Abstracts

Rationale: Obesity is a serious and growing health risk. Brain regions involved in eating behavior are among the more epileptogenic sites, raising questions of whether people with epilepsy might be at increased risk of obesity. The possibility that epilepsy might be associated with a sedentary lifestyle suggests a second risk factor. We examined the incidence of obesity in patients diagnosed with epilepsy and explored the relationship of dietary and exercise habits, demographic factors and olfactory functioning to Body Mass Index in this population.Methods: 108 epilepsy patients were recruited primarily from outpatient epilepsy clinics at two study sites. 28 control subjects, most of whom accompanied patients to their clinic appointments, also participated. All subjects were administered a demographic and health questionnaire, as well as self report measures of eating habits and activity levels and a brief test of olfactory function. Weight and height were recorded to obtain the body mass index (BMI) and waist circumference (WC) was measured to assess risk of cardiovascular and other health outcomes related to obesity.Results: The incidence of obesity among epilepsy patients was 32% compared to 21% in the control group. Among obese epilepsy subjects, there was a higher proportion of males (p=.012), a longer time since epilepsy diagnosis (p=.015), lower olfactory identification scores (p=.04), higher scores on an 'uncontrolled eating' scale (p=,039) and higher scores on an 'eating restraint' scale (p=.023) compared to epilepsy patients of normal weight. There were no differences between obese and normal weight patients in overall activity level as estimated on an exercise questionnaire. Variability in activity estimates was extremely high in all groups evaluated. Among control subjects there was no apparent relationship between obesity and gender, obesity and olfactory identification, or obesity and eating restraint. Demographic and health related variables including household income, psychiatric history, smoking status and number or type of antiepileptic medications did not appear to be different between obese and normal weight epilepsy patients in our sample.Conclusions: Obesity is common in patients diagnosed with epilepsy. This mirrors disturbing trends in the population at large and exceeds the incidence observed in our small group of normal controls. The possibility that this association is related to underlying brain mechanisms affecting both seizures and eating behavior, (including olfactory function) deserves further investigation.