End Binge Eating Now
Sibutramine has been shown to be effective in treating obesity and binge eating (Appolinario et al., 2002) (Smith and Goulder, 2001) (Finer et al., 2000). Brain sites producing serotonin (the nucleus raphe) and norepinephrine (mainly the locus ceruleus), project widely through the brain, including centers involved in regulation of energy balance. Since another serotonin-reuptake inhibitor, fenfluramine, which has been on the market to treat obesity, requires 5HT2C receptors (Vickers et al., 1999) probably located in POMC neurons (Heisler et al., 2002), one hypothesis might be that sibutramine also acts via this serotonergic system. Topiramate, an anticonvulsant drug, has anorectic effects. Topiramate may be an effective treatment for binge-eating disorder (Shapira et al.,2000). Topiramate treatment improves multiple behavioral dimensions of bulimia nervosa. Binge and purge behaviors are reduced, and treatment is associated with improvements in self-esteem, eating attitudes, anxiety,...
The SNRI atomoxetine is playing a growing role in the treatment of ADHD. Translational studies indicate that this agent modulates prefrontal noradrenaline (and dopamine), and is capable of improving response inhibition, a cognitive function dependent on the right inferior frontal gyrus and under likely noradrenergic control. Further clinical trials are required to explore the efficacy and safety of atomoxetine into the longer term in the treatment of ADHD, in children and in adults, and to evaluate the efficacy of this agent in the treatment of other disorders. For example, registered ongoing trials are exploring the utility of atomoxetine in the treatment of alcohol substance abuse, Parkinson's disease, and Binge Eating disorder (www.clinicaltrials.gov). In addition to further clinical trials, it will also be important to explore the role of different components of the brain noradrenaline system in cognition (i.e., sub-receptors) in translational research and to evaluate the effects...
Of a hyperactive HPA axis in depressed patients 295 . Compared with controls, women with anorexia nervosa 296 , bulimia nervosa 297 , binge eating disorder 298 , and the night eating syndrome 299 had higher basal cortisol. Exaggerated cortisol responses to stress have been observed in women with anorexia nervosa 300 , bulimia nervosa 301 , and obesity 302 . Eating is thought to be suppressed during stress because of anorectic effects of CRH, and increased during recovery from stress because of appetite-stimulating effects of residual cortisol 33, 303 . Cortisol secretion is a major component of the stress response 301 , and it has been implicated as a potential mediator for increased energy intake in healthy males 260 and females 33 .
298 Gluck ME, Geliebter A, Hung J, Yahav E. Cortisol, hunger, and desire to binge eat following a cold stress test in obese women with binge eating disorder (BED). Psychosom Med 2004 66 876-881. 306 Hagan M, Wauford P, Chandler P, Jarrett L, Rybak R, Blackburn K. A new animal model of binge eating. Key synergistic role of past caloric restriction and stress. Physiol Behav 2002 77 45-54. 307 Hagan MM, Chandler PC, Wauford PK, Rybak RJ, Oswald KD. The role of palatable food and hunger as trigger factors in an animal model of stress induced binge eating. Int J Eat Disord 2003 34 183-197.
We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.