What’s New in Psychology

Studying a Medication for Binge Eating Disorder  

Jim Windell

            Whether it’s a Thanksgiving dinner or a feast on some other holiday, many of us load our plates with heaping mounds of food – and then go back for seconds. But most of us do this only on holidays and maybe those times when we are feeling massive amounts of stress.

          However, for some people, roughly 3.5 percent of the population, this kind of overeating is a regular occurrence. Called binge eating, this disorder is the most common eating disorder in the U.S.

           The diagnosis has its own DSM-V classification, where it is said to feature recurrent episodes of binge eating. In the DSM-V, an episode of binge eating is characterized by both of the following: 1) Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances; and 2) A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what one is eating).

           The Mayo Clinic classifies it as a serious condition and for those people who suffer from the disorder it almost always involves feeling like they’re not able to stop eating. For many, it leads to being overweight and not infrequently being obese. Also, according to the Mayo Clinic, most people with binge-eating disorder (BED) feel upset about their body size or shape – no matter what the number on the scale is.

           How is it best treated? And is there a pill that will curb the tendency to consume large amounts of food?

           Actually, the medication Lisdexamfetamine, marketed as Vyvanse, first received approval from the Food and Drug Administration for the treatment of ADHD, “but its ability to also reduce the frequency of binge eating episodes led to its approval for binge eating disorder,” says Morgan James, assistant professor of psychiatry and a member of the Rutgers Addiction Research Center at the Brain Health Institute.

            James is the senior author of a new study that looked at the effectiveness of Lisdexamfetamine as a treatment approach to BED.

            The study, published in Psychiatry Research Communications, explores the subjective experiences of individuals with BED and who were prescribed Lisdexamfetamine. Although clinical trials have demonstrated the effectiveness of lisdexamfetamine in reducing binge eating episodes in some patients, patient-centered qualitative data on its use had previously been lacking, according to researchers.

           According to Abanoub Armanious, a master of science student at Rutgers School of Public Health and lead author of the study, “The repositioning of this drug from an ADHD medication to a treatment for binge eating disorder highlights a critical gap in the treatment landscape, as no drug has been specifically developed and FDA-approved for binge eating disorder, despite the disorder's widespread prevalence both in the U.S. and globally. The need for targeted treatment options for binge eating disorder remains a significant, unmet challenge in mental health care.”

           Armanious and James and others involved in the research project conducted a thematic analysis of 111 anonymous reviews submitted by self-identified patients with binge eating disorder on Drugs.com, an independent drug information platform. Researchers then examined the relationship between patients’ subjective perceptions of lisdexamfetamine and their ratings of the drug’s efficacy, revealing how personal experiences with the drug's timing, side effects, and overall impact influenced these evaluations.

           “Our findings revealed that higher perceived efficacy was associated with improved focus and fewer side effects, while lower ratings were linked to concerns about diminishing therapeutic effects, insomnia, and afternoon energy loss,” Armanious said.

           Several challenges with the use of lisdexamfetamine for binge eating were identified in the study. Among these were the finding that many patients experienced their highest binge risk at night, while lisdexamfetamine’s appetite-suppressing effects typically wear off by evening, creating vulnerability for nighttime binge episodes. In addition, the “crash” experienced as lisdexamfetamine wears off can leave patients feeling fatigued, irritable or mentally foggy. Also, some patients self-adjusted their dosage timing, taking lisdexamfetamine closer to their binging hours, but this often resulted in insomnia and other sleep disturbances.

           Armanious said the study’s findings underscore the need for a more nuanced understanding of lisdexamfetamine’s effects on patients with binge eating disorder.

           The development of new medications with an improved side effect profile is a major focus of ongoing work in the James Laboratory at the Rutgers Addiction Research Center at the Brain Health Institute.

           To read the original journal article, find it with this reference:

Armanious, A.J., Asare, A., Mitchison, D. & James, M.H. (2024). Patient perceptions of lisdexamfetamine as a treatment for binge eating disorder: An exploratory qualitative and quantitative analysis. Psychiatry Research Communications, 4(4).