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Efficacy and safety of topiramate in binge eating disorder: a systematic review and meta-analysis
- Mikail Nourredine, Lucie Jurek, Marine Auffret, Sylvain Iceta, Guillaume Grenet, Behrouz Kassai, Michel Cucherat, Benjamin Rolland
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- Journal:
- CNS Spectrums / Volume 26 / Issue 5 / October 2021
- Published online by Cambridge University Press:
- 09 July 2020, pp. 459-467
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Background
To assess the efficacy and safety of topiramate in treating binge eating disorder (BED), using a systematic review and meta-analysis of the available randomized clinical trials (RCTs).
MethodsThe RCTs assessing topiramate vs placebo with or without adjunctive psychotherapy in BED were reviewed using a systematic search in the PubMed, Web of Science, PsycINFO, Cochrane Database of Systematic Review, and ClinicalTrials.gov search Websites, from inception to November 2019. Main outcomes were the changes in binge frequency, quality of life, and weight, respectively. Effect estimates were pooled using random-effect models and presented as risk ratios (RRs) or mean differences (MDs) and their 95% confidence interval (95% CI). Data extraction was performed by two independent reviewers.
ResultsThree studies were eligible for inclusion, involving 528 BED patients. Topiramate was found to be significantly more efficacious than placebo in reducing: (a) the number of binge episodes per week (MD = −1.31; 95% CI = −2.58 to −0.03; I2 = 94%); (b) the number of binge days per week (MD = −0.98; 95% CI = −1.80 to −0.16; I2 = 94%); and (c) weight (MD = −4.91 kg; 95% CI = −6.42 to −3.41; I2 = 10%). However, participants in the topiramate groups withdrew significantly more frequently for safety reasons, relative to placebo participants (RR = 1.90; 95% CI = 1.13-3.18, I2 = 0%).
ConclusionsPreliminary findings support a possible efficacy of topiramate for the treatment of BED, even if safety concerns could limit the practical use of this treatment in BED subjects.
Comparing the impact of two types of bariatric surgery on food preferences: The BARIATASTE pilot study
- Erika Guyot, Sylvain Iceta, Julie-Anne Nazare, Emmanuel Disse, Anestis Dougkas
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E361
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Introduction:
Up to day, the most effective treatment for obesity is bariatric surgery. Nevertheless, weight regain may occur in almost 20% of the patients. Furthermore, nutritional complications such as protein malnutrition and vitamin deficiencies remain common. Clinical experience and scientific literature suggest changes in food preferences after bariatric surgery, which may contribute to weight loss and/or weight regain independently of the surgically-induced reduction of energy intake. Yet, there is inconsistency among the studies as they do not always use objective measures to assess food preferences and only few considered and compared the different types of surgical technics. Our objective was to study the impact of the type of bariatric surgery on the liking and wanting of consuming certain foods varying in composition and appearance.
Materials and methods:We conducted a cross-sectional clinical trial among 90 patients followed at the Integrated Center for Obesity/Hospital of Lyon. The patients were divided into three groups according to whether they had an unoperated severe obesity (OB), a sleeve gastrectomy (LSG) or a gastric bypass (RYGB). We assessed food preferences using the Leeds Food Preference Questionnaire (LFPQ), a behavioral computer task. Binge eating, impulsivity and food addiction were assessed with self-report questionnaires. Statistical analysis of food preferences included ANOVAs, post-hoc comparisons of groups two-by-two and linear regressions to adjust results for potential confounders. Principal Components Analysis (PCA) and Hierarchical Cluster Analysis (HCA) were performed to determine food preference patterns and groups of individuals with similar food preferences.
Results:Our results showed a significant difference in liking scores, with the OB group having higher scores for high-fat savory (HFSA), high-fat sweet (HFSW) and low-fat sweet foods (LFSW) (p < 0.0001) relative to LSG and RYGB groups. Additionally, LSG had greater score of liking for HFSA than RYGB (p = 0.001). There was a high correlation between the binge eating score and the liking scores for HFSA, HFSW and LFSW (p < 0.001).
Discussion:Our study expands the knowledge regarding changes in food preferences after bariatric surgery and may help to better understand potential underlying mechanisms by comparing two different surgical technics. This pilot study will be followed by a prospective study of food preferences after bariatric surgery using the LFPQ, a buffet type food in an experimental restaurant and sensory measurements. Eventually, our project may contribute to modulate post-operative nutritional interventions in order to facilitate the adoption of a healthy diet.