Bupropion for Overweight Women With Binge-Eating Disorder

Abstract

Background Binge eating disorder (BED) is defined by recurrent binge eating (eating unusually large quantities of food during which a subjective loss of control is experienced), marked distress about the binge eating, and the absence of inappropriate weight compensatory behaviors. BED is strongly associated with excess weight and many available psychological and pharmacological approaches fail to produce much weight loss. The objective of this study was to perform a randomized placebo-controlled trial to evaluate the short-term efficacy of bupropion for the treatment of BED in overweight and obese women. Methods Sixty-one overweight and obese (Mean BMI=35.8) women with BED were randomly assigned to receive bupropion (300 mg/d) or placebo for 8 weeks. Participants were enrolled from November 2006 to December 2010. No dietary or lifestyle intervention was given. Primary outcome measures were binge-eating frequency and percent BMI loss. Secondary outcome measures were dimensional measures of eating disorder psychopathology, food craving, and depression levels. Results Eighty-nine percent of randomized participants completed the trial without differential dropout between bupropion and placebo. Mixed effects analyses revealed significant time effects for all outcomes but that bupropion and placebo did not differ significantly on any outcome measure except for weight loss. Participants taking bupropion lost significantly more weight (1.8% BMI loss versus 0.6% BMI loss; F=10.57, p=002). Conclusions Bupropion was well tolerated and produced significantly greater – albeit quite modest – short-term weight loss in overweight and obese women with BED. Bupropion did not improve binge eating, food craving, or associated eating disorder features or depression relative to placebo. Our findings do not support bupropion as a stand-alone treatment for BED. The preliminary findings regarding short-term weight losses suggest the need for larger and longer-term trials to evaluate the potential utility of bupropion for enhancing outcomes of psychological interventions with demonstrated effectiveness for BED but which fail to produce weight loss.

Current and emerging drug treatments for binge eating disorder

“…Four additional RCTs have tested various antidepressants: two were monotherapy placebo-controlled RCTs testing duloxetine [43] and bupropion [44] and two were additive/combination RCTs testing imipramine versus placebo combined with diet and counseling[45] and desipramine as an added treatment following a sequenced approach involving CBT followed by behavioral weight loss [46]. Duloxetine was associated with significantly faster reduction in binge-eating than placebo but did not differ from placebo in binge-eating remission, end-point binge-eating frequency, depression, or weight loss [43].…”

Pharmacological treatment of binge eating disorder: update review and synthesis

“…Only three RCTs testing SSRI antidepressants for BED reported longer-term follow-up data following medication discontinuation and they converged in reporting lack of efficacy for both monotherapy fluoxetine [20] and fluvoxamine [16] and no additive effect relative to placebo when combined when CBT [20] or with behavioral weight loss [21]. Four RCTs have tested other antidepressants, including trials testing monotherapy duloxetine [19] and bupropion [22] and a trial with an additive/combination design testing desipramine as part of an added treatment component in a sequential approach with CBT followed by behavioral weight loss [23]. Duloxetine was associated with significantly faster reduction in binge-eating than placebo but did not differ from placebo in binge-eating remission, end-point binge-eating frequency, or weight loss [19].…”

“…Duloxetine was associated with significantly faster reduction in binge-eating than placebo but did not differ from placebo in binge-eating remission, end-point binge-eating frequency, or weight loss [19]. Bupropion did not differ from placebo on binge-eating remission or binge-eating frequency; bupropion produced statistically significantly greater weight loss than placebo but the amount was clinically insignificant (1.8% BMI loss vs 0.6% BMI loss) [22]. Adding desipramine during the last 6 months of a sequenced CBT-behavioral weight loss treatment did not enhance binge-eating outcomes or weight loss meaningfully (weight loss was statistically significant but not meaningful)[23].…”

Role or Synergistic Interaction of Adenosine and Vitamin D3 Alongside High-Intensity Interval Training and Isocaloric Moderate Intensity Training on Metabolic Parameters: Protocol for an Experimental Study (Preprint)

“…Plant based substances [4,10,11] and medicines [12][13][14][15][16] have been proposed as strategic treatment and preventive measures for obesity. Presently, one of the most challenging issues in the field of pharmacy is the discovery of the most effective anti-obesity intervention with the least negative side effects on humans.…”

“…Presently, one of the most challenging issues in the field of pharmacy is the discovery of the most effective anti-obesity intervention with the least negative side effects on humans. Recently, researchers have focused on the effect of most active forms of vitamin D and have shown its controlling role in the incidence of obesity [13][14][15][16][17].…”