Naltrexone/bupropion for binge-eating disorder: A human laboratory investigation of mechanisms.

BACKGROUND

Binge-eating disorder (BED) is a prevalent, refractory, and serious health issue associated with broad morbidities and psychosocial impairments. There is a pressing need to identify effective therapeutics for BED. Naltrexone/bupropion (NB) targets brain reward systems, suggesting that it may be an effective treatment for both obesity and BED. This is the first human laboratory study to examine potential mechanisms underlying NB effects on eating behaviors in those with BED.

METHODS

Fifty participants with BED (72% with obesity) completed a human laboratory study to examine effects of NB on their (1) ability to resist eating preferred high-caloric snack food, (2) calories consumed, and (3) food craving at baseline and following + 6 weeks and + 12 weeks of NB treatment while enrolled in a 12-week randomized clinical trial (RCT). Hunger, mood, and trough plasma levels of NB were evaluated as secondary outcomes.

RESULTS

NB did not influence decisions to eat but did significantly reduce the number of calories consumed, which were negatively associated with 6beta-naltrexol and bupropion levels. NB also reduced craving for preferred high-caloric sweet snacks and reduced hunger ratings at + 6 but not + 12 weeks.

CONCLUSIONS

This human laboratory investigation support and extend the findings of the RCT. NB may reduce weight in patients with BED by reducing calories consumed during eating episodes of highly preferred high-caloric food. Further, results identified reduced craving and hunger ratings as potential markers of early treatment response.