Long-term weight loss can be difficult to achieve and weight maintenance even more problematic. If mental health difficulties in the form of Bi-Polar II Disorder (BD II) featuring Binge Eating (BE) and/or sub-threshold BE eating disorders are both co-present and common psychological problems in the management of BD II then when obesity is co-present difficulties for clinicians and patients are compounded. Obesity in BD II is far from a stand-alone difficulty – for instance the cyclothymic, anxious-sensitive, impulse-dyscontrol and binge-eating ‘soft spectrum’ of BD II has been shown to present with at least 10% of Bi-Polar patients (Perugi and Akiskal, 2002). Thus the treatment of BD II and Obesity can be frequently associated with impulse control difficulties, mood problems as well as most certainly with raised morbidity/mortality rates (Weber et al, 2011). Psychosocial approaches in weight loss treatment and condition management will need to take account of these nuances. It is suggested here that Trans-diagnostic Cognitive behavioural as well as Motivational Approaches are potentially enticing additions to comprehensive weight loss programs and psychosocial interventions for BD II patients. Motivational Interviewing, and in particular Trans-diagnostic CBT (TDCBT) approaches having been demonstrated as an effective method of behaviour change in addictions, chronic disease management, mental health and a range of other difficulties.
