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Overview of the treatment of binge eating disorder

Published online by Cambridge University Press:  23 November 2015

Susan L. McElroy ,
Anna I. Guerdjikova ,
Nicole Mori ,
Maura R. Munoz  and
Paul E. Keck Jr.
Susan L. McElroy*
Affiliation:
Linder Center of HOPE, Mason, Ohio, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
Anna I. Guerdjikova
Affiliation:
Linder Center of HOPE, Mason, Ohio, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
Nicole Mori
Affiliation:
Linder Center of HOPE, Mason, Ohio, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
Maura R. Munoz
Affiliation:
Linder Center of HOPE, Mason, Ohio, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
Paul E. Keck Jr.
Affiliation:
Linder Center of HOPE, Mason, Ohio, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
*
*Address for correspondence: Dr. Susan L. McElroy, Lindner Center of HOPE, 4075 Old Western Row Road, Mason, OH 45040, USA. (Email: susan.mcelroy@uc.edu or susan.mcelroy@lindnercenter.org)
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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.

Keywords

Binge eatingpharmacotherapypsychotherapyreview
Type
Review Articles
Information
CNS Spectrums , Volume 20 , Special Issue 6: Binge Eating Disorder Differentiating from General Obesity , December 2015 , pp. 546 - 556
Copyright
© Cambridge University Press 2015 

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