Treatment

The goals for treatment of binge-eating disorder are to reduce eating binges and achieve healthy eating habits. Because binge eating can be so entwined with shame, poor self-image and other negative emotions, treatment may also address these and any other mental health issues, such as depression. By getting help for binge eating, you can learn how to feel more in control of your eating.

Psychotherapy

Whether in individual or group sessions, psychotherapy (also called talk therapy) can help teach you how to exchange unhealthy habits for healthy ones and reduce bingeing episodes. Examples of psychotherapy include:

• Cognitive behavioral therapy (CBT). CBT may help you cope better with issues that can trigger binge-eating episodes, such as negative feelings about your body or a depressed mood. It may also give you a better sense of control over your behavior and help you regulate eating patterns.
• Interpersonal psychotherapy. This type of therapy focuses on your relationships with other people. The goal is to improve your interpersonal skills — how you relate to others, including family, friends and co-workers. This may help reduce binge eating that's triggered by problematic relationships and unhealthy communication skills.
• Dialectical behavior therapy. This form of therapy can help you learn behavioral skills to help you tolerate stress, regulate your emotions and improve your relationships with others, all of which can reduce the desire to binge eat.

Medications

Lisdexamfetamine dimesylate (Vyvanse), a drug for attention-deficit hyperactivity disorder, is the first FDA-approved medication to treat moderate to severe binge-eating disorder in adults. A stimulant, Vyvanse can be habit-forming and abused. Common side effects include a dry mouth and insomnia, but more-serious side effects can occur.

Several other types of medication may help reduce symptoms. Examples include:

• Topiramate (Topamax), an anticonvulsant. Normally used to control seizures, topiramate has also been found to reduce binge-eating episodes. However, there are side effects, such as dizziness, nervousness, sleepiness and trouble concentrating, so discuss the risks and benefits with your medical care provider.
• Antidepressants. Antidepressants may reduce binge-eating. It's not clear how these can reduce binge eating, but it may relate to how they affect certain brain chemicals associated with mood.

While these medications can be helpful in controlling binge-eating episodes, they may not have much impact on weight reduction.

Behavioral weight-loss programs

Many people with binge-eating disorder have a history of failed attempts to lose weight on their own. However, weight-loss programs typically aren't recommended until the binge-eating disorder is treated, because dieting may trigger more binge-eating episodes, making weight loss less successful.

When appropriate, weight-loss programs are generally done under medical supervision to ensure that your nutritional requirements are met. Weight-loss programs that address binge triggers can be especially helpful when you're also getting cognitive behavioral therapy.