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Bupropion for Overweight Women With Binge-Eating Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial

J Clin Psychiatry 2013;74(4):400-406
10.4088/JCP.12m08071

Background: Binge-eating disorder (BED) is defined by recurrent binge eating (eating unusually large quantities of food during which a subjective loss of control is experienced), marked distress about the binge eating, and the absence of inappropriate weight compensatory behaviors. BED is strongly associated with excess weight, and many available psychological and pharmacologic approaches fail to produce much weight loss. The objective of this study was to perform a randomized placebo-controlled trial to evaluate the short-term efficacy of bupropion for the treatment of BED in overweight and obese women.

Method: Sixty-one overweight and obese (mean body mass index [BMI] = 35.8) women who met DSM-IV-TR research criteria for BED were randomly assigned to receive bupropion (300 mg/d) or placebo for 8 weeks. Participants were enrolled from November 2006 to December 2010. No dietary or lifestyle intervention was given. Primary outcome measures were binge-eating frequency and percent BMI loss. Secondary outcome measures were dimensional measures of eating disorder psychopathology, food craving, and depression levels.

Results: Eighty-nine percent (n = 54) of randomized participants completed the trial, without differential dropout between the bupropion and placebo groups. Mixed-effects analyses revealed significant time effects for all outcomes but no significant differences between bupropion and placebo on any outcome measure except for weight loss. Participants taking bupropion lost significantly more weight (1.8% vs 0.6% BMI loss; F = 10.57, P = .002).

Conclusions: Bupropion was well tolerated and produced significantly greater—albeit quite modest—short-term weight loss in overweight and obese women with BED. Bupropion did not improve binge eating, food craving, or associated eating disorder features or depression relative to placebo. Our findings do not support bupropion as a stand-alone treatment for BED. The preliminary findings regarding short-term weight losses suggest the need for larger and longer-term trials to evaluate the potential utility of bupropion for enhancing outcomes of psychological interventions that have demonstrated effectiveness for BED but fail to produce weight loss.

Trial Registration: ClinicalTrials.gov identifier: NCT00414167

J Clin Psychiatry 2013;74(4):400–406

Submitted: August 2, 2012; accepted November 12, 2012 (doi:10.4088/JCP.12m08071).

Corresponding author: Marney A. White, PhD, MS, Department of Psychiatry, Yale University School of Medicine, 301 Cedar St, Rm 216, PO Box 208098, New Haven, CT 06520 (marney.white@yale.edu).