From the Guidelines
Binge eating disorder during cancer treatment requires a multidisciplinary approach involving mental health professionals and oncologists, with a focus on nutritional counseling and monitoring to prevent malnutrition and metabolic derangements. Patients should seek specialized psychological support through cognitive behavioral therapy (CBT), which is the first-line treatment, typically delivered in 12-20 weekly sessions 1. Medication options include selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (20-60mg daily) or sertraline (50-200mg daily), or the anticonvulsant topiramate (starting at 25mg daily, gradually increasing to 200-400mg daily) 1. Lisdexamfetamine (Vyvanse) at 30-70mg daily is FDA-approved specifically for binge eating disorder. These medications should be carefully selected considering potential interactions with cancer treatments.
Some key points to consider in the management of binge eating disorder during cancer treatment include:
- Nutritional counseling is essential to maintain proper nutrition during cancer treatment, as both the eating disorder and cancer therapies can impact nutritional status 1
- Regular monitoring of weight, nutritional markers, and mental health symptoms is crucial, as cancer treatments can exacerbate psychological distress and disordered eating behaviors
- The relationship between binge eating and cancer is bidirectional - emotional distress from cancer diagnosis can trigger binge episodes, while binge eating can complicate treatment outcomes through nutritional imbalances and medication absorption issues
- A healthy weight (BMI 20–24.9) in cancer patients must be encouraged, and nutritional interventions should aim to limit weight loss to between 5% and 10% of initial body weight 1
- Patients should consume 5–9 servings/d of fruits and vegetables to ensure sufficient intake of antioxidants and fiber through diet 1
Overall, the management of binge eating disorder during cancer treatment requires a comprehensive approach that addresses the physical and emotional needs of the patient, with a focus on preventing malnutrition and metabolic derangements, and promoting overall health and well-being.
From the Research
Binge Eating Disorder and Cancer Treatment
- Binge eating disorder (BED) is a prevalent eating disorder associated with serious functional impairments and heightened rates of psychiatric and medical comorbidities, including obesity and cancer 2.
- There is evidence to suggest that binge eating may be a risk factor for cancer, and that it may develop after cancer diagnosis, affecting health and relapse during survivorship 2.
- Cognitive-behavioral therapy (CBT) is a well-established approach for treating BED, and has been shown to be effective in reducing binge-eating episodes and improving psychological well-being 3, 4, 5.
- Pharmacotherapy, such as lisdexamfetamine, has also been approved for the treatment of BED, and has been shown to be effective in reducing binge-eating episodes and promoting weight loss 4, 5.
- A multidisciplinary approach to treatment, combining psychotherapy and pharmacotherapy, may be the most effective way to manage BED and reduce the risk of cancer and other comorbidities 3, 4.
- Further research is needed to fully understand the relationship between binge eating and cancer, and to develop effective treatments for BED in the context of cancer prevention and survivorship 2.