In bipolar disorder (BD) patients, obesity is highly prevalent and strongly influenced by maladaptive eating behaviors such as low cognitive restraint, high uncontrolled eating, and emotional eating. These traits contribute to weight gain and complicate treatment. In this context, interventions should not only aim to reduce excessive caloric intake and processed food consumption but also address the behavioral alimentation mechanisms underlying weight regulation. We conducted an observational study to evaluate the effects of tirzepatide, a dual GLP-1/GIP receptor agonist, in a real-world cohort of patients with bipolar disorder and obesity. Eating behaviors were assessed using the Three-Factor Eating Questionnaire. BMI changes were assessed. Safety and tolerability were evaluated using patient-reported outcomes and any treatment discontinuations. Significant improvements were observed across all subscales, with an increase in cognitive restraint and reductions in both uncontrolled eating and emotional eating. Tirzepatide was generally well tolerated, with only mild and transient adverse effects. These results suggest that tirzepatide may provide benefits extending beyond weight loss by enhancing cognitive restraint and reducing uncontrolled eating. In particular, the reduction in emotional eating may help break the cycle between affective symptoms and overeating, potentially lowering the risk of relapse and further metabolic deterioration. Although limited by a small sample size and an observational design, this study provides preliminary evidence that tirzepatide may address both biological and behavioral dimensions of obesity in bipolar disorder, warranting larger and longer-term investigations.
- Open Access
- Article
Beyond Weight Loss: Tirzepatide and Eating Behaviors in Patients with Bipolar Disorder and Obesity
Author Information
Received: 19 Sep 2025 | Revised: 10 Nov 2025 | Accepted: 24 Nov 2025 | Published: 04 Dec 2025
Abstract
Keywords
tirzepatide | bipolar disorder | obesity | emotional eating | cognitive restraint | uncontrolled eating
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