Binge Eating – a Disease?

The recent article in NYTimes (http://www.nytimes.com/2015/02/25/business/shire-maker-of-binge-eating-drug-vyvanse-first-marketed-the-disease.html?emc=eta1) once again reveals the extent to which the pharmaceutical industry contributes to the classification of a common symptom into a disease category for which it can define a medication as the specific treatment and then run a multimillion dollar campaign to market this to the public. Vyvanse, Shire’s top selling drug (worth billions of dollars of profit to Shire) is now being marketed in a heavy media campaign to the public as the treatment of choice for binge eating. Vyvanse is an amphetamine drug used to treat A.D.H.D. Amphetamines have long been used illegally – and often with dangerous consequences – for appetite suppression and weight loss, and while they might be an important arm of supervised treatment for those seriously obese, to push their use for “binge eating” is dangerous. Over-eating, binge-eating, nervous eating as well as other forms of maladaptive eating behavior are common signs of stress and do need to be taken seriously, and at times do require therapeutic intervention. But a first arm of such treatment should be therapy to both assess and treat underlying issues as well as to assist in learning new coping strategies. Both analytically oriented psychotherapy and cognitive behavioral approaches have been shown to be effective.