II. Signs

  1. Uncontrolled consumption of large food amounts

III. Differential Diagnosis

  1. Bulimia Nervosa (contrast with no compensatory purging in binge-eating)

IV. Management

  1. Binge-Eating cessation
    1. Cognitive Behavioral Therapy is preferred behavioral intervention
    2. Self help programs may also assist management
  2. Manage comorbid Major Depression
    1. Selective Serotonin Reuptake Inhibitors (SSRI)
      1. Sertraline, Citalopram and Escitalopram have most evidence for use
  3. Weight Reduction (in combination with Cognitive Behavioral Therapy)
    1. See Obesity Management
    2. Orlistat
      1. Grilo (2005) Biol Psychiatry 57:1193-1201 [PubMed]
    3. Sibutramine
      1. Appolinario (2003) Arch Gen Psychiatry 60:1109-16 [PubMed]
    4. Other agents to control binging and also assist with weight loss
      1. Topiramate
      2. Zonisamide
  4. Other agents
    1. Lisdexamfetamine (Vyvanse)
      1. Consider in adults with >3 days of Binge Eating per week, refractory to other agents
      2. Postulated to act at Dopamine-based reward centers
      3. Dosing starts at 30 mg daily and titrate weekly to 50 to 70 mg daily
      4. (2015) Presc Lett 22(3):17

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