Can Medication and Therapy Together Help Treat Binge Eating Disorder? A Look at the Latest Research

Binge eating disorder (BED) is the most common eating disorder in the world, yet it often goes untreated. Affecting roughly 1%–2% of women and up to 1% of men globally, BED leads to serious health risks and comes with a hefty public health price tag, estimated at nearly $19 billion each year in the U.S. alone.

The good news? There are effective treatments, including both therapy and medication. But until now, we’ve known relatively little about how these treatments work when combined, especially for people who also struggle with obesity.

A recent clinical trial led by Dr. Carlos Grilo and colleagues and published in the American Journal of Psychiatry takes a deeper dive into this very question.

What Did the Study Look At?

The study compared three treatment approaches for adults with BED and obesity (BMI ≥30):

• Cognitive-behavioral therapy (CBT) alone

• Lisdexamfetamine (LDX)—a stimulant medication approved by the FDA for BED, alone

• A combination of CBT and LDX

Researchers wanted to know which approach worked best for reducing binge eating episodes and supporting weight loss.

What Were the Results?

The findings were promising. The combination of CBT and LDX led to the highest remission rate from binge eating—about 70%. In comparison, CBT alone achieved 44.7% remission.

This suggests that combining medication and therapy might offer the most powerful benefits, especially for individuals looking to address both binge eating and weight-related health concerns.

Why Does This Matter?

BED is not only emotionally distressing but is often tied to serious medical issues like diabetes and cardiovascular disease. While therapy like CBT is effective at addressing the emotional and behavioral roots of binge eating, it typically doesn’t lead to significant weight loss. On the other hand, medications like LDX can support weight loss but may not address the underlying psychological issues.

That’s why the combined approach is so compelling—it tackles the problem from both sides.

But There’s a Catch

The study wasn’t placebo-controlled, which means we need to be careful in interpreting the results. Could the high remission rate in the combo group be partly due to patient expectations rather than the treatment itself? That’s a question future studies with better controls will need to answer.

Interestingly, some other large studies have shown that CBT alone can lead to remission rates of 70–80%, which is just as high as the combined treatment in this trial. That inconsistency suggests we need more research before drawing firm conclusions.

Looking Ahead

As new weight-loss medications like GLP-1 agonists (e.g., semaglutide) begin to be explored for BED, the future may hold even more personalized, effective treatments. But to truly understand what works best—and why—future research needs to use careful, placebo-controlled designs.

What This Means for Patients and Providers

If you're struggling with binge eating, know that help is available—and effective. Whether it’s through therapy, medication, or a combination of both, treatment can bring real relief.

For healthcare providers, this study adds to the growing evidence that combining targeted interventions may improve both psychological symptoms and physical health. But as always, treatment should be personalized to meet each individual’s needs.

Sources:

American Journal of Psychiatry, February 2025, By Tom Hildebrandt, Psy.D. & Elizabeth Martin, Ph.D.

Mount Sinai School of Medicine, Department of Psychiatry

New Jersey Institute of Technology, Department of Biomedical Engineering