bipolar disorder, a mental health condition that involves distinct shifts in mood, affects 4.4% of American adults at some point in their lives.

With bipolar disorder, you might experience:

  • episodes of depression, or periods where you have a “down” or low mood
  • episodes of mania or hypomania, or periods where you have an “up” or elevated mood
  • both types of episodes

Along with the mood episodes that characterize the condition, you might notice other symptoms, including changes in your sleep patterns and appetite.

Roughly 30% of people with bipolar disorder also experience episodes of binge eating, which involves eating a very large amount of food in a short period of time and often feeling unable to stop eating.

Experts aren’t yet certain what makes binge eating so common among people with bipolar disorder, but they have come up with a few potential explanations. Read on for more details, plus tips to find support.

Binge eating can occur on its own, or it can happen as a symptom of an eating disorder such as binge eating disorder (BED) or bulimia nervosa.

Binge eating disorder (BED) vs. bulimia nervosa

BED involves a pattern of binge eating that happens on a weekly basis for at least 3 months. Around 2.8% of adults will have BED in their lifetime.

Bulimia nervosa involves both binge eating and purging. After a binge eating episode, people with this condition purge to get rid of the excess calories, typically by inducing vomiting, taking laxatives, fasting, or exercising to an extreme. About 1% of adults will have bulimia nervosa in their lifetime.

People with a bipolar disorder diagnosis are much more likely to have an eating disorder than the general population. The reverse is also true.

A systematic review of 47 studies with 30,230 total participants found:

  • 12.5% of people with a primary diagnosis of bipolar disorder also had BED.
  • 9.1% of people with a primary diagnosis of BED also had bipolar disorder.
  • 7.4% of people with a primary diagnosis of bipolar disorder also had bulimia nervosa.
  • 6.7% of people with a primary diagnosis of bulimia nervosa also had bipolar disorder.

Bipolar disorder and eating disorders have a few things in common. Both conditions:

  • tend to start in early life
  • have a cyclical course
  • may involve fluctuating energy levels, emotional reactivity, and changes in eating patterns

In fact, binge eating behavior typically appears around the same time as your first mood episode, though the exact order of their appearance doesn’t seem to influence outcomes very much.

One condition may affect the other

If you have both conditions, you may have a harder time managing emotions than you would with either condition alone. You may also notice more severe anxiety or impulsivity symptoms.

Mood episodes can also trigger episodes of binge eating.

For some people, binge eating may happen more often during episodes of mania than episodes of depression.

In short, mania could boost feelings of impulsivity and your appetite. Depression, meanwhile, might make your appetite disappear. You might lack energy to prepare food, and the very thought of eating could leave you feeling nauseated.

But the reverse pattern can also occur. You might forget to eat during an episode of mania and experience intense cravings for certain foods during a period of depression.

Because of the interaction between the two conditions, some researchers believe “bipolar disorder with eating disorder” should be a diagnosable subtype.

Potential theories to explain the link between bipolar disorder and binge eating include:

Genetics

Part of the connection may relate to shared genetic factors. Both bipolar disorder and binge eating have been linked to variations in the PRR5-ARHGAP8gene. This gene influences many processes in your body such as helping you regulate food intake or keeping your energy levels stable.

Heritability studies support this finding: In fact, an older 2014 study found women are twice as likely to develop an eating disorder if one parent had bipolar disorder.

Brain-derived neurotrophic factor

Brain-derived neurotrophic factor (BDNF) is a molecule that serves many functions in the brain, including helping regulate both mood and appetite.

During a mood episode, you’ll typically have lower BDNF levels than usual. This drop can lead to emotional disruption and abnormal food intake, especially if you have an eating disorder. Research has directly linked lower BDNF levels to binge eating in people with bulimia nervosa.

The fluctuation may help explain why mood episodes can trigger binge eating.

In both bipolar disorder and eating disorders, BDNF levels tend to rise after treatment.

Medication side effects

Some bipolar disorder medications may play a part, as well.

Antipsychotics, for instance, may lead to binge eating or compulsive eating behaviors because long-term exposure to these drugs can decrease your body’s ability to recognize fullness. These medications can also increase activity in the parts of your brain associated with anticipating food rewards.

Mood stabilizers generally don’t cause binge eating directly, but some of them can cause weight gain. If this side effect concerns you, you may try to counteract it by restricting your food intake — which may, in some cases, prompt a cycle of bingeing and purging.

