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There's a Promising Pill For Binge Eating Disorder

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Correction appended, Jan. 15, 2015

A drug typically used to treat ADHD in adults and kids may also be an effective treatment for binge eating disorder, a new study shows.

In the study, published in the journal JAMA Psychiatry, researchers tested the safety and effectiveness of the drug lisdexamfetamine dimesylate on people with binge eating disorder—those who repeatedly eat an excessive amount of food, accompanied by a sense of having no control. When people took the drug every day for 11 weeks, half of them stopped binge eating entirely, which was more than the placebo group.

A drug that can treat both ADHD and an eating disorder may seem like an odd pairing, but lisdexamfetamine dimesylate works by acting on the dopamine and norepinephrine systems in the brain, which are two pathways that help control rewards and control. People with binge eating disorder can experience reward dysfunction and be very impulsive, similar to symptoms in people with ADHD. Norepinephrine helps with focus and concentration, while the dopamine helps recalibrate the rewards system—so the drug may help binge eaters feel more in control and able to avoid mindless eating.

"This study adds to our toolbox in that we have another treatment to potentially offer to people suffering binge eating disorder," says study author and eating disorders and obesity expert Denise E. Wilfley of Washington University School of Medicine in St. Louis. "What we really want is a comprehensive treatment plan. There is a lot of loneliness and isolation needs to be met." ( Pharmaceutical company Shire, which has a version of lisdexamfetamine dimesylate, funded the trial and has supported prior research performed by Wilfley as well).

Another drug called topiramate has been used similarly to treat eating disorders, but has been shown to have some serious side effects, including cognitive problems. But in the new study, lisdexamfetamine dimesylate caused side effects similar to those in people with ADHD who take the drug, none of them serious, the results showed. One patient in the new study died, but the cause of death was determined to be methamphetamine overdose. The study authors do not believe it was related to the study.

Other treatments like cognitive behavioral therapy and interpersonal psychotherapy have already proven to be successful at treating binge eating disorder—which was only formally recognized as a disorder in 2013—but this study didn't compare the effectiveness of the drug to the other treatments. Another question researchers want to explore is whether the drug wears off at night, a common time for people to binge, so more research is needed.

Even so, the fact that the drug succeeded because it was able to give a person more cognitive control opens the door to other non-pharmacological treatments, some of which show impressive results. Meditation, for instance, has been shown to help enhance executive function, as has exercise. Given how recently binge eating disorder was formally recognized as a problem, researchers hope there will soon be a variety of ways to treat it.

Correction: The original version of this story misstated the relationship between the pharmaceutical company Shire and the trial's research. The company funded the study.

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