EpistemisHyperorexia / Binge eating
Specialty: Psychiatry.
Why it occurs
- Binge Eating Disorder
- Bulimia nervosa
- Atypical depressive episode (with vegetative reversal: hypersomnia and hyperorexia)
- Side effects of psychotropic drugs (olanzapine, clozapine, mirtazapine, valproic acid)
- Prader-Willi syndrome or other genetic alterations
- Hypothalamic dysfunction (tumors, trauma)
Initial workup
Blood analysis with electrolytes (potassium, sodium, chlorine, magnesium, calcium), serum amylase (elevated in repeated vomiting), venous blood gases (metabolic alkalosis if purging occurs); electrocardiogram (ECG) to measure QTc interval; EDI-3 scale (Eating Disorder Inventory).
red flags
Presence of dangerous compensatory behaviors (recurrent self-induced vomiting, extreme abuse of laxatives/diuretics) that cause severe hypokalemia (<3.0 mEq/L), cardiac arrhythmias or suspected esophageal rupture (Boerhaave syndrome).
Standard management
- Lisdexamfetamine — approved specifically for the treatment of moderate to severe binge eating disorder
- Topiramate — GABA/glutamate stabilizer and modulator that reduces the urge to eat and promotes weight loss
- Fluoxetine — High-dose SSRIs, e.g. e.g., 60 mg/day, indicated for bulimia nervosa
- Vyvanse — under strict medical supervision due to potential for abuse
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Psychiatry
- Listed causes
- 6
- Treatment options
- 4