Drug Treatments for Anorexia, Bulimia and Binge Eating Disorder
Wednesday, May 26 2010 Laura Collins
We have drugs for everything now, right? Too hot, too weak, too sad, too hyper - there's a pill. Not enough hormones, low insulin, can't breathe - the doctor has a script for you. But what about anorexia? Bulimia? Binge Eating Disorder?
Isn't There A Pill For That?
I was surprised to learn that there were few available medications for eating disorders. Yet it makes sense now: we don't know exactly what - or what combination - of brain changes are happening to a person who develops these conditions. Psychiatric drugs are hard to work with because the symptoms one is treating, and the measurement of success, require the patient to have self-knowledge and report changes accurately. With mental illness, there are problems with perception, insight, and motivation.
We do not yet know what genetic, biological, chemical, structural, or external stimuli are involved. We do not know how to measure success. We don't even know if the categories we use to describe these eating disorder conditions are valid!
We do have some leads, however, and it does seem to depend on diagnosis.
State of Nutrition Matters
When a patient with anorexia is undernourished, the question of drugs is complicated. Most psychiatric drugs require nutrition to work properly. Although some so-called antipsychotic drugs and anti-anxiety medications are sometimes prescribed to help through the distress of restoring a malnourished patient, the renourishment itself is the primary "drug" of choice. Lack of nutrition and stored energy in the body - even just below normal needs - have a drug effect of their own: numbing emotions. Taking away that 'drug' by feeding the patient fully sets off a kind of withdrawal effect: crippling anxiety and mood changes.
The News For Bulimia Is Better
Medication treatments for bulimia are more encouraging. Bulimics are less compromised nutritionally (though they suffer other horrible side effects) and respond better to drugs. I'm not being specific here for a reason, though: these are issues that must be discussed with medical professionals with a specialty in eating disorder treatment.
Medications for Treatment of Binge Eating Disorder
How about Binge Eating Disorder? Here's the sad thing: we don't know. Too little research has been done to know what helps, or comparing treatments. It is only in recent years that BED has been recognized as an eating disorder in its own right, and research is just beginning.
So far, I have seen no reason to believe that eating disorders could ever be treated entirely by drug treatment. Treatment for these complex conditions require multidisciplinary attention and the best bet is to find and work with cutting edge evidence-based specialists.