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.