Binge Eating Disorder medications & treatments

Medically reviewed by  Jamie Winn, PharmD

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According to the National Association of Anorexia Nervosa and Associated Disorders, an estimated 30 million Americans live with an eating disorder with binge eating disorder having the highest lifetime prevalence at 5.5%. More than half of people with binge eating disorders are women.

Binge eating disorder can have significant impacts on a person’s physical, emotional and social life. The earlier it is identified and treated, the greater the chance for recovery or improved quality of life.

What is a binge eating disorder?

Binge eating disorder (BED) is a severe but treatable common eating disorder characterized by recurrent episodes of eating large amounts of food, often very quickly and to the point of discomfort. If you binge eat at least once a week for 3 months, you may have a binge eating disorder. When you have a binge eating disorder, you know you are eating too much food but cannot stop yourself in the moment. You may feel guilt and shame afterward and hide it from family and friends.

Unlike people with anorexia or bulimia nervosa, those with binge eating disorder don’t throw up their food, overexercise, use laxatives, or starve themselves to compensate for this overeating. People with binge eating disorders are often overweight or obese.

Binge eating disorder causes

The exact causes of binge eating disorder are not known, but experts think it is a combination of risk factors such as:

• Genetics
• Biological factors
• Long-term dieting
• Low self-esteem
• Poor body image
• Anxiety or depression
• Childhood obesity

Thankfully, this condition is treatable with medication, therapy, and lifestyle changes. 

How is binge eating disorder diagnosed?

To properly diagnose binge eating disorder, your doctor will look at your symptoms, review your medical and family history, and perform a physical exam.

Binge eating disorder symptoms

You may have a binge eating disorder if you have binged at least once a week for the past three months. Some symptoms of binge eating disorder that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) require for diagnosis include:

• Eating an unusually large amount of food in a short period of time
• Feeling a loss of control during your binge
• Eating even when you’re full or not hungry
• Eating until you’re uncomfortably full
• You hoard food
• Eating alone because you’re embarrassed about how much you eat
• Feelings of guilt or shame about your eating habits
• Binge eat without purging or other compensatory behaviors

Binge eating disorders can vary from short-term to recurrent or they may persist for years if left untreated. You should talk with a mental health professional who focuses on eating disorders to get properly diagnosed. They will discuss with you your eating patterns and symptoms and will help you decide on the best treatment plan if you have been diagnosed with a binge eating disorder. 

What are some binge eating disorder treatment options?

The goals for the treatment of binge-eating disorder are to reduce eating binges and achieve healthy eating behaviors. This generally involves a combination of medication, psychotherapy, lifestyle changes, and nutritional counseling.

Medications

Currently, three main classes of drugs have been studied in double-blind, placebo-controlled clinical trials in binge eating disorders:

• Antidepressants. It is unclear how they reduce binge-eating episodes but they can improve your mood which may lead to less binging. Some commonly prescribed include selective serotonin reuptake inhibitors (SSRIs) Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine).
• Central nervous system (CNS) stimulants. Commonly used for attention deficit hyperactivity disorder (ADHD), Vyvanse (lisdexamfetamine dimesylate), is the first drug approved by the FDA to treat moderate to severe binge eating disorder.
• Anticonvulsants. Topamax (topiramate) which is used to treat seizures and bipolar disorder, is effective in reducing episodes of binge eating.

Psychotherapy

Sometimes called “talk therapy,” psychotherapy is counseling to help you change any harmful thoughts or behaviors which can reduce the number of binge-eating episodes. Some examples include:

• Cognitive-behavioral therapy (CBT). CBT can help you deal with your negative emotions and triggers that cause your binge eating. It can help improve your self-image and help you take control of your food intake.
• Interpersonal psychotherapy (IPT). This therapy focuses on improving your communication skills and how you relate to your family, friends, and co-workers. This can be helpful if your triggers involve unhealthy relationships and communication issues with those closest to you.
• Dialectic behavior therapy (DBT). DBT can help you deal with stress and other triggers to help reduce your binge eating behaviors.

