This study evaluated available controlled treatment studies to determine utility of
pharmacotherapy for
binge-eating disorder (BED). The authors identified randomized placebo-controlled trials testing
pharmacotherapy-only treatments and controlled trials testing
pharmacotherapy with psychotherapy treatments. Meta-analysis was performed on placebo-controlled trials with data for attrition, remission, and
weight loss. Qualitative review was performed on remaining controlled treatment literature. A total of 33 studies were considered of which 14 studies with a total of 1,279 patients were included in the meta-analysis of
pharmacotherapy-only treatment and 8 studies with a total of 683 patients were included in the qualitative review of
pharmacotherapy combined with psychotherapy interventions. No evidence suggested significant differences between medication and placebo for attrition. Evidence suggested that pharmacological treatments have a clinically significant advantage over placebo for achieving short-term remission from
binge eating (48.7% vs. 28.5%) and for
weight loss, although
weight losses are not substantial. No data exist to allow evaluation of longer-term effects of
pharmacotherapy-only treatment for BED. Combining medications with psychotherapy interventions failed to significantly enhance binge outcomes, although specific medications (
orlistat,
topiramate) enhanced
weight losses achieved with cognitive behavioral therapy and behavioral
weight loss. In summary, BED patients can be advised that certain
pharmacotherapies may enhance likelihood of stopping
binge eating short term, but that longer-term effects are unknown. Although some
weight loss may occur, it is unlikely to be substantial with available medications. Combining medications with cognitive or behavioral treatments is unlikely to enhance binge outcomes, but specific medications (
orlistat,
topiramate) may enhance
weight losses, albeit modestly.