Medication prescribed for people with Binge Eating Disorder:
Advice for clients and carers
The mainstay of treatment for binge eating disorder is some form of talking therapy.
This is usually offered individually (CAT or CBT are offered at Vincent Square EDS) or
sometimes with your family to support healthy eating patterns.
Prescribed medicines may be part of your care plan to treat your eating disorder. This
leaflet describes the different medicines most commonly prescribed for binge eating
disorder.
Antidepressants
Antidepressants can be used to help reduce the frequency of bingeing. They can also
help treat symptoms of depression which may occur at the same time as an eating
disorder. The most common group of antidepressants prescribed are called selective
serotonin reuptake inhibitors (SSRIs).
Antidepressants for Binge Eating: Taking an SSRI should help reduce the frequency
of bingeing in the short term though the longer term effects are unknown. As with a
talking therapy the SSRI helps you achieve more controlled eating and a stable weight
rather than significant weight loss. Antidepressants on their own have not been shown
to be as effective as some talking therapies such as CBT. They can be a useful first
step, especially if there is a long wait to access a talking therapy. If you are already
receiving a talking treatment such as CBT then there is unlikely to be an added benefit
from starting an SSRI unless you are also depressed. Fluoxetine (Prozac) is the usual
first choice. You may be offered a higher dose of SSRI than you would take for
depression. E.g. 60mg of fluoxetine.
Antidepressants for Depression:
If your depressive symptoms are severe, longstanding or associated with suicidal
thoughts then your doctor may discuss taking an antidepressant. The most commonly
used antidepressants are called selective serotonin reuptake inhibitors (SSRI). E.g.
fluoxetine, citalopram or sertraline. Some other prescriptions such as venlafaxine and
mirtazapine are sometimes used. They work in a slightly different way but do a similar
job. However they have slightly different side effects and you should ask your doctor for
an information leaflet.
Antidepressants usually take between two and six weeks to take full effect. It is
recommended that you carry on taking them for at least six months after your mood
recovers. If you have experienced two or more episodes of depression then you should
consider taking them for two years or longer. You should usually reduce the dose
gradually rather than stopping abruptly to avoid unwanted withdrawal symptoms.
Topiramate (Topamax): This is usually used to treat epilepsy or migraines. It has also
been shown to help reduce the frequency of binges (but does not achieve significant
weight loss without additional psychological support). This benefit has not yet been
shown to last in the long term and the evidence is that talking therapies such as CBT
have the best chance of successfully treating your eating disorder. However, you may
consider it if you have a long wait for therapy.
If you are already receiving a talking therapy such as CBT you might consider adding in
topiramate. If taken alongside talking therapy such as CBT it can help achieve modest
weight loss even though it may not change your eating patterns beyond what you would
achieve though therapy alone.
(It can interfere with other medicines such as the oral contraceptive pill.) You should
only consider this if your body mass index (BMI) is over 30.
Orlistat (Xenical): This reduces the amount of calories that the body is able to absorb
through fatty food. It has been shown to help people with binge eating disorder lose a
modest amount of weight during CBT.
You can talk to your GP about being prescribed this. You may need to take it up to
three times a day. It can also be bought over the counter in a pharmacy (Alli) and you
should let your doctor know if you are using it. It should only be considered if your BMI
is over 28. If you continue to overeat fatty foods while taking it you may experience
unpleasant tummy upset and diarrhoea. You may also need to take vitamin
supplements if you use it for a long time.
Other medications: Sibutramine (Reductil) and rimonabant (Acomplia) have both been
withdrawn due to dangerous side effects and are no longer available.
Vincent Sq Clinic J Arkell 8/7/2010
Vincent Sq Clinic M Raikkonen 04/04/2013
This document is also available in other languages, large print, Braille, and audio format upon request.
Please email communications.cnwl@nhs.net
Dokument ten jest na życzenie udostępniany także w innych wersjach językowych, w dużym druku, w
alfabecie Braille'a lub w formacie audio.
Mediante solicitação, este documento encontra-se também disponível noutras línguas, num formato de
impressão maior, em Braille e em áudio.
Dokumentigaan waxaa xitaa lagu heli karaa luqado kale, daabacad far waa-wayn, farta indhoolaha (Braille)
iyo hab dhegaysi ah markii la soo codsado.
Be belge istenirse, başka dillerde, iri harflerle, Braille ile (görme engelliler için) ve ses kasetinde de temin
edilebilir.
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