Vyvanse Approved To Treat Binge Eating Disorder
Va va voom, here comes Vyvanse, a new drug just approved to treat Binge Eating Disorder (BED).
Vyvanse is a central nervous system stimulant that was first released in 2007 to treat attention-deficit hyperactivity disorder (ADHD). It has now been shown to “help curb binge eating episodes” and decrease the number of binge eating days per week and related obsessive-compulsive binge eating behaviors.
The release of this drug has made more headlines than when the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), first named BED a stand-alone eating disorder. The DSM is the bible for mental health diagnoses.
To this end, I am glad that the media, medical doctors and consumers are talking about BED. It’s a largely misunderstood disorder and those who suffer from it lead miserable lives. Anything that captures interest in this eating disorder can’t be a bad thing.
Binge Eating Disorder Drug First Used For ADHD
Much of the discussion is about the return of “speed” for weight loss and all the side effects and potential for abuse, leading to dependence. And yet, the manufacturer Shire states that it was not studied for weight loss nor recommended for weight loss.
What I found more interesting was that the medication was first released to treat ADHD. Those who have worked in the field for some time know that there is a correlate relationship between ADHD and BED. There are a few theories as to why.
Those with BED tend to have some similar characteristics to ADHD:
- Impulsivity and “delay aversion” which makes the availability of fast food and easy access foods a problem.
- Those with BED tend to be inattentive toward early signs of hunger, they are too distracted until they are too hungry to wait and tend to overeat when they do eat.
- Once they start eating, they also have a difficult time stopping when they are satisfied because they tend to “check out” while eating, again in a distractible and sometime dissociative state.
- Neurobiological mechanisms similar to those with ADHD that show a reward deficiency syndrome and insufficient dopamine.
- Food can create pleasure, flooding the brain with dopamine, especially when eaten in large quantities within a short period of time.
- High incidence of depression, agitation and inattention.
- Food may be used to self-regulate mood or correct the emotions evoked by the distress caused by the binge eating itself. Binge eating is cyclical, therefore lends itself to the chicken or egg syndrome.
Attention Deficit Trait (a Cousin to ADHD) and Binge Eating Disorder
Another interesting and related correlation I stumbled upon was when reading Dr. Edward Hallowell’s work, called Attention Deficit Trait or ADT. Yes, this is a cousin to ADHD.
Hallowell claims ADT is caused by “brain overload” or over-stimulated circuits. The core symptoms are distractibility, inner frenzy and impatience. He says that it is not uncommon for those who experience this to “self-medicate.”
Hallowell sees this as our brains’ natural response to exploding demands on our time and attention.
- When our brain is tired, we lack the “executive function” to reason and make good choices.
- The brain then defaults to the deep centers of the brain that regulate fear and survival.
- We tend to revert into black-and-white thinking. We forget the big picture, goals and values related to choice.
So, if we put this all together, I just want to say, Of Course! (my personal tag line)
I hope those of you who experience binge eating, especially at night, are feeling validated and a big light bulb went off above your head.
Cognitive Behavioral Interventions For Treating BED
As a Doctor of Behavioral Health, my focus of study is on human behavior and motivational change theory. Dr. Hallowell’s prescription is a holistic approach to healing the brain which includes creating safe, calm spaces and people in our life.
Research also supports the ability of cognitive behavioral interventions for the treatment of BED to significantly reduce binge eating. Those with mindfulness-based components help focus inattentive and dissociative tendencies in order to “pause” and make better choices.
Our program at Green Mountain at Fox Run helps women who binge and emotionally eat by combining the power of choice using mindful awareness with a re-structuring process which can interrupt the famine-and feast cycle by eating predictable and nourishing meals.
Drug May Help Treat BED But Doesn’t Replace Other Types Of Care
As an eating disorder therapist for over two decades, I have had many clients who have entered treatment for their eating disorder while also being medicated for ADHD. Unfortunately, the tendency had been for them to use food to self-medicate the anxiety provoked by the stimulant.
We often see night eating brought on by the inability to calm oneself and get to sleep. Even more tragic, some will turn to benzodiazepines (sedatives) to counter the side effects.
For this reason, I encourage a thoughtful response to the availability of this new medication. As with all medications, there is percentage of those who respond well and are helped, alleviating their suffering.
For others, they may rush to their doctors to get a “magic pill” and end up feeling shameful and discouraged, much like the long-term results of the newest diet.
Ultimately, it can be thought of as a potential “tool in the BED treatment toolbox” that may help some, but it’s important to keep in mind that it doesn’t replace other important aspects of care.
Learn More about Our Binge Eating Program