title: Pharmacological treatment of binge eating disorder: update review and synthesis.
abstract: BACKGROUND
  Binge eating disorder (BED), a formal eating disorder diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is characterized by recurrent binge eating, marked distress about binge eating, and the absence of extreme weight compensatory behaviors. BED is more prevalent than other eating disorders, with broader distribution across age, sex and ethnic/racial groups, and is associated strongly with obesity and heightened risk for psychiatric/medical comorbidities.
  
  
  METHODS
  This article provides an overview of pharmacotherapy for BED with a focus on Phase III randomized controlled trials (RCTs). The search with minimal methodological inclusion requirements yielded 22 RCTs investigating several different medication classes; most were pharmacotherapy-only trials with 8 trials testing combination approaches with psychological-behavioral methods.
  
  
  CONCLUSIONS
  The evidence base regarding pharmacotherapy for BED remains limited, although this year the FDA approved the first medication (i.e., lisdexamfetamine dimesylate; LDX) specifically for moderate-to-severe BED. Data from RCTs suggest certain medications are superior to placebos for reducing binge eating over the short term; almost no data exist regarding longer-term effects of pharmacotherapy for BED. Except for topiramate, which significantly reduces both binge eating and weight, tested medications yield minimal weight loss and LDX is not indicated for weight loss. Psychological-behavioral and combination approaches with certain medications yield superior outcomes to pharmacotherapy-only acutely and over longer-term follow-up.
authors.affiliation: Oslo University Hospital, Regional Department for Eating Disorders, Division of Mental Health and Addiction , Oslo , Norway +43 664 1880 910; deborah.lynn.reas@ous-hf.no.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Reas
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Grilo
mesh_terms: D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D056912:Binge-Eating Disorder / Q000188:drug therapy*; D001835:Body Weight / Q000187:drug effects; D017326:Clinical Trials, Phase III as Topic; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D009765:Obesity / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D000077236:Topiramate; D015431:Weight Loss / Q000187:drug effects
chemical_list: D019440:Anti-Obesity Agents; D000927:Anticonvulsants; D000928:Antidepressive Agents; D000077236:Topiramate; D005632:Fructose
keywords: binge eating; binge eating disorder; medication; obesity; pharmacotherapy; placebo