Treatment Options for Binge-Eating Disorder

These treatments lowered binge-eating and related psychopathology
These treatments lowered binge-eating and related psychopathology

A systematic review and meta-analysis on treatment options for binge-eating in adults showed that cognitive behavioral therapy, lisdexamfetamine, 2nd generation antidepressants, and topiramate lowered binge-eating and related psychopathology. Full findings from the analysis are published in Annals of Internal Medicine

Kimberly A. Brownley, PhD, from the University of North Carolina at Chapel Hill, and coauthors aimed to summarize evidence about the benefits and harms of psychological and pharmacologic treatments for adults with binge-eating disorder. A search of clinical databases returned nine waitlist-controlled psychological trials and 25 placebo-controlled trials that assessed pharmacologic or combination therapy. 

A decrease in binge-eating frequency and an increase in binge-eating abstinence was seen with therapist-led cognitive behavioral therapy (relative risk [RR] 4.95, 95% CI: 3.06–8.00), lisdexamfetamine (RR 2.61, 95%  CI: 2.04–3.33), and 2nd generation antidepressants (RR 1.67, 95% CI: 1.24–2.26). Both lisdexamfetamine (mean difference [MD] –6.50, 95% CI: –8.82 to –4.18) and 2nd generation antidepressants (MD –3.84, 95% CI: –6.55 to –1.13) decreased binge-eating-related obsessions and compulsions; the 2nd generation antidepressants also reduced symptoms of depression (MD –1.97, 95% CI: –3.67 to –0.28). 

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Patients treated with lisdexamfetamine experienced more headache, gastrointestinal upset, sleep disturbance, and sympathetic nervous system arousal vs. placebo. Other types of cognitive behavioral therapy and topiramate also increased abstinence and decreased binge-eating frequency and related psychopathology. Further, topiramate reduced weight and increased sympathetic nervous system arousal and lisdexamfetamine reduced weight and appetite. 

Study limitations included many treatments being evaluated only in single studies and outcomes measured inconsistently across trials. 

For more information visit annals.org.

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