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Treatments for Binge-Eating Disorder

The following treatment guidelines are meant as a reference tool only, and are not intended as treatment advice or to replace the clinical decision-making process of psychiatrists or other health professionals who administer these treatments. In clinical practice there are often good reasons why treatment approaches differ from what is described here.

 

The three main forms of treatment for Binge-Eating Disorder, as described below, are nutritional rehabilitation, group psychotherapy and medications. The question of whether it is best to combine some or all of these modalities at the outset of treatment remains inclusive [ref].

A reasonable approach would be to start with group Cognitive Behavioral Therapy (CBT) and, for obese individuals, to consider adding an exercise component to the therapy or adding nutritional rehabilitation. After several weeks, medications can be added if necessary.

Nutritional Rehabilitation

Many individuals with Binge-Eating Disorder also suffer from obesity. Weight loss programs that use behavioral techniques along with low-calorie diets have been shown not only to help these individuals lose weight, but also to help reduce their binge-eating behaviors [ref].

Psychotherapy

Most of the psychotherapies that have been studied in Binge-Eating Disorder have been delivered in group format. CBT [ref], Interpersonal Therapy [ref], and Dialectical Behavioral Therapy [ref] in group formats have all been shown to be effective.

CBT is probably the first choice among these psychotherapies because it has the most evidence supporting its use [ref]. Incorporating physical exercise as part of a CBT treatment has been shown to help reduce binge-eating behaviors in addition to also helping patients lose weight [ref].

Medications

SSRI antidepressants have been shown to be effective in reducing binge-eating behaviors, with doses at the higher end of the therapeutic range recommended [ref, ref]. These would be the first choice of medications to try given the amount of available supporting evidence.

Sibutramine [ref], an appetite-suppressant medication, and Topiramate [ref], an anticonvulsant with weight-loss properties, have also been shown to be effective for treating binge-eating behaviors, especially when weight loss is also a goal.

 

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