Binge-eating disorder can be treated with talk therapy or drugs

By Andrew M. Seaman People with recurring episodes of binge-eating can be helped with talk therapy or medication, according to a new review of previous studies. People with binge-eating disorder have brief, psychologically distressing binge-eating episodes multiple times a week for at least three months. The disorder is linked to mental health problems, chronic pain, obesity and diabetes, the researchers write in Annals of Internal Medicine. Binge-eating disorder will affect about 3 percent of people in the U.S. during their lifetimes, according to lead author Kimberly Brownley, of the University of North Carolina at Chapel Hill, and her colleagues. Brownley's team analyzed data from nine studies of psychological treatments and 25 studies of medications in patients with binge-eating disorder. A type of psychotherapy called cognitive behavioral therapy, a class of drugs known as second-generation antidepressants and the amphetamine known as lisdexamfetamine, or Vyvanse, all helped reduce binge-eating, the researchers found. The medications also reduced obsessions and compulsions related to the disorder. CBT can teach people to identify thoughts associated with binge-eating, and help them change their behaviors, Brownley said. Additionally, lisdexamfetamine and second-generation antidepressants can help decrease people's impulses to eat. Examples of second-generation antidepressants include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). The study can't prove whether one second-generation antidepressant is better than the others, however. Lisdexamfetamine and topiramate (Topamax) also led to weight loss among people with binge-eating disorders. "We can’t say if any of these treatments is fundamentally better than the other," Brownley said. "There have been no head-to-head (comparisons) and that’s really essential." The review shows, however, that treatments are available and people don't have to suffer through the disorder alone, she added. In an editorial accompanying the new review, Dr. Michael Devlin, of the Columbia University College of Physicians and Surgeons in New York City says doctors can have a hard time recognizing binge-eating disorder. "Greater than expected weight dissatisfaction, large weight fluctuations, and depressive symptoms in individuals of any size all should raise the practitioner's index of suspicion," he suggests. SOURCE: and Annals of Internal Medicine, online June 27, 2016.