Obesity drug effective for binge eating disorder

[Halo]

Obesity drug effective for binge eating disorder

Reuters Health
Wednesday, February 6, 2008

NEW YORK (Reuters Health) - "Out of control" binge eaters may benefit from the appetite-suppressant drug sibutramine, based on a study showing that the drug reduces the number of binge eating episodes, along with weight and associated psychological illness.

Sibutramine appears to modify internal signals that control hunger and feelings of fullness, Dr. Denise E. Wilfley, of Washington University School of Medicine, St. Louis, Missouri, and colleagues report in the American Journal of Psychiatry.

Binge eaters often eat large amounts of food while feeling a loss of control over their eating. It is different from the binge-purge syndrome of bulimia because binge eaters do not purge afterward by vomiting or taking laxatives. Binge eating disorder is contributing to the rise in obesity.

In a study lasting 24 weeks, Wilfley's team examined the effects of sibutramine, compared with placebo, in 304 binge eaters. Overall, 289 of them had at least one post-randomization efficacy measure (sibutramine, n = 150; placebo, n = 139). Average adherence to study medication was 76.2 percent in the sibutramine group and 82.6 percent in the placebo group.

Binge eaters who received sibutramine had a significantly greater reduction in average weekly binge frequency compared to binge eaters who received placebo; in the sibutramine group, the frequency dropped from 3.3 binges per week to 0.6, compared with a drop from 3.4 to 1.3 in the placebo group.

Average weight loss was also greater in the sibutramine group than the placebo group (4.3 kg or 9.5 lbs versus 0.8 kg or 1.8 lbs).

Sibutramine-treated patients also had higher levels of overall improvement; however, no significant change in quality of life scores was observed between the groups. Side effects of sibutramine included headache, dry mouth, constipation, insomnia, and dizziness.

This placebo-controlled trial suggests that sibutramine may be effective in binge eaters, the researchers conclude.

SOURCE: American Journal of Psychiatry, January 2008

 

[amastie]

Thank you for this.

I'm starting to think I'm the only binge eater here. Have yet to see replies by others. Maybe I still will.

I've tried everything for my binge eating except weight loss surgery (am on waiting list but the surgeon has resigned from the public hospital where I was due to have the surgery. At present, have an appointment to be referred to a different public hospital but even that option is questionable given my strong inclination to sabotage anything that will help me lose weight - which doesn't auger well for anything that will achieve that. But I have had Sibutramine (also called here Reductil) prescribed for me.

I didn't notice it in your informative post, Halo, that it is also known to increase blood pressure. Mine is controlled, just, with medication so Reductil isn't a particularly desirable medication, but I'm still thinking of taking it and perhaps look at increasing the blood pressure medication to help offset that effect.

I wonder also how long it is possible to stay on the Sibutramine. Typically, any weight loss medications are short term. I've lost weight in the past on other weight loss medication but couldn't stay on it and put all the weight back on.

I have found counselling that seeks to help me heal the need to overeat seems most to help but that is ongoing and I cannot see an end in sight to that right now.

I wonder if anorexia and bulimia are this resistant to any kind of help..

I believe anorexia is particularly resistant, maybe because when so much weight is lost, the will to live is lost along with it.

I often feel that too. I can't believe that my 'glucose impairment' hasn't given way to full-on diabetes when I have spent the last few days bingeing uncontrollably on sweets among other things. It's as if I'm arguing against *not* being diabetic. And yet I seek medical advice to help delay it. From what little I've read abut anorexics, there isn't that contradiction, but maybe there is.

But I wake each day, am glad to find myself involved in things like voluntary work and use that to keep myself engaged in the world.

Moving on..

amastie

 

[amastie]

Just following up this thread.

I started on Sibutramine early March, stayed on it each day for a month but its effect on blood pressure and constipation were too strong. Have since taken it only occasionally, when I feel the beginning of another binge and it always seems to work immediately. By far, the most successful of any medication or treatment I've ever taken to lose weight, I can wholeheartedly recommend it (though watch out for the blood pressure and get ready to take *safe* laxatives daily. So far, it's been amazing. Hope that my experience can help others
amastie

 

[forgetmenot]

I am happy this medication is working for you Amastie. I binge eat when i am depressed sometimes and other times i won't eat at all. It is good to see there is a medication that can help Keep us up to date on your progress I'll pass this information along to others who will be happy to hear about it. thanks and take care mary:2thumbs:

 

[amastie]

Looking back:

2009, over about ten months, lost 42kg (92.5 lbs). More than I'd ever lost. Blood pressure medication had to be raised because of it, but I thought it well worth it given how much I lost, and how easily. After that period, it seemed to lose effect. I immediately started to gain weight from bingeing. Forget exactly when, but sometime after finishing it, I mentioned to the GP nice-feeling fainting turns that I had most days. I had put them down to low blood sugar or low blood pressure. I was stunned when she immediately sent me into the precedure room for an ecg. ("Why?" "Because your heart is stopping" "Huh?!) It was true. Still feeling very well, I was hustled into an ambulance and shipped off to emergency ward. The head doctor started to tell me that my life was on the line.. For the first time in my life, the words came in response to him "Doctor, there is nothing you can tell me that is worse than living for forty years with mental illness" and I knew it was true. I was totally unafraid.

A number of us had to wait for a pacemaker till a specialist could be found. They got one finally off his holiday. The morning that the pacemaker was to be inserted I actually *did* black out, and was taken in straight away. That was about two years ago now. I've never had a problem with the pacemaker at all, but having need of one did shock me. In the meantime, Reductil has been banned in Australia after studies found too many complications related to the heart.

When the Reductil stopped working, as always I immediately started to regain the weight. Gained 32 kg (70.5 lbs) before I felt that my stomach wasn't going down between binges. Something was different but it was hard not to put it down just to the bingeing. Saw GP who was annoyed to see my obviously distended stomach. "By the way, I also have a cough". She checked my lungs. All ok. Still annoyed "An allergic cough". Prescribed an antihistamine for it.

The following weekend (Sept 2010) I saw a different GP who referred me for an ultrasound. Had that on the Tuesday. "Sit up!" "Why?" "Because your abdomen is carrying about 10kg of fluid and is not giving your lungs room to expand" (thus the cough). Sent to emergency again. Took about a fortnight to diagnose, and only by a sample of the fluid which proved cancerous. "Cancer of unknown primary with mets to peritoneum". That was around October 2010

After being drained of the fluid in my abdomen, of course my weight went down. Have now finished 11 cycles of chemo to which I responded much better than expected. No scans have ever shown any sign of tumours anywhere, including the peritoneum, but the chemo put a stop to the fluid build-up and my cancer marker (a number) came down to within normal limits. It has started to go up again. We're just waiting to see how it goes before going on another chemo probably - like others have done in an online forum I joined (for those who have peritoneal cancer.)

Since I handled the chemo so well, without any nausea at all (only loss of my hair which has grown back) I soon started to binge heavily. Have put back on about 40kg, still going up. (I know why_

Wanted to write this update in case others think they can get away with taking Reductil or related medications. There was no history at al of heart problems in my family. The cancer was unrelated I expect. Peritoneal cancer is quite rare I am told, especially if it is the primary - and my oncologist doesn't know if mine is since they can't find any evidence of cancer anywhere else.

I remain calm about the cancer. (More than calm actually) But I'm not doing anything consciously to sabotage the treatments that I am given. Even though I have at times been in touich with the will to binge in order to sabotage the treatments, I don't consciously eat to do so. I never did. But I know that I am.

That's my update.