Binge eating disorder treatments show promise but come with risks and costs

Binge eating disorder (BED) affects people who regularly feel unable to control their eating habits. The condition involves eating large amounts of food even when not hungry, often until uncomfortably full. Diagnosis requires at least one binge per week for three months, along with significant distress over the behaviour.

The disorder has several treatment options, but costs and side effects vary widely. Cognitive behavioural therapy (CBT) is the first recommended treatment for BED. It helps patients recognise and change harmful thought and behaviour patterns. Often, CBT is combined with dialectical behavioural therapy (DBT) to teach acceptance of setbacks that can’t be avoided.

Medication also plays a role in managing the disorder. Lisdexamfetamine (Vyvanse) is the only FDA-approved drug for BED, working by suppressing appetite. A 2025 study found that 70.2% of patients treated with both Vyvanse and therapy entered remission.

Other drugs, like GLP-1 medications, are not officially approved for BED but show promise. These medications mimic a natural hormone produced in the small intestine, affecting receptors in the brain. Observational studies suggest they reduce binge eating even without weight loss. However, they come with a high price tag—ranging from a few hundred to over a thousand dollars—since they lack FDA approval for BED.

There are risks too. The appetite-suppressing effects of GLP-1 drugs could appeal to people with anorexia nervosa, potentially worsening disordered eating patterns. Treatment for BED includes therapy, approved medications, and off-label options like GLP-1 drugs. While Vyvanse and CBT offer proven results, unapproved alternatives remain costly. The choice of treatment depends on effectiveness, affordability, and individual health risks.