Key Points

• Binge eating disorder is one of the most common eating disorders in the United States.
• It affects people of all sizes, ages, and sexes, but females are most affected.
• Binge eating disorder treatment involves therapy, medical nutrition programs, and, in some cases, medication.
• Vyvanse is FDA-approved for binge eating disorder; antidepressants and anticonvulsants are also used for treatment.
• Research is also examining the effectiveness of GLP-1 agonists like semaglutide.

Millions of Americans struggle with binge eating disorder, making it one of the most prevalent eating disorders in the U.S. It's not just about eating too much; it can lead to severe health issues and deeply affect mental health.

Yet, there's hope.

Recovering from a binge eating disorder involves a team effort. Treatments can include Cognitive Behavioral Therapy to help rewire existing thought patterns and nutritional therapy by a registered dietitian. 

While the stimulant medication Vyvanse is approved to manage binge eating symptoms, other promising new options are being explored.

What is binge eating disorder?

Binge eating disorder (BED) doesn't discriminate—it can impact anyone, regardless of age, sex, or weight.

It's a serious condition connected to health issues like type 2 diabetes and heart disease. Although often linked to obesity, BED also affects individuals who aren't obese.

Gia Eapen, MD, says, "If you find yourself regularly eating large amounts of food in one sitting, often eating alone and feeling out of control, and doing this at least once a week for three months, it might be time to consider whether BED is playing a role in your life."

How is binge eating disorder diagnosed?

Doctors diagnose BED by looking for specific patterns, such as:

• Eating unusually large amounts of food in a short time (usually within 2 hours)
• Feeling out of control during eating episodes
• Experiencing these episodes at least once a week for three months
• Feeling distressed about the binge eating
• Not regularly purging or engaging in compensatory behaviors like excessive exercise or laxative misuse after binges (which may veer towards bulimia)

Self-screening tools like the Binge Eating Scale may help you assess the severity of your binge eating behaviors and track your improvement during treatment.

Medication for binge eating disorder: Vyvanse (lisdexametamfetamine)

Vyvanse, or lisdexametamfetamine, is the first drug approved by the FDA to treat moderate to severe binge eating disorder (BED) in the United States and Canada. It is a Central Nervous System (CNS) stimulant which, in clinical trials, has been shown to reduce binge eating episodes.

People who stay on Vyvanse generally have fewer relapses, suggesting it helps manage binge eating disorder symptoms rather than curing it.

How does Vyvanse treat binge eating disorder?

Vyvanse targets symptoms of impulsivity and inattention, much like it does for individuals with ADHD.

This oral medication kicks in quickly to enhance impulse control, sharpen brain processing, and lift mood, all of which can help decrease binge eating episodes.

Unlike fast-acting drugs like Adderall, Vyvanse is a prodrug, meaning it activates more slowly in the body.

Vyvanse side effects

Vyvanse side effects include milder ones like dry mouth, sleeplessness, reduced appetite, faster heart rate, and feeling jittery and anxious.

There are also very serious side effects of Vyvanse, like psychosis, heart attacks, high blood pressure (hypertension), stroke, and more.

What are Vyvanse alternatives for binge eating disorder?

There are several alternatives to Vyvanse for binge eating disorder treatment.

Antidepressants and anticonvulsants are commonly used, and researchers are now examining the potential benefits of GLP-1 agonists like semaglutide (found in Ozempic and Wegovy).

Eapen, MD, explains, "Each treatment option works differently, so finding the right fit for effective symptom management is crucial. Always consult a healthcare provider to determine the best treatment for your needs. Remember, combining medication with lifestyle changes and nutritional therapy from a Registered Dietitian can help improve your chances of success."

1. Antidepressants (SSRIs) for binge eating disorder

About half of those who binge eat also suffer from a mood disorder like depression.

As a result, SSRIs or selective serotonin reuptake inhibitors are common antidepressants that may be prescribed when applicable. Commonly used SSRIs are Paxil (Paroxetine), Prozac (Fluoxetine), and Zoloft (Sertraline).

How do SSRIs (antidepressants) treat binge eating disorder?

Antidepressants can be quite effective in managing binge eating disorder. They increase levels of brain chemicals such as serotonin, dopamine, and norepinephrine, which influence appetite, mood, and impulse control. This can lead to fewer binge-eating episodes.

Additionally, many antidepressants reduce appetite as a side effect. Since binge eating disorder often occurs alongside other conditions like depression and anxiety, treating these with antidepressants can also address some of the root causes of binge eating.

SSRI side effects

Common SSRI side effects include nausea, headaches, sleep disturbances, and sexual dysfunction. Some people might also experience increased anxiety or jitteriness, especially in the early stages of treatment.

2. Anticonvulsants for binge eating disorder

Topamax (topiramate) is an anti-epileptic drug that has been shown to reduce binge eating episodes, obsessive thoughts about food, and lower weight.

