Pharmacologic treatment of binge eating disorder SCoTT CroW
I’m a 45-year-old woman who presented for treatment of BED at a multidisciplinary eating disorder treatment program. I began engaging in episodes of binge eating in the seventh grade. About three times a week I eat a large amount of food with loss of control, usually in secret. I don’t have a history of purging, except for brief experimentation when I started college. I have begun psychotherapy sessions and have been working with a dietician about two months prior to this latest medication evaluation. I feel my “relationship with food” has improved substantially, and the amount of time I spend thinking about eating, weight, and shape-related issues has diminished somewhat. The frequency of eating binges has gone from four or five times a week down to three a week, but I believe this has plateaued. I have had “lifelong depression”, which my therapist says sounds like recurring episodes of major depression, about nine bouts in total, each lasting six months to a year. I’ve no history of substance use disorder except for a drinking pattern suggestive of alcohol abuse in college. I’ve had occasional panic attacks and some diffuse anxiety, primarily focused on eating-related issues. My therapist says I’ve no oCD, no PTSD, and no social phobia. I’m interested in considering medication to try to get my binge eating under better control, and I want to lose at least 50lbs (my current height is 5’5” and my current weight is 212lbs for a BMI of 35.3). My therapist and dietician are somewhat hesitant about desire for weight loss; the internist feels that I should consider trying to lose weight, but suggests a weight loss goal of between 15 and 20lbs.