In the quest to conquer bulimia nervosa, are bulimia sibutramine treatments a viable solution? 

Because many drugs are already successfully being used to help treat bulimia nervosa, including anti-depressants such as Paxil, Zoloft and Prozac, many people have wondered about the effectiveness of sibutramine treatments for those with bulimia nervosa. 

First, some facts about bulimia:

• Many factors are thought to contribute to bulimia, including biological, psychological, family, social, and the media.

• In Western countries, about 1% to 3% of women suffer from bulimia nervosa at some point in their lives (the number for men is only about one tenth of that of women).

• Treating bulimia can be difficult, because the disorder is as much mental as it is physical, and involves improvement of the person’s self esteem and self-image.

What is the idea behind bulimia sibutramine treatments?

Sibutramine (Meridia) is a stimulant and anti-depressant made by Abbott Laboratories.  It is a neurotransmitter reuptake inhibitor that increases satiety.  In more common terms, this means that sibutramine makes you feel full by altering the balance of chemicals in the brain; because of this effect, sibutramine has been shown to help people lose weight.  Since sibutramine is traditionally prescribed to help people eat less, many people wonder if sibutramine bulimia treatments hold any promise in reducing the overeating episodes common in bulimia nervosa.

Could bulimia sibutramine treatments complement other bulimia management components?

The best bulimia treatment strategy appears to be an integrative one that combines two or more strategies.  Most commonly, this means combining drug therapy with cognitive behavior therapy to combat the eating disorder on many levels, all at once.  While some drugs have been proven effective when used in conjunction with counseling or behavior therapy, it is currently not advised to use sibutramine in patients with bulimia nervosa. To understand why bulimia sibutramine treatments are currently not recommended, we must understand how binge-eating and true bulimia nervosa are different.

Bulimia sibutramine treatment vs. binge-eating disorder sibutramine treatment

Research has shown that sibutramine is effective in treating binge-eating disorder.  Binge-eating disorder is characterized by uncontrolled consumption of huge amounts of food, without any consequent action to rid the body of the food or calories.  Compare this to bulimia nervosa: bulimia nervosa is also characterized by eating large amounts of food; however, with bulimia nervosa, the person also seeks to get rid of the extra calories that were consumed. One or several methods may be used to get rid of the food or calories, including vomiting, using diuretics or laxatives, or through excessive exercise. 

Since sibutramine has been shown to be effective with binge-eating disorder, could sibutramine bulimia treatments also hold promise?  For now, the answer is no.  The makers of sibutramine actually list bulimia nervosa as a contraindication to taking the drug; this means that when bulimia nervosa is present, the patient should not be prescribed sibutramine. 

Why are bulimia sibutramine treatments currently not allowed?

A person with bulimia nervosa typically purges the body of the extra calories consumed during bingeing episodes.  Additionally many bulimia sufferers eat very little or nothing at all in the time between bingeing/purging episodes.  These behaviors may cause the person to become underweight. Because sibutramine is an appetite suppressant, it is thought that sibutramine would only cause further weight loss.  The bottom line is that the appetite-suppressant effect of sibutramine would further compound the problems associated with bulimia nervosa, and so it is not recommended for treatment in bulimia nervosa.

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