People diagnosed as chronic binge eaters can benefit from cognitive-behavioral therapy, a form of therapy that helps patients understand the reasons behind their actions. That understanding can then help them change their behavior, said study lead author Kimberly Brownley. She's an associate professor with the University of North Carolina Center of Excellence for Eating Disorders.
The new research review also identified prescription drugs that appear to help curb binge eating, including second-generation antidepressants such as Prozac, Zoloft and Wellbutrin.
People with binge-eating disorder can also try a drug called Vyvanse (lisdexamfetamine). It's currently the only FDA-approved medication for binge-eating disorder, Brownley said.
"We found strong evidence to support these three different forms of treatment," Brownley said.
But, it appears that there's no one-size-fits-all treatment.
"We can't say, 'Start with this treatment and then add this other treatment in,'" Brownley said. "There's a lot more research to be done. But we have provided a good platform for physicians to figure out how to guide their patients' care."
The new evidence review appears online June 28 in the Annals of Internal Medicine.
Binge-eating disorder affects about 3.5% of women and 2 percent of men in the United States, according to the U.S. National Institutes of Health.
But it wasn't until 2013 that the American Psychiatric Association judged binge-eating disorder a true illness and included it in its diagnostic manual, the DSM-5.
Binge-eating disorder is different from bulimia, because the person who binges doesn't feel compelled to purge the food afterwards. People with bulimia often try to prevent weight gain by vomiting, using laxatives or overexercising after they've overeaten, Brownley said.
People who occasionally down a whole pint of ice cream or a family-size bag of chips in one sitting don't necessarily have binge-eating disorder, pointed out Dr. Michael Devlin, a professor of psychiatry at Columbia University Medical Center in New York City.
"This is not occasional overeating, but a major problem," said Devlin, who wrote an editorial accompanying the evidence review. "The criteria are careful to specify it really has to be out-of-control eating and people have to be stressed by it, not just feeling bad, but feeling really disgusted with yourself or very depressed."
A binge-eating episode involves eating a large amount of food within a couple of hours, with no sense of control over what one is doing, Brownley said.
To be diagnosed with binge-eating disorder, a person would have at least one episode a week for three months. Someone with the disorder will eat much more rapidly than normal, eat until they're uncomfortably full, eat when they're not hungry, hide their eating out of embarrassment, or feel disgusted, depressed, or guilty after a binge episode, Devlin said.
"It's a real disorder. It's not just overeating. And it's important for people to realize there are treatments for it," he said.
For their review, Brownley and her colleagues looked at 34 different clinical trials that tested potential treatments for binge-eating disorder.
The researchers found that patients who take part in cognitive-behavior therapy were about five times more likely to abstain from binge eating than people not receiving the therapy.
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