Full Answer Section

1. Bulimia Nervosa (BN):

• Recommended Treatments:
  • Psychotherapy:Cognitive behavioral therapy (CBT) is the first-line treatment for BN. It focuses on identifying and changing negative thoughts and behaviors related to food and weight.
  • Fluoxetine (Prozac):The only FDA-approved medication for BN. It is a selective serotonin reuptake inhibitor (SSRI) antidepressant.
• Rationale for Fluoxetine: BN often co-occurs with depression and anxiety. Fluoxetine helps regulate serotonin levels in the brain, potentially improving mood, reducing urges to binge and purge, and promoting healthy eating behaviors.
• MOA of Fluoxetine: Fluoxetine blocks the reuptake of serotonin by neurons, leading to increased levels of this neurotransmitter in the brain. Serotonin is involved in mood regulation, impulse control, and appetite.
• Evidence for Fluoxetine: Studies show that Fluoxetine, combined with psychotherapy, is more effective than either treatment alone in reducing bingeing and purging episodes in individuals with BN.

2. Anorexia Nervosa (AN):

• Recommended Treatments:
  • Nutritional Rehabilitation:Restoring a healthy weight through a structured meal plan is crucial for physical recovery.
  • Family-Based Therapy (FBT):Especially effective for adolescents with AN, FBT involves family members in supporting healthy eating habits and recovery efforts.
  • Individual Psychotherapy:CBT or psychodynamic therapy can help address underlying thoughts and emotions that contribute to AN.
  • No FDA-approved medications:While some medications may be used to manage co-occurring conditions like depression or anxiety, there is currently no medication specifically approved for AN itself.
• Rationale for a Multifaceted Approach: AN is a complex disorder requiring interventions that address both the physical and psychological aspects.

3. Binge Eating Disorder (BED):

• Recommended Treatments:
  • Cognitive Behavioral Therapy (CBT):Similar to BN, CBT helps individuals with BED identify and change unhelpful thoughts and behaviors around eating.
  • Lisdexamfetamine (Vyvanse) and Bupropion (Wellbutrin):These are the only FDA-approved medications for BED.
• Rationale for Medications: Lisdexamfetamine is a stimulant that may help regulate appetite and reduce impulsivity associated with binge eating. Bupropion, a norepinephrine and dopamine reuptake inhibitor, may improve mood and decrease cravings.
• MOA of Lisdexamfetamine: Lisdexamfetamine increases dopamine and norepinephrine levels in the brain, potentially promoting feelings of satiety and reducing impulsivity.
• MOA of Bupropion: Bupropion increases levels of norepinephrine and dopamine, which may improve mood and decrease cravings for high-calorie foods.
• Evidence for Medications: Studies indicate that Lisdexamfetamine and Bupropion, combined with CBT, can be effective in reducing binge eating episodes in individuals with BED.

Conclusion:

Treatment for eating disorders should be individualized and tailored to the specific needs of each patient. Psychotherapy remains a cornerstone of treatment for all three disorders discussed. For BN and BED, FDA-approved medications can be a valuable adjunct to psychotherapy, offering additional support in managing symptoms and promoting recovery. While there is no cure for AN yet, a combination of therapies can help individuals restore a healthy weight and relationship with food.