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Obesity Drug Helps Binge Eaters

New Clues Into How Brain Chemistry Affects Baffling Eating Disorder
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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."

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.

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