Overweight and eating disorders in people with epilepsy
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Background: Epilepsy is a common neurological disease and occurs in 0.7-1.3 % of the general population. It is associated with comorbid mental disorders such as depression and anxiety, and with a high risk for adverse outcome during pregnancy and delivery. Epilepsy affects people of all ages, but especially among young people it represents a challenge in how to cope with the disease. This makes young people with epilepsy a vulnerable group. Aims: We hypothesized that young people with epilepsy have more eating disorders than the general population, and wanted to determine the prevalence of eating disorders among young people with epilepsy. A particular focus was put on pregnant women with epilepsy (WWE). We also wanted to investigate how comorbid eating disorders influence outcome of pregnancies in WWE. A second hypothesis we investigated was that young people with epilepsy are more overweight, and that such overweight leads to an increased risk for an adverse pregnancy-outcome in WWE. Material and methods: We used the Norwegian Mother and Child Cohort Study (MoBa) to study pregnancies in WWE. More than 100.000 women were included in this cohort, whereas 706 women reported a diagnosis of epilepsy. We compared pregnancies in women with and without epilepsy in relation to eating disorders and overweight, and also pregnancy-outcome. MoBa is linked to the Norwegian Medical Birth Registry (MBRN). Secondly we used the Health Profile for Children and Youth in Akershus Study to study prevalence of eating disorders among youth with epilepsy of both genders. We investigated also additional variables such as overweight, diet and physical activity. Results: We found that WWE have an increased rate of binge eating disorder compared to women without epilepsy. WWE were also more overweight and obese than the general population. Both of these variables were associated with adverse outcome during pregnancy and delivery in WWE. Young people with epilepsy in Akershus were more likely to have had contact with health personnel due to eating disorders than the referent. Conclusion: Pregnancies in WWE have a higher risk of adverse outcome. An increased rate of overweight and weight inducing eating disorders are contributing factors to this. The increased rate of eating disorders among people with epilepsy is evident from an early age, and this is important for health personnel to be aware of in their interaction with these patients. Early diagnosis and treatment is of great importance.
Består avPaper I: Kolstad E, Gilhus NE, Veiby G, Reiter SF, Lossius MI, Bjørk M (2015): "Epilepsy and eating disorders during pregnancy: Prevalence, complications and birth outcome", Seizure 28: 81-84. The article is available in the main thesis. The article is also available at: https://doi.org/10.1016/j.seizure.2015.02.014.
Paper II: Kolstad E, Gilhus NE, Veiby G, Bjørk M (2016): "Overweight in epilepsy as a risk factor for pregnancy and delivery complications", Epilepsia 57(11): 1849-1857. The article is available in the main thesis. The article is also available at: https://doi.org/10.1111/epi.13573.
Paper III: Kolstad E, Bjørk M, Gilhus NE, Alfstad K, Clench-Aas J, Lossius M. (2018): "Young people with epilepsy have an increased risk of eating disorder and poor quality diet", Epilepsia Open 3(1): 40-45. The article is available in the main thesis. The article is also available at: http://hdl.handle.net/1956/17578.