Binge eating medications: Binge eating disorder treatment

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 Nutritionist. The stimulant medication Vyvanse is approved to manage binge eating symptoms, and some promising new options are being explored.

With this multi-disciplinary approach, finding your way back to health is achievable.

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.

Expert Registered Dietitian Rita Faycurry RD 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."

Binge eating disorder medication: Vyvanse (lisdexametamfetamine)

Vyvanse, or lisdexametamfetamine, is the first drug approved by the FDA to treat moderate to severe binge eating disorder 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.

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).

Faycurry RD 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."

Fay can help you get started with a Registered Dietitian near you who specializes in eating disorders and is covered by your insurance.

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.

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

However, Topamax has its side effects.

Common ones 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.

GLP-1 agonists: Ozempic for binge eating disorder

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.

However, 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.

While semaglutide has been effective in reducing appetite among obese individuals—thanks to its ability to mimic GLP-1, a natural protein that signals fullness to the brain—its effectiveness for those who are not obese or do not have diabetes is still unclear.

Moreover, since the drug is relatively new, there's no long-term data on using Ozempic for binge eating disorders.

Do medications to treat binge eating disorder work?

Rita Faycurry, a Registered Dietitian, shares, "Binge eating disorder only got its own spot in the DSM-5 in 2013; before that, it was mixed in with other unspecified eating disorders."

"Like anorexia and bulimia, it's a complex mental health condition. We've learned much through research, but there's still more to uncover. It’s 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," Faycurry RD adds.

The best treatment for binge eating disorder involves a mix of talk therapy, nutritional counseling, and medication as needed. Get help for eating disorder treatment from trauma-informed specialists.

Fay can help you find a Registered Dietitian near you, 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.