Bingeing, purging, starving, persistent body dissatisfaction, and chronic dieting can often be symptoms of depression. People with eating disorders use food to boost their mood or sedate their anxiety. After all, food is the most available, cheapest, legal, and socially accepted mood altering drug on the market!
In some cases, therapy plus medication can be extremely effective in helping relieve both eating disorder symptoms and underlying depression. Many people are understandably reluctant to take medication. “If I take medication, aren’t I just turning to a pill as a crutch the way I’ve always turned to food? Aren’t I just substituting one dependency for another?” This is the question patients most often ask when a doctor or therapist suggests that medication might be helpful for their eating disorder. In truth, medication does not perform miracles but, in certain cases, it can be a powerful tool to help a person make peace with emotional eating. Many patients who tried medication have said: “I used to feel so down. All I wanted was to binge and sleep. It feels like a heavy curtain has lifted and I am more hopeful. I feel more like the “old” me I used to know!”
Types of Medications for Eating Disorders
Many different kinds of biochemical problems underlie the various depressions and anxiety disorders, so there are many types of medications used to treat them. Sometimes a trial period is needed until the most effective medication for each person is found. The most effective medications currently used for depression/anxiety/bulimia/binge eating disorder/premenstrual mood disorders are:
SSRIs include Prozac, Lexapro, Zoloft, and Celexa. These antidepressant medications can help people get increased control over their eating and lessen the urge to binge and purge.
SNRIs include Effexor and Cymbalta.
Wellbutrin is an anti-depressant medicine which is also helpful for Seasonal Affective Disorder. Unlike other anti-depressants which may cause weight gain, Wellbutrin can cause weight loss. It also has a low risk for side effects.
Topamax – has proven helpful in the treatment of bulimia, migraines, and can reduce binge eating episodes. This medication can also cause weight loss.
Vyvanse – In 2015, Vyvanse became the first medication approved by the Federal Drug Administration for the treatment of moderate to severe binge eating disorder. The drug has proven to reduce binge eating episodes. However, Vyvanse is an amphetamine and is highly addictive. Side effects include insomnia, agitation, mania, and it has been associated with elevated blood pressure and a higher risk of heart attack and stroke. Patients should be hesitant and wary with this medication, and it should be carefully monitored by a doctor.
How do you decide if you can be helped by medication? If your situation is not urgent, my recommendation is to begin a trial run of therapy. Therapy for emotional eating blends behavioral work, which focuses on improving your habits to help you get back the control of your eating, plus psychotherapy to address the emotional stress underlying your eating problems. If there is no change in your eating behaviors after this initial therapy, then I suggest a consultation for medication. However, if the situation is urgent at the outset—your depression, anxiety, or panic are out of control, or if you are struggling with suicidal impulses, alcoholism or drug abuse—then a medication evaluation is necessary. An immediate evaluation would also be required if you have anorexia with life-threatening weight loss or medical complications due to bulimia. Occasionally hospitalization is needed to help someone stabilize this type of crisis.
When You Take Medications
Medications can be extremely helpful in treating eating disorders, depression, and anxiety. It is important to be regularly monitored by a psychiatrist or your medical doctor.
To get the best result from medication:
- Be patient since it can take several weeks for the medication to become effective.
- If you have side effects, discuss them with your doctor. Sometimes they will get better with time or a change in dosage or prescription will help.
- Make the commitment to be consistent in the time and dosage of your medicine.
- Avoid alcohol and recreational drugs which can worsen depression or heighten the effect of your prescribed medication.
- Discuss with your doctor any herbs, supplements, vitamins, birth control pills, over the counter or prescription medications you are taking since they may interfere with antidepressants.
- If you want to stop, speak with your doctor about how to taper off so you do not suffer any withdrawal symptoms.
Ongoing medical research continues to shed light on the complexity of eating disorders and their biological underpinnings. Leaving no stone unturned to help yourself with your eating problems, which might include a trial run of medication, can be a truly compassionate act on your own behalf.
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