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While the effects of obesity on the brain are of major interest in medicine, they remain markedly under\u2010researched in psychiatry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We obtained body mass index (BMI) and magnetic resonance imaging\u2010derived regional cortical thickness, surface area from 836 bipolar disorders (BD) and 1600 control individuals from 14\u00a0sites within the ENIGMA\u2010BD Working Group. We identified regionally specific profiles of cortical thickness using K\u2010means clustering and studied clinical characteristics associated with individual cortical profiles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We detected two clusters based on similarities among participants in cortical thickness. The lower thickness cluster (46.8% of the sample) showed thinner cortex, especially in the frontal and temporal lobes and was associated with diagnosis of BD, higher BMI, and older age. BD individuals in the low thickness cluster were more likely to have the diagnosis of bipolar disorder I and less likely to be treated with lithium. In contrast, clustering based on similarities in the cortical surface area was unrelated to BD or BMI and only tracked age and sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We provide evidence that both BD and obesity are associated with similar alterations in cortical thickness, but not surface area. The fact that obesity increased the chance of having low cortical thickness could explain differences in cortical measures among people with BD. The thinner cortex in individuals with higher BMI, which was additive and similar to the BD\u2010associated alterations, may suggest that treating obesity could lower the extent of cortical thinning in BD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.13172","type":"journal-article","created":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T10:10:05Z","timestamp":1639217405000},"page":"509-520","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Diagnosis of bipolar disorders and body mass index predict clustering based on similarities in cortical thickness\u2014ENIGMA study in 2436 individuals"],"prefix":"10.1111","volume":"24","author":[{"given":"Sean R.","family":"McWhinney","sequence":"first","affiliation":[{"name":"Department of Psychiatry Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1680-8480","authenticated-orcid":false,"given":"Christoph","family":"Ab\u00e9","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9544-3944","authenticated-orcid":false,"given":"Martin","family":"Alda","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4949-856X","authenticated-orcid":false,"given":"Francesco","family":"Benedetti","sequence":"additional","affiliation":[{"name":"Vita\u2010Salute San Raffaele University  Milan Italy"},{"name":"Psychiatry and Psychobiology Unit Division of Neuroscience IRCCS San Raffaele Scientific Institute  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erlend","family":"B\u00f8en","sequence":"additional","affiliation":[{"name":"Unit for Psychosomatics\/CL Outpatient Clinic for Adults Division of Mental Health and Addiction Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"del Mar Bonnin","sequence":"additional","affiliation":[{"name":"Hospital Clinic University of Barcelona Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Salud Mental (CIBERSAM)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiana","family":"Borgers","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of M\u00fcnster  M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Brosch","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy Philipps\u2010University Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6421-2633","authenticated-orcid":false,"given":"Erick J.","family":"Canales\u2010Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"FIDMAG Germanes Hospital\u00e0ries Research Foundation Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Salud Mental (CIBERSAM)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dara M.","family":"Cannon","sequence":"additional","affiliation":[{"name":"Clinical Neuroimaging Laboratory Centre for Neuroimaging &amp; 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