Q & A: Sibutramine for Binge Eating Disorder

Q: What is the current status of the use of sibutramine (Meridia) for binge eating disorder?

A: Sibutramine has been approved by the FDA for the treatment of obesity, and results in about a 10% weight loss, as long as the medication is continued. Some patients experience a modest rise in blood pressure while taking this medication, so patients on this drug need to be carefully monitored. Sibutramine has not been effective for treating depression, a condition that commonly co-occurs with binge eating disorder. A recent large-scale study by Wilfrey et al tested sibutramine versus placebo, in doses of 15 mg/day for 24 weeks, in a population of patients with binge eating disorder (Am J Psychiatry 2008; 165:51). Those taking sibutramine lost an average of 4.3 kg (8.82 lb), whereas patients on placebo lost 0.8 kg (1.76 lb). Sibutramine had only a moderate impact on binge eating per se: Those taking sibutramine reported 2.7 fewer eating binges per week, compared with 2.0 fewer eating binges a week among those taking placebo. Furthermore, we don’t know what happened either to these patients’ weight or binge eating symptoms after the drug was discontinued. So, at least with respect to its long-term value, the jury on sibutramine for binge eating disorder is still out

— J.Y.