Weight Loss Medications for Adult Patients With Obesity and Binge Eating-A Systematic Review and Meta-analysis.

OBJECTIVE: To evaluate the effect of approved weight loss medications on binge eating (BE) episodes in individuals with obesity. METHODS: We systematically searched databases for randomized clinical trials and prospective interventional studies assessing BE episodes in patients with obesity treated with weight loss medications. Eligibility, data extraction, and risk of bias assessment were performed independently and in duplicate. Extracted data included baseline characteristics, therapy, BE scales, and study duration. RESULTS: Eight randomized controlled trials (870 participants) were included. Most participants were women (>63%), mean age 45 years, body mass index 35 to 40 kg/m. Liraglutide (n = 231) showed a greater weight loss (-4.95 kg [-7.12, -2.77]) and a reduction in BE episodes in most individual studies but did not reach statistical significance in the meta-analysis. Naltrexone/bupropion (n = 378) reduced BE episodes in individual studies, but inconsistent reporting limited pooled analysis. Orlistat (n = 448) showed no significant effect on BE episodes or weight loss. CONCLUSION: Liraglutide was an effective intervention for weight loss in patients with obesity who experience BE. The use of liraglutide and naltrexone/bupropion as seen in individual studies may be an effective intervention to improve BE severity in this population; however, meta-analysis was not feasible due to the heterogeneous assessment tools used to measure response in BE episodes. Larger randomized and prospective studies with a longer follow-up are needed to evaluate the consistency of the data presented in this review.