Self-soothing

For many people, food ties into feelings: It can offer comfort, spark excitement, or trigger a sense of shame.

If you have a mood disorder that affects your emotions, you may also find yourself using food to counteract unwanted emotional symptoms.

Participants in a 2021 study reported the following motivations for non-hungry eating:

  • to feel more in control, especially if they had rapid shifts in mood
  • to cope with depressive symptoms such as fatigue and anhedonia
  • to comfort themselves when stressed

Trauma

Trauma is a known risk factor for both bipolar disorder and disordered eating behaviors, especially binge eating. An older 2013 study included 717 adults, including 68 people with both bipolar disorder and BED. Roughly 45% of this subgroup also had post-traumatic stress disorder (PTSD).

A similar 2022 study looked at teens and young adults who had bipolar disorder. Among those with a co-occurring eating disorder, around 1 in 5 had PTSD.

FYI

Existing research on binge eating and bipolar disorder mostly involves people receiving treatment for severe symptoms, and people with bipolar I disorder are overrepresented in these studies.

Experts have yet to determine if people with bipolar I disorder are actually more likely to experience binge eating than people with bipolar II disorder, or if they simply get treatment more often.

Learn the difference between bipolar I and bipolar II disorder.

People with both bipolar disorder and BED often have more severe symptoms, including:

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Bipolar disorder, in turn, may affect the severity of eating disorder symptoms. People with both conditions tend to have worse scores in measures of:

  • impulse regulation
  • awareness of hunger and fullness cues
  • body dissatisfaction
  • concern about weight
  • concern about eating habits

Without a doubt, more severe symptoms can increase the impact of these conditions on your quality of life. Food-related tasks, such as buying groceries or preparing meals, may become a source of distress. Relationships, too, can become overwhelming or tense when loved ones don’t understand what you’re going through.

Maybe you spend a lot of time and energy trying to avoid binge eating or prevent mood episodes. But you may not always find this possible because willpower alone can’t treat mental health symptoms. After an episode, you might find yourself expending even more energy trying to navigate feelings of self-frustration, failure, or other emotional distress.

Having both conditions may also increase your chances of developing physical health concerns.

Any of these concerns can be difficult enough to handle on their own, so managing a combination of symptoms may feel pretty exhausting. But treatment can go a long way toward improving symptoms and, in turn, your everyday life.

Because binge eating and bipolar disorder affect each other, it’s important to address both issues in your treatment plan.

For bipolar disorder

Bipolar disorder treatment often involves a combination of talk therapy and medication. If the side effects of medication contribute to binge eating behaviors, you can talk with a psychiatrist or doctor about trying a medication less likely to cause those side effects.

Learn more about treatment options for bipolar disorder.

For binge eating

Treatment for binge eating tends to lean more heavily on therapy than medication. A therapist may work with you to:

Eating disorder support groups may also play a part in recovery.

How to get treatment for BED.

Can medication treat binge eating?

Some people may use the drug topiramate to halt medication-related weight gain or reduce binge eating behaviors.

However, topiramate is approved to treat epilepsy and migraine attacks, not weight loss, and it can cause serious side effects. It’s generally reserved for cases where other treatments haven’t worked.

For both conditions

Though plenty of studies have considered bipolar disorder treatment and binge eating treatment, virtually no research has explored treating the two conditions together.

Studies examining the relationship between bipolar disorder and food typically focus on obesity and weight loss, not binge eating. What’s more, BED treatment trials often exclude people with bipolar disorder, in part because of how medications for bipolar disorder can affect weight and appetite.

However, recent studies have provided a glimmer of insight into effective treatments.

In the small 2021 study mentioned above, some participants with both bipolar disorder and an eating disorder praised dialectical behavior therapy (DBT) for helping them deal with stress in the moment.

Some participants found cognitive behavioral therapy (CBT) less effective, although this approach has shown promise for helping reduce depression for people living with BED.

Many people with bipolar disorder experience episodes of binge eating. Experts believe a range of factors beyond your control, from genetics to trauma, may play a part in the relationship between the two.

Whatever the cause, co-occurring bipolar disorder and binge eating can involve a complex combination of symptoms, and these conditions require holistic care.

When looking for professional support, it’s important to build a care team that listens to your concerns and works with you to find the most effective treatment approach.


Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.