Antidepressants May Help Control Binge Eating

May 25, 2005 (Atlanta) -- Popular antidepressants like Prozac and Zoloft can help binge eaters control the amount of food they eat, at least in the short-term, researchers report.

A review of seven studies on binge eating that compared treatment with antidepressants with a placebo showed that medications won every time, says researcher Josue Bacaltchuk, MD, associate professor of psychiatry at the Federal University of Sao Paulo in Brazil.

Overall, 41% of people taking antidepressants stopped bingeing after an average of eight weeks, compared with just 22% of those taking placebo, says Bacaltchuk.

His study was presented at the annual meeting of the American Psychiatric Association.

Six of the seven studies used Prozac, Zoloft, Luvox, or Celexa. They're all members of the class of drugs called selective serotonin reuptake inhibitors, or SSRIs, that boost levels of serotonin, a mood-regulating chemical, in the body.

Victims Often Obese

As many as 1 in 100 Americans suffer from binge eating disorder, characterized by a compulsive, unhealthy need to eat, even when they are full. Binge eaters are unable to control the amount of food they eat. They are typically distressed about their behavior, but they do not induce vomiting, fast, or abuse laxatives or diuretics.

Binge eating episodes are associated with at least three of the following symptoms.

• Eating rapidly
• Eating until feeling uncomfortably full
• Eating when not hungry
• Eating alone because of embarrassment
• Feeling disgusted, depressed, or guilty after overeating

No one knows what causes the condition, yet researchers say that about half of patients with the eating disorder have depression. It is also more common among the severely overweight but can be found among people of any weight.

Antidepressants are "currently considered the treatment of choice for binge eating, even though they're not approved for the condition," Bacaltchuk tells WebMD. He says "the drugs didn't help people lose weight."

But don't throw the baby out with the bathwater, Bacaltchuk says. "If the drug is working to control bingeing, maybe think about adding a weight loss drug or psychotherapy," he says.

Researchers are also trying to determine if Topamax, an epilepsy drug sometimes used to treat depression, or the weight loss drug Meridia might work even better.

Early studies suggest both drugs pack a one-two punch against binge eating disorder and obesity, Bacaltchuk says.

Eric Holander, MD, director of the Compulsive, Impulsive and Anxiety Disorder Program at Mt. Sinai School of Medicine in New York, agrees.

"Studies are showing that Topamax has a really whopping effect, bigger than you'd expect with an antidepressant," Holander tells WebMD. "People binge less frequently and eat less food when they do binge, with less distress."