Treatments and drugs

By Mayo Clinic Staff

The goals for treatment of binge-eating disorder are to reduce eating binges, to improve your emotional well-being and, when necessary, to lose weight. Because binge eating is so entwined with shame, poor self-image, self-disgust and other negative emotions, treatment needs to address these and other psychological issues. By getting help for binge eating, you can learn how to properly lose weight and keep it off.

There are four main types of treatment for binge-eating disorder.

Psychotherapy

Psychotherapy, whether in individual or group sessions, 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 eating patterns. If you're overweight, you may need weight-loss counseling in addition to CBT.
  • Interpersonal psychotherapy. Interpersonal psychotherapy focuses on your current relationships with other people. The goal is to improve your interpersonal skills — how you relate to others, including family, friends and colleagues. This may help reduce binge eating that's triggered by poor 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

There's no medication specifically designed to treat binge-eating disorder. But, several types of medication may help reduce symptoms, especially when combined with psychotherapy. Examples include:

  • Antidepressants. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) may be helpful. It's not clear how these can reduce binge eating, but it may relate to how they affect certain brain chemicals associated with mood.
  • The anticonvulsant topiramate (Topamax). Normally used to control seizures, topiramate has also been found to reduce binge-eating episodes. However, potentially it can cause serious side effects, so discuss these risks with your doctor.

Behavioral weight-loss programs

Many people with binge-eating disorder have a long 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 very low calorie diets may trigger more binge-eating episodes.

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.

Self-help strategies

Some people with binge-eating disorder find self-help books, videos, Internet programs or support groups effective. Some eating disorder programs offer self-help manuals that you can use on your own or with guidance from mental health experts. However, you still may need professional treatment with psychotherapy or medications.

Apr. 03, 2012