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Treatments and drugs
By Mayo Clinic staffThe goals for treatment of binge-eating disorder are to reduce eating binges, to improve your emotional well-being and, when necessary, to lose weight. Because binge eating is so entwined with shame, poor self-image, self-disgust and other negative emotions, treatment needs to address these and other psychological issues.
There are four main types of treatment for binge-eating disorder.
Psychotherapy
Psychotherapy, whether in individual or group sessions, can help teach you how to exchange unhealthy habits for healthy ones and reduce bingeing episodes. Examples of the types of psychotherapy that may be helpful include:
- Cognitive behavioral therapy. Cognitive behavioral therapy may help you cope better with issues that may trigger binge-eating episodes, such as negative feelings about your body or a depressed mood. It may also give you a better sense of control over your behavior and eating patterns. However, cognitive behavioral therapy hasn't been shown helpful in reducing weight. So if you're overweight, you may need additional treatment.
- Interpersonal therapy. Interpersonal therapy focuses on your current relationships with other people. This may help reduce binge eating that's triggered by poor relationships and unhealthy communication skills. The goal is to improve your interpersonal skills — how you relate to others, including family, friends and colleagues. You learn how to evaluate the way you interact with others and develop strategies for dealing with relationship and communication problems.
- Dialectical behavior therapy. This form of therapy can help you learn behavioral skills to help you tolerate stress, regulate your emotions and improve your relationships with others, all of which can reduce the desire to binge eat.
Medications
There's no medication specifically designed to treat binge-eating disorder. But, several types of medication have been found to be helpful in reducing the symptoms of binge-eating disorder. Combining therapy with medications may be more effective than either treatment alone. The types of medications that may be helpful for binge-eating disorder include:
- Antidepressants. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) may be helpful for binge eating. It's not clear how these can reduce binge eating, but it may be related to how they affect certain brain chemicals associated with mood.
- The anticonvulsant topiramate (Topamax). Normally used to control seizures, topiramate has also been found to reduce binge-eating episodes. However, it can cause serious side effects, including a numb, burning or tingling sensation, and trouble in thinking.
Behavioral weight-loss programs
Weight-loss programs typically aren't recommended until the binge-eating disorder is treated, because very low calorie diets may trigger more binge-eating episodes.
However, when necessary, weight-loss programs for people with binge-eating disorder are generally done under medical supervision to ensure that your nutritional requirements are met. Some programs are known as very low calorie diet programs because they include an initial period of strict calorie restriction for fast weight loss.
Weight-loss programs may also address issues that tend to trigger binges, but generally to a lesser extent than psychotherapy does. However, weight-loss programs, especially those that are not medically supervised, may not be appropriate for everyone with binge-eating disorder.
Self-help strategies
Some people with binge-eating disorder find self-help books, videos and support groups effective. Some eating disorder programs offer self-help manuals that you can use on your own or with guidance from mental health experts. Self-help strategies may not be effective on their own, though. You still may need professional treatment with psychotherapy or medications.
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- Douglass L. Yoga as an intervention in the treatment of eating disorders: Does it help? Eating Disorders. 2009;17:126.
- Meridia (sibutramine): Market withdrawal due to risk of serious cardiovascular events. U.S. Food and Drug Administration. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm228830.htm. Accessed Oct. 8, 2010.
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