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Obesity Drug Helps Binge Eaters

New Clues Into How Brain Chemistry Affects Baffling Eating Disorder
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WebMD Health News

Nov. 10, 2003 -- At first glance, the study findings may seem anything but surprising: The popular "antiobesity" drug Meridia used by millions to lose weight appears to help obese binge eaters shed excess pounds, but this new report shows that the drug can also help binge eaters control their eating behavior.

Specifically, Brazilian researchers find that obese patients with binge eating disorder given a daily 15 mg dose of Meridia reported fewer days of binge eating and lost an average of 16 pounds during the three-month study. By comparison, a group of similarly obese binge eaters getting a placebo had no change in the frequency of their binge-eating days and gained an average of 3 pounds during the study.

But this new research, published in the latest issue of Archives of General Psychiatry, may provide yet another piece to a puzzle that has long baffled experts: Exactly what causes binge eating disorder, which affects at least one of every 100 Americans, and how can it successfully be treated?

"We have all these hints that there may be some abnormal brain chemistry that gives risk to this irresistible urge to eat, and many different drugs that alter brain chemistry have been investigated," says Susan L. McElroy, MD, professor of psychiatry and psychopharmacology at the University of Cincinnati College of Medicine and director of its weight management program.

"But what's interesting is that all of these drugs have slightly different mechanisms, so we really don't know the exact mechanism involved in binge eating disorder," she tells WebMD. "So when a drug seems safe and effective, it really helps us. This is a great study because it was well done. And it's exciting because it provides another alternative for people with binge eating disorder."

In recent years, several studies have looked at various antidepressants and other drugs that alter brain chemistry as possible treatments for binge eating disorder -- including two by McElroy published this year. She was not involved in the Brazilians' study.

She found that both Topamax, an epilepsy drug sometimes used to treat depression and other illness, and Celexa, an antidepressant in the same class of drugs as Prozac, Zoloft, and Paxil, helped patients lose weight and reduce bingeing episodes compared with those getting a placebo.

Currently, only one drug, Prozac, is specifically approved to treat an eating disorder, bulimia, in conjunction with counseling. However, many antidepressants and other drugs are used "off-label" in conjunction with therapy for various eating disorders.

But Meridia has produced some of the most impressive results to date, says lead researcher of the new study, Jose C. Appolinario, MD, DSc, of Federal University of Rio de Janeiro.

"We were surprised at the substantial amount of weight loss observed," he tells WebMD. "This amount of weight loss was (rarely) observed in clinical trials of binge eating disorder with other agents."

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