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/m(2) 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/m(2) vs..1 +/- 1.2 kg/m(2)) 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.