Subscribe Now/Learn More
PsychiatryOnline subscription options offer access to the
DSM-5 library, books,
journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists
and mental health professionals with key resources for diagnosis, treatment, research,
and professional development.
Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org
or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).
For patients with subsyndromal anorexia nervosa or bulimia nervosa, who meet most but not all of the DSM-IV-TR criteria, provide treatment similar to that provided for patients who fulfill all criteria.
Provide nutritional rehabilitation.
Behavioral weight control programs incorporating low- or very-low-calorie diets may help with weight loss and usually reduce symptoms of binge eating.
Weight loss is often difficult to maintain, and binge eating can recur with weight gain.
Obese binge eaters who primarily wish to lose weight should be treated with the same approaches as other obese individuals.
Provide psychosocial treatment.
Cognitive-behavioral therapy has evidence for efficacy in individual and group formats as well as in self-help and guided self-help sequenced treatment programs.
Interpersonal therapy and dialectical behavior therapy also have efficacy in treating behavioral and psychological symptoms.
Other diets, behavior therapies, psychodynamic psychotherapy, and non-weight-directed psychosocial treatments are less well studied but may be of benefit for binge eating, weight loss, or stabilization in some patients.
Self-help organizations and 12-step-based approaches have been tried, but no systematic outcome studies are available.
Consider if the patient would benefit from an antidepressant or other medication.
Antidepressant treatment is associated with short-term reductions in binge eating but generally does not result in substantial weight loss.
SSRIs have the fewest difficulties with adverse effects and the most evidence for efficacy when used at the high end of the recommended dosage range.
Sibutramine, an appetite suppressant medication, is effective for binge suppression in the short-term and can produce significant weight loss.
Topiramate, an anticonvulsant, can reduce bingeing and decrease weight, but its use may be limited by side effects.
Consider if the patient would benefit from the combination of psychotherapy and pharmacotherapy.
Although limited evidence is available, combined treatment is frequently used in clinical practice.