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Behavioral Therapy ± Naltrexone-Bupropion for Binge-Eating Disorder

Used with behavioral weight loss therapy (BWL), naltrexone-bupropion was associated with significant improvements in binge-eating disorder, researchers report. Participants in the study had comorbid obesity, and those on BWL with or without bupropion-naltrexone had consistently superior results, compared with no BWL.

The double-blind, placebo-controlled trial used a 2×2 balanced factorial design to randomize 136 patients with binge-eating disorder (81.6% women; mean age, 46.5 years; mean BMI, 37.1) to placebo, naltrexone-bupropion, BWL + placebo, or BWL + naltrexone-bupropion. “Intention-to-treat binge-eating remission rates were 17.7% in the placebo group, 31.3% in the naltrexone-bupropion group, 37.1% in the BWL + placebo group, and 57.1% in the BWL + naltrexone-bupropion group,” the authors report. “Logistic regression of binge-eating remission revealed that BWL was significantly superior to no BWL, and that naltrexone-bupropion was significantly superior to placebo, but there was no significant interaction between BWL and medication. Mixed models of complementary measures of binge-eating frequency also indicated that BWL was significantly superior to no BWL. The rates of participants attaining 5% weight loss were 11.8% in the placebo group, 18.8% in the naltrexone-bupropion group, 31.4% in the BWL + placebo group, and 38.2% in the BWL + naltrexone-bupropion group. Logistic regression of 5% weight loss and mixed models of percent weight loss both revealed that BWL was significantly superior to no BWL. Mixed models revealed significantly greater improvements for BWL than no BWL on secondary measures (eating disorder psychopathology, depression, eating behaviors, and cholesterol and HbA1c levels).”

Source: American Journal of Psychiatry