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 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.
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"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: http://bit.ly/292ktiC and http://bit.ly/292kovz Annals of
Internal Medicine, online June 27, 2016.
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