What Medications Are Used to Treat Binge Eating?

Binge eating disorder is the most common eating disorder in the United States. It is a psychiatric condition that requires treatment, says Janet Lydecker, PhD, assistant professor and team member of the Program for Obesity, Weight, and Eating Research (POWER) at Yale School of Medicine.

While most people occasionally overeat or find comfort in food, that doesn’t necessarily mean they have a binge eating disorder. A healthcare professional can evaluate you and determine whether you have this condition. 

Accordingly, they will determine a treatment plan based on your needs and goals. The treatment plan may involve therapy, medication, or a combination of the two.

This article covers how binge eating disorder is diagnosed, treatment options, the efficacy of treatment, and how binge eating disorder treatment can be improved.

Diagnosis of Binge Eating Disorder

“A psychologist or another healthcare provider will interview a patient about their eating habits in order to make a diagnosis,” says Lydecker.

According to Lydecker, binge eating disorder has some key features, which include: 

• The individual has regular binge eating episodes where they eat a large amount of food in a short amount of time until they are uncomfortably full.
• The person is upset or distressed about their binge eating habits.
• They often feel out of control when eating, like they can’t stop once they’ve started, or feel zoned out while eating. This loss of control is what makes binge eating different from normal eating or overeating.

Additionally, binge eating disorder is different from bulimia, which includes both binge eating and purging of food.

Treating Binge Eating Disorder

Lydecker outlines the treatments for binge eating disorder, which include medication and therapy.

Medication

Lisdexamfetamine dimesylate (LDX), sold under the brand name Vyvanse, is the only FDA-approved medication to treat binge eating disorder. 

This medication is a stimulant that is also used to treat attention deficit hyperactivity disorder (ADHD). 

As with any medication, Vyvanse has several potential side effects, so it is important to discuss the safety of taking the medication with a healthcare provider who knows you. For example, your healthcare provider would carefully assess whether you have heart problems or are at risk for stroke. 

Other medications that may be given for binge eating disorder are used off-label because they are not approved for the treatment of this condition. Several of these are weight-loss medications because many patients with binge eating disorder also have obesity and one of their goals may be to lose weight for their health. 

Weight loss medications can include Xenical (orlistat), Qsymia (phentermine-topiramate), Contrave (naltrexone-bupropion), Victoza (liraglutide), Ozempic (semaglutide), and Imcivree (setmelanotide).

People with binge eating disorder who also have co-occurring mood disorders may be prescribed antidepressant medications.

Therapy

The recommended psychological treatment for binge eating disorder is cognitive-behavioral therapy (CBT), which is very effective at reducing the number of binge eating episodes individuals have. 

CBT treatment usually involves weekly meetings with a therapist that focus on how thoughts connect with emotions and binge eating behaviors.

The therapist works with the patient to interrupt any triggers leading to binge eating episodes. CBT also teaches patients to problem-solve behavior patterns to reduce the likelihood of binge eating.

Other psychological treatments include interpersonal therapy, which focuses on improving relationships to reduce distress, and behavioral weight-loss counseling, which focuses on setting goals and using social support to make gradual, sustainable changes in eating and exercise.

Treatment Outcomes

Lydecker discusses treatment duration and outcomes for binge eating disorder below.

Many individuals with binge eating disorder have two goals when they start treatment:

1. They want to stop binge eating
2. They want to lose weight for their health

In general, CBT is very good at helping individuals stop binge eating, but it does not necessarily help with weight loss. Behavioral weight-loss counseling tends to be better with weight loss than CBT and also helps individuals to stop binge eating. 

Medications seem to be helpful while patients are taking them, but not much is known about how patients do long-term after they stop taking the medications. 

More importantly, many patients fail to improve with just one form of treatment, so the next step in treating binge eating disorder is figuring out whether combining some of these treatments is more powerful and lasting than using one treatment by itself. 

Tips to Improve Treatment Outcomes

These are some strategies that can help you reduce binge eating and improve treatment outcomes:

• Pay attention to hunger cues: Eat when you’re hungry. Pay attention to cues such as a growling stomach, irritability, lightheadedness, and low blood sugar levels. Don’t wait until you’re starving to eat, as that could trigger binge eating. Research has shown that eating regular meals helps reduce the risk of binge eating.
• Hide your trigger foods: If there are certain foods that you tend to eat during binge eating episodes, try to avoid keeping them at home. If another family member wants to keep them in the house, try explaining why you would rather they didn’t, or ask them to hide them from you. You can ask them to give you a small portion to satisfy your cravings and so you don’t feel deprived. Avoid eating these foods when you’re alone.
• Identify your triggers: Try to identify the triggers that cause you to binge eat, and avoid them as much as possible. For instance, if you tend to binge eat at buffet-style restaurants, try to avoid making plans to go to those places. Avoid food-related social interactions if they are triggers for you; plan other activities instead.
• Eat mindfully: Make it a point not to eat while working, reading, watching television, or doing other activities. Be mindful of the food you’re eating. Pay attention to the way it tastes and feels. Avoid eating when you’re bored. This can help you better manage emotional eating.
• Maintain a food journal: Keep a food journal in which you write down everything you eat in a day. This can help you be accountable to yourself. You can also use your journal to note down any other emotions you’re experiencing. Reporting your food intake to someone else a few times a week can also help increase accountability.
• Plan your meals: Building a healthy meal plan can help ensure that you’re prepared for mealtime and less likely to resort to binge eating. It can be helpful to see a nutritionist, as they can help you develop a nutritious meal plan that doesn’t leave you feeling deprived.
• Stay active: Exercising can help you stay fit and active. Pick an activity you enjoy and ask a friend to go with you, to make the habit more likely to stick.
• Drink lots of water: Make it a point to drink plenty of water (at least 64 fluid ounces per day). Binge eating diets can involve a lot of salt and sugar, which can dehydrate you, so it's important to hydrate. Thirst can also be mistaken for hunger and cause you to binge eat.
• Put away the weighing scale: If you find yourself weighing yourself often and thinking about your weight all the time, it may help to put away your weighing scale and only check your weight at your healthcare provider’s office. Weighing yourself can sometimes be a trigger for binge eating.

Summary

Binge eating disorder is a psychiatric condition that can lead to serious health complications if left untreated. If you think you or a loved one may have a binge eating disorder, you should seek treatment from a healthcare professional. Treatment can involve therapy and medication.

Vyvanse is the only FDA-approved medication to treat binge eating disorder. However, your healthcare provider may also prescribe medications to help you lose weight or treat depression or anxiety. Treatment typically takes around three months.