Racial/ethnic differences in adults in randomized clinical trials of binge eating disorder.

We performed a qualitative review of treatment studies of binge eating disorder (BED), focusing on randomized clinical trials (RCTs). Limited effectiveness has been demonstrated for self-help strategies, and substantial effectiveness has been shown for cognitive behavioral therapy (CBT) and interpersonal therapy (IPT). CBT and IPT may each be more effective than behavior weight loss therapy (BWLT) for reducing binge eating over the long term. The stimulant pro-drug lisdexamfetamine dimesylate (LDX) is the only drug approved by the FDA for the treatment of BED in adults based on 2 pivotal RCTs. Topiramate also decreases binge eating behavior, but its use is limited by its adverse event profile. Antidepressants may be modestly effective over the short term for reducing binge eating behavior and comorbid depressive symptoms, but are not associated with clinically significant weight loss. A RCT presented in abstract form suggests that intranasal naloxone may decrease time spent binge eating. There is no RCT of obesity surgery in BED, but many patients with BED seek and receive such surgery. While some studies suggest patients with BED and obesity do just as well as patients with obesity alone, other studies suggest that patients with BED have more post-operative complications, less weight loss, and more weight regain. This evidence suggests that patients with BED would benefit from receiving highly individualized treatment.

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What pharmacological interventions are effective in binge-eating disorder? Insights from a critical evaluation of the evidence from clinical trials

International Journal of Obesity ◽

10.1038/s41366-021-01032-9 ◽

2022 ◽

Author(s):

David J. Heal ◽

Jane Gosden

Keyword(s):

Clinical Trials ◽

Eating Disorder ◽

Binge Eating ◽

Binge Eating Disorder ◽

Critical Evaluation ◽

Pharmacological Interventions

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Efficacy and safety of topiramate in binge eating disorder: a systematic review and meta-analysis

CNS Spectrums ◽

10.1017/s1092852920001613 ◽

2020 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Mikail Nourredine ◽

Lucie Jurek ◽

Marine Auffret ◽

Sylvain Iceta ◽

Guillaume Grenet ◽

...

Keyword(s):

Systematic Review ◽

Eating Disorder ◽

Binge Eating ◽

Binge Eating Disorder ◽

Randomized Clinical Trials ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

Efficacy And Safety ◽

Mean Differences

Abstract Background. To assess the efficacy and safety of topiramate in treating binge eating disorder (BED), using a systematic review and meta-analysis of the available randomized clinical trials (RCTs). Methods. The RCTs assessing topiramate vs placebo with or without adjunctive psychotherapy in BED were reviewed using a systematic search in the PubMed, Web of Science, PsycINFO, Cochrane Database of Systematic Review, and ClinicalTrials.gov search Websites, from inception to November 2019. Main outcomes were the changes in binge frequency, quality of life, and weight, respectively. Effect estimates were pooled using random-effect models and presented as risk ratios (RRs) or mean differences (MDs) and their 95% confidence interval (95% CI). Data extraction was performed by two independent reviewers. Results. Three studies were eligible for inclusion, involving 528 BED patients. Topiramate was found to be significantly more efficacious than placebo in reducing: (a) the number of binge episodes per week (MD = −1.31; 95% CI = −2.58 to −0.03; I2 = 94%); (b) the number of binge days per week (MD = −0.98; 95% CI = −1.80 to −0.16; I2 = 94%); and (c) weight (MD = −4.91 kg; 95% CI = −6.42 to −3.41; I2 = 10%). However, participants in the topiramate groups withdrew significantly more frequently for safety reasons, relative to placebo participants (RR = 1.90; 95% CI = 1.13-3.18, I2 = 0%). Conclusions. Preliminary findings support a possible efficacy of topiramate for the treatment of BED, even if safety concerns could limit the practical use of this treatment in BED subjects.

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