Treating Binge Eating Disorder with FDA-Approved Medicines

Years ago, treating binge eating disorder (BED) with medication was uncommon. Researchers say drugs can be effective when combined with traditional therapy and ongoing support.

Vyvanse: Common Medication for Binge Eating

The most common pharmacological treatment for binge eating disorder (BED) is lisdexamfetamine dimesylate, commonly known by the brand name Vyvanse.

This drug is a central nervous system stimulant approved to treat children and adults with attention deficit hyperactivity disorder (ADHD). Researchers have studied the effectiveness of Vyvanse for BED with promising results. Patients had fewer bingeing episodes, and they also experienced other clinical benefits.¹

Researchers hypothesize that the mechanism behind this success is related to the neurological foundations of binge eating behaviors and how Vyvanse alters this neurology. 

The psychological underpinnings of BED should still be considered in treatment, as Vyvanse does not address these issues. As a result, many have criticized the use of the medication.

Benefits

People who stay on Vyvanse tend to avoid relapse for longer than those who do not, suggesting the medication keeps the eating disorder suppressed rather than treating it.² Like other mental health disorders, eating disorders are chronic conditions that must be continually managed.

Side Effects

Other adverse side effects of Vyvanse could be cause for concern, including these:¹

• Dry mouth
• Insomnia
• Decreased appetite
• Increased heart rate
• Constipation
• Feeling jittery 
• Anxiety

In rare cases, vyvanse may also cause psychotic or manic symptoms, even in individuals with no previous history. The risks are higher with doses above 100 mg.³ For people with BED, the FDA recommends a maximum dose of 70 mg.⁵

Researchers continue to seek more information on the effect, positive or negative, that Vyvanse has on treating binge eating disorder.

Other Binge Eating Disorder Medication

Fluoxetine, more commonly known as Prozac, is another FDA-approved drug to treat eating disorders. However, it is approved to treat bulimia nervosa, not BED. Even so, researchers are looking into how this drug can be used to treat BED.

Research results are mixed, with some studies finding benefits on binge-eating behavior and others finding no added benefits when fluoxetine is paired with CBT.⁴ 

Small studies also found benefits in BED treatment with the following medications:⁴

• Topiramate
• Zonisamide 
• Acamprosate
• Duloxetine
• Atomoxetine

Since the FDA doesn’t approve these for binge eating disorder, your doctor may not use them first. But these options may be worth exploring with your doctor if you don’t respond to the traditional BED pharmacological solutions.

Binge Eating Disorder Treatment

Binge eating disorder (whether moderate to severe) mustn’t be treated with medication alone. Although some binge eating disorder medications have proven effective, it’s essential to pair them with therapy to get to the core of the eating disorder.

If the correct type of therapy and additional support are not utilized, binge eating episodes will likely continue. Even if medication for binge eating is used alone and does reduce binge eating, it’s usually not a long-term solution, with the eating disorder returning once the drug is discontinued.

Therapy is the most effective in reducing binge eating and instilling healthy eating habits.⁶ These can include:

• Cognitive behavioral therapy
• One-on-one psychotherapy
• Dialectical behavior therapy
• Family therapy

How to Treat Binge Eating Disorder with Medication

Pharmacological treatment for binge eating disorder can be hugely beneficial regarding how neurobiology and co-occurring disorders impact binge eating disorder. However, it is clear that the most effective treatment prioritizes psychotherapy and considers medication as a potential supplement to psychotherapy.

Medical supervision by a healthcare professional is required for any eating disorder treatment plan that includes medicines.