Nutritional counseling

Nutritional counseling is not dieting but is a therapeutic approach to help you live an overall healthier lifestyle. It can help with weight loss, improve your overall wellness, and help you develop long-term healthy eating habits. 

What is the best medication for binge eating disorder?

The best medication to treat binge eating disorder will depend on the individual’s specific medical binge eating disorder, medical history, medications that the individual is already taking that may potentially interact with binge eating disorder medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best medication for you. The table below includes a list of the most prescribed or over-the-counter binge eating disorder medications approved by the Food and Drug Administration (FDA).

Best medications for binge eating disorder

Your healthcare professional will determine the right dosage based on your response to the treatment, medical binge eating disorder, weight, and age. Other possible serious side effects may exist; this is not a complete list.

What are the most common side effects of binge eating disorder medications?

As with all medicines, those used for binge eating disorders will have some side effects, depending on the class you are taking:

• Antidepressants commonly cause nausea, insomnia, fatigue, headache, and a decreased sex drive.
• CNS stimulants like Vyvanse (lisdexamfetamine) can be habit-forming and abused. Its side effects include insomnia, dry mouth, headache, and decreased appetite.
• Anticonvulsants are commonly associated with drowsiness, confusion, impaired coordination, and fatigue.

What are some home remedies for binge eating disorder?

Although the treatment of binge eating disorder should involve a health care professional, there are some self-care measures you can take to help reduce or prevent the urge to binge eat.

Binge eating disorder prevention

• Eat breakfast. It is common for people with this condition to skip breakfast. You may be able to resist the urge to eat a big meal later in the day if you eat breakfast.
• Find and use your support group. It is much easier to deal with a condition like this if you have family, friends, and healthcare professionals to support and encourage you.
• Remove binge foods from your house. If you are aware of certain foods that are more likely to trigger a binge-eating episode, you should remove them and avoid keeping them in your house.
• Avoid dieting, unless it is supervised by a physician. Dieting can lead to more binge-eating episodes. You should always talk with your doctor before starting any weight loss program.
• Reduce and manage stress. Stress is a big trigger for binge eating so try mindfulness and meditation practices, yoga, exercise, and deep breathing to relax and control your stress instead of turning to food for comfort.
• Get regular exercise. Exercise can help with weight loss, improve body image, reduce anxiety symptoms, and boost your mood.

Frequently asked questions about binge eating disorder

Are binge eating disorders the same as overeating?

Overeating, such as when you have an extra helping of a meal even when you’re already full can be normal for many individuals. Binge eating disorder can be defined as recurring episodes of eating more food in a shorter amount of time than most people would eat with feelings of lack of control to stop.

How common is binge eating disorder?

Binge eating disorder is the most common eating disorder in the U.S. Nearly 3% of adults experience it in their lifetime. American women (3.5%) and men (2%) will experience a binge eating disorder during their lifetime, making it three times more common than anorexia and bulimia combined.

What are some complications of binge eating disorder?

There are serious complications that can come from binge eating including:

• Weight gain and obesity, which can lead to type 2 diabetes, high blood pressure, high cholesterol, heart disease, and arthritis.
• Depression, anxiety, and other mental health problems
• Some types of cancer
• Sleep apnea
• Substance abuse
• Arthritis

How can I support a friend or loved one with a binge eating disorder?

Support from friends and family can help people with binge eating disorders receive care and improve their quality of life. Some ways to support them include:

• Learn about the disorder.
• Don’t talk about diets or weight loss.
• Listen with an open mind.
• Don’t try to threaten or scare them into seeking help.
• Encourage them to seek professional help.

 Related resources for binge eating disorder

• Binge eating disorder. National eating disorders
• Binge eating disorder overview. MayoClinic
• Binge eating disorder. WomensHealth
• Definition and facts for binge eating disorder. National Institute of Diabetes and Digestive and Kidney Diseases
• Binge eating disorder. National Eating Disorders Collaboration
• What is binge eating disorder? WebMD
• What are eating disorders? Psychiatry.org