Living With Food: The Science Supporting Eating Disorder Treatment

Understandably, if you have an eating disorder, there may be a fear that medications will make you gain weight. This fear will be intensified if you happen to consult the internet, where you are likely to find multiple websites and individuals who state that medications have contributed to or caused them to gain weight. The reality of treatment with medications is quite different. For the vast majority of patients with eating disorders, medications can be used safely without weight gain.

It is important to know there are multiple classes of medications that may be used for issues of depression, anxiety, and purging. In general, the selective serotonin reuptake inhibitors, the norepinephrine reuptake inhibitors, and the benzodiazepines, are not associated with significant weight gain in any population. Second generation anti-psychotics have been associated with weight gain in some populations but not significantly for patients with anorexia. There may, however, be a concern for people with a history of bingeing. The primary reason why most medications won’t make you gain is that in order to gain one must eat past fullness. For someone with anorexia, it is highly unlikely that any medication could make one eat past fullness. The illness itself provides some relief from this fear. For patients with bingeing disorders, who do eat past fullness, weight gain may be a real concern that will need to be addressed with your psychiatrist.

When a psychiatrist who is experienced in treating eating disorders prescribes medications, the concern about weight gain and medications comes first. There is no scientific support for using medication for either gaining or losing weight. And no one with an eating disorder should be put on a medication for this purpose. Balanced eating habits, working to reduce behaviors, and behavioral change are the keys to weight change with eating disorders. The combination of the illness itself, the safety of most medications, the awareness of possible side effects of some medications, and the understanding of how recovery occurs, make medications safe for people with eating disorders, when prescribed correctly and under the right circumstances.

Should you have any questions or comments regarding this post, please email blog@eatingdisorderscleveland.org.

Contributions by Sarah Emerman