Topiramate for the Treatment of Binge Eating Disorder Associated With Obesity: A Placebo-Controlled Study

Background: In a single-center, placebo-controlled study, topiramate reduced binge eating and weight in patients with binge eating disorder (BED) and obesity. The current investigation evaluated the safety and efficacy of topiramate in a multicenter, placebo-controlled trial. Methods: Eligible patients between 18 and 65 years with ≥ 3 binge eating days/week and a body mass index (BMI) between 30 and 50 kg/m2 were randomized. Results: A total of 407 patients enrolled; 13 failed to meet inclusion criteria, resulting in 195 topiramate and 199 placebo patients. Topiramate reduced binge eating days/week (−3.5 ± 1.9 vs. −2.5 ± 2.1), binge episodes/week (−5.0 ± 4.3 vs. −3.4 ± 3.8), weight (−4.5 ± 5.1 kg vs. .2 ± 3.2 kg), and BMI (−1.6 ± 1.8 kg/m2 vs. .1 ± 1.2 kg/m2) compared with placebo (p < .001). Topiramate induced binge eating remission in 58% of patients (placebo, 29%; p < .001). Discontinuation rates were 30% in each group; adverse events (AEs) were the most common reason for topiramate discontinuation (16%; placebo, 8%). Paresthesia, upper respiratory tract infection, somnolence, and nausea were the most common AEs with topiramate. Conclusions: This multicenter study in patients with BED associated with obesity demonstrated that topiramate was well tolerated and efficacious in improving the features of BED and in reducing obesity. [Copyright &y& Elsevier]