Overview of the treatment of binge eating disorder

Abstract

We performed a qualitative review of treatment studies of binge eating disorder (BED), focusing on randomized clinical trials (RCTs). Limited effectiveness has been demonstrated for self-help strategies, and substantial effectiveness has been shown for cognitive behavioral therapy (CBT) and interpersonal therapy (IPT). CBT and IPT may each be more effective than behavior weight loss therapy (BWLT) for reducing binge eating over the long term. The stimulant pro-drug lisdexamfetamine dimesylate (LDX) is the only drug approved by the FDA for the treatment of BED in adults based on 2 pivotal RCTs. Topiramate also decreases binge eating behavior, but its use is limited by its adverse event profile. Antidepressants may be modestly effective over the short term for reducing binge eating behavior and comorbid depressive symptoms, but are not associated with clinically significant weight loss. A RCT presented in abstract form suggests that intranasal naloxone may decrease time spent binge eating. There is no RCT of obesity surgery in BED, but many patients with BED seek and receive such surgery. While some studies suggest patients with BED and obesity do just as well as patients with obesity alone, other studies suggest that patients with BED have more post-operative complications, less weight loss, and more weight regain. This evidence suggests that patients with BED would benefit from receiving highly individualized treatment.

The Efficacy of Psychological Therapies in Reducing Weight and Binge Eating in People with Bulimia Nervosa and Binge Eating Disorder Who Are Overweight or Obese—A Critical Synthesis and Meta-Analyses

“…This meta-analysis concur with a review by McElroy et al [16] for the effectiveness of CBT in reducing binge eating frequency in the short-term, but do not support their more supportive findings in the longer-term . Although BWLT showed greater effects for weight loss at the end of treatment in comparison to CBT in three trials [17,30,34], no significant differences were found between these interventions in meta-analyses, in either the short or long term.…”

“…A further systematic review reported that even very low calorie diets may be beneficial for individuals with BED [15]. Another recent review found CBT and Interpersonal Therapy (IPT) to be the most effective treatments for binge eating reduction over the short and long term for patients with BED [16]. However, these last two approaches do not target weight loss.…”

Paliperidone Palmitate Once-Monthly Reduces Risk of Relapse of Psychotic, Depressive, and Manic Symptoms and Maintains Functioning in a Double-Blind, Randomized Study of Schizoaffective Disorder

“…4,8,10,11 To manage psychotic, depressive, and manic symptoms, schizoaffective disorder is treated with complex pharmacologic regimens that include antipsychotics, mood stabilizers, and antidepressants. [12][13][14] Only oral paliperidone, administered as monotherapy or adjunctively with mood stabilizers and/or antidepressants, has received regulatory approval for acute treatment of schizoaffective disorder [5][6][7]15 ; however, no widely accepted clinical guidelines for acute or maintenance treatment exist.…”

Managing comorbid obesity and depression through clinical pharmacotherapies

“…As patients with mood disorder and obesity have high rates of binge eating behavior, it is important to be aware of the growing number of pharmacological agents efficacious for BED or BN (see Table 3) [125,126]. These drugs include antidepressants, lisdexamfetamine, and the antiepileptic drugs topiramate and zonisamide.…”