Stimulants as a Treatment for Binge Eating disorders
Although used primarily as a treatment for ADHD, stimulant medications have also shown some early success in the treatment of certain eating disorders. Specifically, I and others have treated patients with bulimia and Binge Eating Disorder with medications such as Concerta and Adderall and seen a marked reduction in their binging behavior. A recent paper in JAMA Psychiatry described success treating Binge Eating Disorder (BED) with Vyvanse.
There are a number of theories as to why these medications are effective. Stimulants help people suppress their impulsivity, thereby allowing them to resist the urges to binge. There is a also a direct appetite suppressant effect which may make the urges less powerful. For those patients with co-occurring ADHD, the stimulants may allow them to live a more structured life, which can include regular meals throughout the day. This makes them less prone to binge at night. Lastly, an article in the American Journal of Psychiatry reported a relationship between ADHD and obesity. This suggests that there may be a more complicated relationship between ADHD, appetite, eating behavior and metabolism.
The most likely explanation at the neurological level involves Dopamine pathways. Without getting too technical, the stimulants appear to affect re-uptake of Dopamine as well as at least one of the Dopamine receptors. These pathways are involved in impulsivity, reward, and eating behavior.
Last updated 12/2/17