Studies have found that Topamax is effective in reducing the frequency of binge eating episodes. In clinical trials, patients on Topamax showed significant improvements compared to those on a placebo, with a marked decrease in the number of binges.

How does Topamax treat binge eating disorder?

Anticonvulsants like Topamax (topiramate) treat binge eating disorder (BED) by dialing down the brain's overactivity, which can reduce impulsive behavior linked to overeating.

It helps quiet the neurological chatter that contributes to the urge to binge.

Topamax side effects

Common Topamax side effects include tingling sensations, dizziness, fatigue, and sometimes more severe issues like cognitive disturbances or mood changes. These side effects are important to consider when weighing the benefits of using Topamax for BED.

3. GLP-1 agonists: Ozempic for binge eating disorder

GLP-1 agonists like semaglutide work differently than traditional medications. They target receptors in the brain's appetite and reward centers. This affects both hunger signals and the pleasure response to food.

A September 2023 study found that semaglutide, the main ingredient in Ozempic, outperformed Vyvanse and topiramate, both common treatments for severe binge eating disorder. Vyvanse is FDA-approved for this use, while topiramate is typically prescribed off-label.

While this represents hope for those battling binge eating urges, there are a few things to consider about this study: It was small, involving only 48 people, and only 19 received semaglutide alone. Additionally, all participants were classified as obese.

Semaglutide may help people who are obese lower their appetite, but it’s not clear how effective it is for people who do not have obesity or type 2 diabetes. Since the drug is relatively new, there's also no long-term data on using Ozempic for binge eating disorders.

Do medications for binge eating disorder work?

Eapen, MD, explains, “Like anorexia and bulimia, binge eating disorder is a complex mental health condition. However, it’s relatively new and earned its spot in the DSM-5 as an official eating disorder only in 2013. While we’ve learned much through research, there's still more to uncover.”

What is the best treatment for binge eating?

Treating BED is not just about medication—factors like biology, emotional eating, nutrition, and co-existing mental health conditions like depression, anxiety, substance use disorder, and obsessive-compulsive disorder (OCD) may cause binge eating disorder.

The best treatment for binge eating disorder involves a mix of talk therapy, nutritional counseling, and medication as needed.

When medications for binge eating are prescribed, they're typically part of a treatment plan that includes:

• Regular check-ins with a doctor to monitor medication effectiveness and side effects
• Psychological counseling to address emotional triggers and develop coping strategies
• Nutritional guidance from a registered dietitian to establish regular eating patterns
• Tools to track progress, like keeping a food-mood journal or using the Binge Eating Scale

Control binge eating. Find a registered dietitian covered by insurance. 

Frequently Asked Questions (FAQs)

How long do I need to take medication for binge eating disorder?

Treatment duration varies by individual. 

Eapen, MD, says, “Many patients take medication for at least 6-12 months, but some may need longer-term management. It all depends on your progress and how you respond to a particular dosage. Regular evaluations with your healthcare provider determine when doses can be safely reduced or when medication can be discontinued.” 

Will insurance cover medications for binge eating disorder?

Insurance coverage for binge eating medications varies. Vyvanse may be covered when prescribed specifically for BED. Antidepressants typically have good coverage, while GLP-1 medications may require prior authorization from your insurance provider. 

Check with your insurance provider about specific medication coverage and requirements for your health plan.

How quickly do binge eating medications start working?

According to Eapen, MD, “Most medications may take 2-4 weeks to show initial benefits. Vyvanse may provide some improvement within days, while antidepressants typically require 3-4 weeks to reach full effectiveness. GLP-1 medications generally show effects within 1-2 weeks as the dosage is gradually increased.”

However, it’s important to note that medications for binge eating are not magic pills; it’s possible to binge eat on Ozempic and similar drugs. So, it’s important to get comprehensive binge eating disorder treatment, including mental health and nutrition counseling. 

Can I take these medications with other prescriptions?

Many medications for BED can interact with other prescriptions. For example, stimulants like Vyvanse could interact with certain antidepressants or heart medications. Always provide your doctor with a complete list of all medications, supplements, and over-the-counter drugs and follow their recommendation.

Is it safe to take binge eating medications long-term?

Medications for binge eating are only available with a prescription and must be taken under medical supervision. Safety involves learning about the indications and contraindications of each medication you take and getting educated about potential side effects. 

Some medications may require occasional breaks or dosage adjustments over time, and your healthcare provider will advise you on whether it is safe for you to take specific medications for binge eating over time.

Who should avoid these medications?

People with certain medical conditions should avoid specific BED medications. Vyvanse isn't recommended for those with heart problems or glaucoma. SSRIs may not be suitable for those taking certain pain medications. GLP-1 medications are contraindicated for those with personal or family history of medullary thyroid cancer. This is not a comprehensive list. Please consult your healthcare provider to learn if medications for binge eating may work for you.

Find a registered dietitian who specializes in binge eating disorder, covered by insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.