title: Combining Pharmacological and Psychological Treatments for Binge Eating Disorder: Current Status, Limitations, and Future Directions.
abstract: Binge eating disorder (BED) is characterized by recurrent binge eating and marked distress about binge eating without the extreme compensatory behaviors for weight control that characterize other eating disorders. BED is prevalent, associated strongly with obesity, and is associated with heightened levels of psychological, psychiatric, and medical concerns. This article provides an overview of randomized controlled treatments for combined psychological and pharmacological treatment of BED to inform current clinical practice and future treatment research. In contrast to the prevalence and significance of BED, to date, limited research has been performed on combining psychological and pharmacological treatments for BED to enhance outcomes. Our review here found that combining certain medications with cognitive behavioral therapy (CBT) or behavioral weight loss (BWL) interventions produces superior outcomes to pharmacotherapy only but does not substantially improve outcomes achieved with CBT/BWL only. One medication (orlistat) has improved weight losses with CBT/BWL albeit minimally, and only one medication (topiramate) has enhanced reductions achieved with CBT in both binge eating and weight. Implications for future research are discussed.
authors.affiliation: Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA. carlos.grilo@yale.edu.
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Grilo
authors.affiliation: Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.|Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Reas
authors.affiliation: Neuropsychiatric Research Institute, Fargo, ND, USA.|Department of Clinical Neuroscience, School of Medicine and Health Sciences, University of North Dakota, Fargo, ND, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
mesh_terms: D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D056912:Binge-Eating Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D052018:Bulimia Nervosa / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000639:trends; D005632:Fructose / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D007783:Lactones / Q000008:administration & dosage; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D000077403:Orlistat; D016032:Randomized Controlled Trials as Topic; D000077236:Topiramate; D015431:Weight Loss
chemical_list: D019440:Anti-Obesity Agents; D007783:Lactones; D000077236:Topiramate; D005632:Fructose; D000077403:Orlistat
keywords: Behavioral weight loss; Binge eating disorder; Cognitive behavioral therapy; Medication; Obesity; Pharmacotherapy