NEDA TOOLKIT for Parents
Patients with a history of repeated weight loss
followed by weight gain (“yo-yo” dieting) or patients
with an early onset of binge eating may benefit from
following programs that focus on decreasing binge
eating rather than on weight loss [II].
The anticonvulsant medication topiramate is effective
for binge reduction and weight loss, although adverse
effects may limit its clinical utility for some individuals
[II]. Zonisamide may produce similar effects regarding
weight loss and can also cause side effects [III].
There is little empirical evidence to suggest that obese
binge eaters who are primarily seeking weight loss
should receive different treatment than obese
individuals who do not binge eat [I].
iv. ii. Other Psychosocial Treatments
Substantial evidence supports the efficacy of
individual or group CBT for the behavioral and
psychological symptoms of binge eating disorder [I].
IPT and dialectical behavior therapy have also been
shown to be effective for behavioral and
psychological symptoms and can be considered as
alternatives [II]. Patients may be advised that some
studies suggest that most patients continue to show
behavioral and psychological improvement at their 1-
year follow-up [II]. Substantial evidence supports the
efficacy of self-help and guided self-help CBT
programs and their use as an initial step in a
sequenced treatment program [I]. Other therapies that
use a “non-diet” approach and focus on self-
acceptance, improved body image, better nutrition
and health, and increased physical movement have
been tried, as have addiction-based 12-step
approaches, self-help organizations, and treatment
programs based on the Alcoholics Anonymous model,
but no systematic outcome studies of these programs
are available [III].
iii. Medications
Substantial evidence suggests that treatment with
antidepressant medications, particularly SSRI
antidepressants, is associated with at least a short-
term reduction in binge eating behavior but, in most
cases, not with substantial weight loss [I]. The
medication dosage is typically at the high end of the
recommended range [I]. The appetite-suppressant
medication sibutramine is effective for binge
suppression, at least in the short term, and is also
associated with significant weight loss [II].
Combining Psychosocial and Medication
Treatments For most eating disorder patients, adding
antidepressant medication to their behavioral weight
control and/or CBT regimen does not have a
significant effect on binge suppression when
compared with medication alone. However,
medications may induce additional weight reduction
and have associated psychological benefits [II]. Adding
the weight loss medication orlistat to a guided self-
help CBT program may yield additional weight
reduction [II]. Fluoxetine in conjunction with group
behavioral treatment may not aid in binge cessation
or weight loss but may reduce depressive symptoms
[II]. b.
Night Eating Syndrome
Progressive muscle relaxation has been shown to
reduce symptoms associated with night eating
syndrome [III]. Sertraline has also been shown to
reduce these symptoms [II].
Definitions The three categories of endorsement are as follows:
[I] Recommended with substantial clinical confidence
[II] Recommended with moderate clinical confidence
[III] May be recommended on the basis of individual
circumstances Links
Link to Full Summary:
http://www.guideline.gov/content.aspx?id=9318 Link to Information for the Public:
http://www.nice.org.uk/nicemedia/pdf/cg009publicinf oenglish.Pdf
Page | 55