Medications for Eating Disorders

Abstract

Anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) are the primary eating disorders (EDs). The only psychopharmacological treatment options for eating disorders with approval in some countries include fluoxetine for bulimia nervosa and lisdexamfetamine for binge eating disorder. The current scientific literature has increased our understanding of how medication could be beneficial for patients with eating disorders on a molecular, functional, and behavioural level. The primary outcome criterion in the majority of psychopharmacological randomised controlled trials (RCTs) in anorexia nervosa is an increase in body mass index (BMI), as the risks of a low body weight in anorexia nervosa are clear from a medical point of view. However, froma patient perspective, they might feel such a trial and such psychopharmacological treatment were just a way to speed up weight gain for the clinicians' benefit. In the context of a quality improvement (QI) project, we surveyed patients with anorexia nervosa and carers. Over half of the patients said they would find medication useful if it helped reduce anxiety (53%) or sleep problems (53%). Therefore, the inclusion of such Patient Reported Outcome Measures (PROMs) into the outcome criteria for RCTs should be considered.