Fluoxetine and Binge Eating Disorder: Does It Work?

Fluoxetine is commonly used in binge eating disorder, but what does the science support it? Learn about the effective alternatives. 

Fluoxetine For Binge Eating Disorder

Eating disorders are serious health issues, that cause various mental and physical problems. As such, finding effective treatment options is important.

Prozac, sold under the generic name Fluoxetine, is one of the medications that have been studied the most in eating disorders. It is currently the only FDA-approved drug for treating bulimia.

Binge eating disorder (BED) is another common eating disorder. Unlike bulimia, in binge eating disorder people frequently overeat but do not purge afterward. This often leads to being overweight.

It is the most prevalent eating disorder in the US and currently, only one medication is approved by the FDA for treating BED. So what does the research say about Fluoxetine?

Binge Eating Disorder

Binge Eating Disorder is a prevalent eating disorder characterized by recurrent episodes of consuming large amounts of food in a short period, without subsequent purging behaviors.

Unlike other eating disorders like bulimia, individuals with BED typically do not engage in compensatory actions such as excessive exercise or fasting. Binge eating disorder has the same neurobiology as substance use disorder.

Ramifications

BED affects people of all ages, genders, and backgrounds, and it often coexists with other mental health disorders such as depression, anxiety, and substance abuse. 

Binge eating is associated with significant emotional distress and impairment in daily functioning. It frequently leads to obesity, which is why it is essential to diagnose and intervene early.

Treatment Approach

Treatment for BEDs may involve a combination of psychotherapy, medication, and nutritional counseling tailored to address the underlying psychological, emotional, and behavioral aspects of the disorder. 

Currently, lisdexamfetamine is the only medication approved by the FDA for the treatment of Binge Eating Disorder.

Fluoxetine (Prozac)

Fluoxetine, sold under the brand name Prozac, is a commonly prescribed medication used to treat a variety of mental health disorders. It belongs to a class of drugs called selective serotonin reuptake inhibitors and is foremost considered to be an antidepressant.

The medication is primarily used to alleviate symptoms of depression, anxiety disorders, obsessive-compulsive disorder, and certain eating disorders like bulimia nervosa. It is often considered a first-line treatment due to its effectiveness and relatively tolerable side effect profile compared to older antidepressants. 

Using Fluoxetine For Binge Eating Disorder

Early studies of Fluoxetine showed potential for the drug, however, later research has not been able to conclusively prove any significant impact on binge eating and weight outcomes in randomized controlled trials.

The FDA has not approved the use of Fluoxetine for binge eating disorder. As such, any use of Fluoxetine in binge eating disorder is considered off-label.

Why Fluoxetine is Used

As previously stated, binge eating disorder often occurs with other debilitating mental health conditions, such as depression and various anxiety disorders. Antidepressants, such as Fluoxetine, can improve the symptoms of these coexisting conditions, which may be an important part of the treatment. 

In the most recent guidelines (2023) for eating disorders, the American Association of Psychiatry (APA) recommends the use of antidepressants or Lisdexamphetamine for binge eating disorder in patients who have not responded to psychotherapy.

How is Binge Eating Disorder Treated?

Treatment for binge eating disorder typically involves lifestyle changes, therapy, and sometimes medications.

1. Psychotherapy

Cognitive-behavioral therapy (CBT) is commonly used to address distorted thoughts and behaviors related to food and body image. CBT also teaches different approaches to change the way you respond to difficult situations that may otherwise trigger binge eating episodes.

2. Lifestyle Changes

Like most mental disorders, adopting healthy habits such as balanced nutrition, regular exercise, and stress management techniques is important for managing BED symptoms, as improved general health can lead to better emotional and physical well-being. 

3. Medications

Medical treatment is most often used when psychotherapy has proven insufficient. Lisdexampetamine is the FDA-approved treatment for BED. It has been shown to decrease the amount of binge eating days per week as, well as reduce the risk of relapse.

Antidepressants, such as Fluoxetine, may also be prescribed as a part of the medical treatment for binge eating disorder. Bupropion has not shown any effect on binge eating itself, but combining it with exercise may be an effective strategy for managing overweight.

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Cover image by shurkin_son on Freepik

Author: J. Martin, M.D.
Last update: March 09, 2024

Disclaimer: The information provided is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider, such as a physician, before starting any new treatment or making changes to your existing treatment plan. Individual responses to treatment may vary, and a healthcare professional can provide personalized guidance based on your specific needs and circumstances. If you are experiencing severe or persistent symptoms of disease or mental illness, seek immediate medical attention.