title: Binge-Eating Disorder in Adults: A Systematic Review and Meta-analysis.
abstract: BACKGROUND
  The best treatment options for binge-eating disorder are unclear.
  
  
  OBJECTIVE
  To summarize evidence about the benefits and harms of psychological and pharmacologic therapies for adults with binge-eating disorder.
  
  
  METHODS
  English-language publications in EMBASE, the Cochrane Library, Academic OneFile, CINAHL, and ClinicalTrials.gov through 18 November 2015, and in MEDLINE through 12 May 2016.
  
  
  METHODS
  9 waitlist-controlled psychological trials and 25 placebo-controlled trials that evaluated pharmacologic (n = 19) or combination (n = 6) treatment. All were randomized trials with low or medium risk of bias.
  
  
  METHODS
  2 reviewers independently extracted trial data, assessed risk of bias, and graded strength of evidence.
  
  
  RESULTS
  Therapist-led cognitive behavioral therapy, lisdexamfetamine, and second-generation antidepressants (SGAs) decreased binge-eating frequency and increased binge-eating abstinence (relative risk, 4.95 [95% CI, 3.06 to 8.00], 2.61 [CI, 2.04 to 3.33], and 1.67 [CI, 1.24 to 2.26], respectively). Lisdexamfetamine (mean difference [MD], -6.50 [CI, -8.82 to -4.18]) and SGAs (MD, -3.84 [CI, -6.55 to -1.13]) reduced binge-eating-related obsessions and compulsions, and SGAs reduced symptoms of depression (MD, -1.97 [CI, -3.67 to -0.28]). Headache, gastrointestinal upset, sleep disturbance, and sympathetic nervous system arousal occurred more frequently with lisdexamfetamine than placebo (relative risk range, 1.63 to 4.28). Other forms of cognitive behavioral therapy and topiramate also increased abstinence and reduced binge-eating frequency and related psychopathology. Topiramate reduced weight and increased sympathetic nervous system arousal, and lisdexamfetamine reduced weight and appetite.
  
  
  CONCLUSIONS
  Most study participants were overweight or obese white women aged 20 to 40 years. Many treatments were examined only in single studies. Outcomes were measured inconsistently across trials and rarely assessed beyond end of treatment.
  
  
  CONCLUSIONS
  Cognitive behavioral therapy, lisdexamfetamine, SGAs, and topiramate reduced binge eating and related psychopathology, and lisdexamfetamine and topiramate reduced weight in adults with binge-eating disorder.
  
  
  BACKGROUND
  Agency for Healthcare Research and Quality.
authors.affiliation: From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Brownley
authors.affiliation: From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Berkman
authors.affiliation: From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Peat
authors.affiliation: From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kathleen N
authors.initials: KN
authors.lastname: Lohr
authors.affiliation: From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Cullen
authors.affiliation: From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Carla M
authors.initials: CM
authors.lastname: Bann
authors.affiliation: From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
mesh_terms: D000328:Adult; D019440:Anti-Obesity Agents / Q000009:adverse effects / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use; D056912:Binge-Eating Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D000069478:Lisdexamfetamine Dimesylate / Q000009:adverse effects / Q000627:therapeutic use; D000077236:Topiramate
chemical_list: D019440:Anti-Obesity Agents; D018687:Antidepressive Agents, Second-Generation; D000697:Central Nervous System Stimulants; D000077236:Topiramate; D005632:Fructose; D000069478:Lisdexamfetamine Dimesylate