Binge-eating disorder never had a pharmaceutical treatment before January of 2015, when the Food and Drug Administration expanded the use of Vyvanse to treat BED.
The disorder is characterized by recurrent episodes of overeating where the person feels a lack of control. These episodes occur at least once a week for three months, according to the American Psychiatric Association’s fifth edition and most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-V). This 2013 publication states, “An ‘episode of binge eating’ is defined as eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances.”
A common misconception is that BED is simply eating a lot of food, but it’s actually much less common than overeating and much more severe. It can lead to several health issues including weight gain, obesity, and psychological stress.
So when the FDA announced the first pharmaceutical treatment for BED, several people, who posted in forums on Reddit and Drugs.com, said they felt excited and nervous.
The FDA’s press release quotes Mitchell Mathis, M.D., director of the Division of Psychiatry Products in the FDA’s Center for Drug Evaluation and Research, as saying, “The approval of Vyvanse provides physicians and patients with an effective option to help curb episodes of binge eating.” The press release also explains two clinical trials that included 724 adults with moderate-to-severe BED. The studies were sponsored by Shire, Vyvanse’s manufacturer.
“In the studies, participants taking Vyvanse experienced a decrease in the number of binge eating days per week and had fewer obsessive-compulsive binge eating behaviors compared to those on the inactive pill (placebo),” the press release states.
The results seem promising. However, Clinical Director Melissa Gerson of Columbus Park Collaborate specializes in treating eating disorders and demonstrated more hesitation toward Vyvanse’s new use in an article published Feb. 6, 2015, in International Business Times. “I just don’t want there to be the message that there’s a simple pill you can take. These are longstanding behavior patterns that need to be explored and shifted,” Gerson said in the IBT article. “I can’t imagine how you would see any long-term improvements in the symptoms,” Gerson continued in regard to Vyvanse’s use as treatment of BED with no additional means like therapy.
Vyvanse is more commonly known for its use as treatment for ADHD, attention deficit hyperactivity disorder. The DSM-V has an extensive diagnostic criteria for ADHD, but the criteria include having a persistent pattern of inattention and/or hyperactivity-impulsivity that is seen before the age of 12, occurs regularly, and interferes with a person’s function in more than one setting.
Vyvanse functions as a central nervous system stimulant and is a Schedule II controlled substance, which means the drug has high potential for abuse that could possibly lead to dependence. The National Center for Biotechnology Information explains the use of Vyvanse “resulting in measurable behavioral changes such as euphoria, mental alertness and excitement and appetite suppression.”
In a Reddit forum regarding Vyvanse and binge-eating disorder, one user, whose username has not been included to protect his/her privacy, posted about a year ago saying, “Adderall suppresses appetite to an extreme. I used to have an eating disorder too, and abused adderall to not feel hungry. Very bad, but it is an extremely powerful suppressant.” Adderall uses a different active ingredient than Vyvanse, but both drugs are commonly prescribed to treat ADHD and have comparable effects. In a different Reddit forum regarding Vyvanse and its use for BED treatment, someone, who will also not be named, posted, “I use it on the side, but it works against my regular meds. It’s not smart, but it helps a lot because you don’t eat and you forget to eat. Just force yourself to drink water.”
These posts raise the question, are people being fully-educated of Vyvanse’s risks before being prescribed its usage? Multiple people also commented either asking about the weight people have lost since using Vyvanse to treat BED or telling stories of their own weight loss. But being overweight is not part of the diagnostic criteria for BED in the DSM-V. While losing weight may have medical benefits depending on a person’s health condition, it’s not the purpose of Vyvanse.
The FDA’s press release that announced Vyvanse’s use to treat BED says, “Vyvanse is not approved for, or recommended for, weight loss. Its efficacy for weight loss has not been studied.”
People suffering from BED deserve a long-term solution and not something that will just mask the disorder’s symptoms.