ABSTRACT

Pharmacotherapy is an important aspect of treatment for individuals with obesity and binge eating. The broadest range of potential options exists for those with binge eating and obesity who are without other psychopathology in need of pharmacotherapy. Many of the psychotropic agents previously studied in binge eating disorder (BED) generally have well recognized antidepressant and anxiolytic effects. Major depression, dysthymia, and various anxiety disorders frequently co-occur with BED. When BED and either a depressive or an anxiety disorder are present, a rational approach involves the selection of a drug known to have both anti-binge eating and antidepressant and/or anxiolytic effects. Higher doses of fluoxetine are widely viewed as the pharmacologic standard of treatment for bulimia nervosa and many experts would strive to achieve similarly high doses for BED. Comorbid psychopathology is extremely common in BED, even in community samples not seeking treatment, and is still higher in those seeking treatment.