Can Medication Treat Eating Disorders Among Children and Adolescents?

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Young people receiving treatment for eating disorders are often taking some kind of medication. However, guidelines about the use of medication (or any kind of treatment) for eating disorders among children and adolescents are lacking. This can leave young people, parents, and clinicians unsure about how effective medication is for eating disorders.

While research on the effectiveness of medication for young people with eating disorders is still in its early stages, big progress has been made. Today, several studies have investigated different types of medication for young people with anorexia, bulimia, binge eating, or unspecified eating disorders.

Preliminary evidence suggests that some medications can help support young people’s recovery process, in combination with other treatment approaches like individual therapy, family therapy, or nutritional support that address the underlying causes of eating disorders.

This blog offers some more information on the different medications used to treat eating disorders in children and teenagers and the research that lies behind them.

Treating Anorexia Nervosa: Olanzapine and Others

Anorexia nervosa is a type of eating disorder that usually begins between the ages of 15 and 19. Children and adolescents with anorexia have a markedly low body weight and restrict their energy intake through their eating habits, excessive exercise, using laxatives, or other ways.

Research suggests that some antipsychotic medications such as Olanzapine can help teenagers to gain weight and improve eating disorder symptoms. Olanzapine may also support general functioning and decrease hyperactivity. 

Among smaller-scale case studies, doctors have described different ways that Olanzapine may affect some of the thoughts and attitudes that underpin disordered eating behaviours. These include:

  • reducing body image distortion and concerns
  • decreasing agitation
  • decreasing paranoid ideas related to food or eating
  • improvements in sleep
  • less anxiety surrounding food and weight

However, the results of scientific studies have not always been consistent. Some studies have found that Olanzapine has little to no effect on young people’s weight but may cause significant side effects. Currently, there are no medications approved for the treatment of anorexia among young people or adults, although they may be prescribed off-label.

Experts agree that anorexia should not be treated with medication alone. Eating disorders are rooted in emotions, memories, thinking patterns, and behaviours that should be addressed through therapeutic treatment approaches to achieve long-term, meaningful change. This might involve family-based therapy, cognitive-behavioural therapy, or other approaches.

Bulimia Nervosa and Anti-Depressants

Bulimia nervosa is an eating disorder characterised by cycles of out-of-control eating (binging) followed by attempts to rid the body of food/calories (purging). 

Young people with bulimia may use binging and purging as a way to distract themselves from painful emotions, thoughts, and memories. They also often experience feelings of shame, guilt, and self-loathing about these behaviours. These feelings can intensify and maintain disordered eating behaviours.

Research suggests that anti-depressants may help to reduce binging and purging cycles while improving symptoms of anxiety and depression that may underlie bulimic behaviours. Fluoxetine, a type of SSRI (selective serotonin reuptake inhibitor), is recommended by the American Psychiatric Association guidelines for the treatment of bulimia nervosa among adults. 

While research among children and adolescents is lacking, one open trial found that SSRIs alongside psychotherapy led to reduced binge eating and purging among adolescents aged 12-18.

SSRIs may help to treat bulimia nervosa in several ways. They may affect the body’s hunger and fullness signals, making binge eating episodes (and therefore purging) less likely. SSRIs may also treat depressive symptoms or co-morbid depressive disorders that can underpin bulimic behaviours.

Evidence suggests that combination treatments of psychotherapy and medication may be more effective than psychotherapy alone. However, taking medication may also make it less likely that individuals complete their treatment program. It’s important for every young person to work with a treatment provider to determine the treatment program that’s most effective for them.

Treating Binge Eating Disorder with CNS Stimulants

Individuals with binge eating disorder (BED) experience episodes of out-of-control eating, accompanied by psychological distress. While research on medication for BED among adolescents is only just beginning, many studies have explored the effects of SSRIs, CNS stimulants, and other medications on binge eating disorder among adults. 

Lisdexamfetamine, a type of stimulant drug, is the only medication approved by the Federal Drug Administration in the US for the treatment of BED. Lisdexamfetamine is a drug used to treat attention-deficit hyperactivity disorder (ADHD) that increases activity in the brain and central nervous system.

Binge-eating behaviours have a lot to do with impulsivity, inhibitions, and reward systems. Food can become a temporary ‘reward’ that produces strong urges, or even compulsions, to engage in binge eating. At the same time, stronger impulses and weaker inhibitions make out-of-control experiences more likely.

CNS stimulants like Lisdexamfetamine affect the balances of brain chemicals that tap into these systems, regulating impulses, inhibitions, and reward, making binge eating episodes less likely. Lisdexamfetamine may also affect appetite/fullness signals in the brain, impacting eating behaviours.

While Lisdexamfetamine is not yet approved for children and adolescents, a retrospective study found that the medication improved binge eating symptoms and was well-tolerated. However, more research is needed to understand the effectiveness and safety of Lisdexamfetamine in young people.

Binge Eating Disorder and SSRIs

While SSRIs are not approved for the treatment of BED, some evidence suggests that SSRIs may enhance the effects of cognitive-behavioural therapy in treatment of BED and help to prevent relapse. As an improved medication for bulimia nervosa, doctors at public and private eating disorder clinics may still prescribe SSRIs for BED, especially if other treatment approaches are not effective by themselves.

Eating Disorders and Co-Occurring Conditions

Many young people with eating disorders also live with a co-occurring mental health disorder such as anxiety, depression, or PTSD. These co-occurring disorders can contribute to or even drive disordered eating behaviours, causing children and teenagers to use food as a coping mechanism for distressing emotions, memories, or thoughts.

Eating disorder treatment requires directly addressing disordered eating behaviours, by intervening in binge-purge cycles, establishing regular and nutritious meal plans, or reducing binge eating behaviours. But treating the underlying causes of eating disorders is equally important to promote lasting change and overall well-being.

Many co-occurring disorders may be treated with medication, including anxiety, depression, and the impact of trauma. This means that these medications may improve eating disorder symptoms too – and make up part of eating disorder treatment.

The Wave Clinic: A Private Eating Disorder Treatment Centre with a Difference

The Wave Clinic is a private mental health treatment centre that specialises in eating disorder treatment for children, teenagers, and young adults. We provide top-tier, individualised programs that combine different approaches to address the underlying causes of disordered eating behaviours.

Our private eating disorder clinic offers different levels of care, including facilities for young people at the highest risk. This includes ICU beds, 24-hour medical support, monitoring, and the relevant medical equipment required for emergency interventions. Young people who require less medical support stay in our main house, supported by staff and surrounded by a community of young people and team members.

As encapsulated by one of our core elements of treatment, ‘destination future’, our programs take a long-term perspective, supporting young people to develop the skills they need to build stable and fulfilling futures. As well as clinical care, we offer personal learning programs, enriching experiences, social responsibility projects, vocational qualifications, and much more.

If you’d like to find out more about our programs, get in touch today. We’re here for you.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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