Obesity Drug Helps Binge Eaters
New Clues Into How Brain Chemistry Affects Baffling Eating Disorder
In fact, the weight loss he observed is better than the 1 pound per week expectation from using Meridia for its intended and FDA-approved purpose -- to help those with clinical obesity lose weight. The drug was approved in 1997 and has since been prescribed to at least 9 million Americans with a body mass index of 30 or higher who have failed lifestyle changes alone in the management of obesity.
But Meridia has its share of controversy. Last year, Italy's Health Ministry briefly suspended the sale of products containing sibutramine, the primary ingredient in Meridia; that ban was lifted months later. And this year, the consumer interest group Public Citizen continued its push to have Meridia banned, with an August letter to the FDA saying that it documented nearly 50 cases of deaths from cardiovascular problems among people using the drug.
Meridia reportedly works by making people feel full soon, so people consume less food. This action would affect a different part of the brain than what may be involved in depression, says McElroy.
However, Appolinario tells WebMD that his Meridia patients also had fewer depressive episodes than those on placebo, with no measured side effects. That's significant because major depression affects between 30% and 50% of those with binge eating disorder -- characterized in this study by at least two episodes per week of uncontrollable eating, even when they feel full or don't want to eat.
His study, funded by the Brazilian branch of Abbott Laboratories, which manufactures Meridia, is believed to be the first published trial examining Meridia as a binge-eating treatment. But American researchers completed a similar study that hasn't been published.
"As I recall, our findings were pretty consistent with this one -- the drug seems to be very effective for those with binge eating disorder," says Lisa Lilenfeld, PhD, of Georgia State University, one of the investigators in that 20-site study.
Meanwhile, eating disorders specialist Marsha D. Marcus, PhD, says that Appolinario's results are encouraging but his study was too short to imply a long-range solution. She runs the Behavioral Medicine and Eating Disorders Program at the University of Pittsburgh Medical Center and is a spokeswoman for the Academy for Eating Disorders.
"It yielded results that one might expect," she tells WebMD. "The $64 million question remains: Once the drug is withdrawn, in the absence of other interventions, what will happen? It's likely the weight would be regained."