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Cited by 4Eating Disorders and BehaviorsPharmacology and Obesity TreatmentNutrition, Health and Food Behavior

Pharmakotherapie der Essstörungen—Ein Update

Bauman, Tabea, Voderholzer, Ulrich·2025·Der Nervenarzt
DOI 10.1007/s00115-025-01804-y
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Abstract

Background Anorexia nervosa, bulimia nervosa and binge-eating disorder are severe mental illnesses and are often associated with mental comorbidities, such as depression, anxiety and obsessive-compulsive disorders. Psychotherapy is considered the primary method of treatment; however, in the clinical practice it is not uncommon to also use psychopharmacotherapy.Material and methods The article considers international and national guidelines as well as the updated World Federation of Societies of Biological Psychiatry (WFSBP) guidelines to summarize the current evidence on psychopharmacotherapy of eating disorders.Results Anorexia nervosa: psychopharmacotherapy for anorexia nervosa should especially support weight gain. To date, there is no evidence for the efficacy of antidepressants for weight gain in anorexia nervosa. For antipsychotics, such as olanzapine in particular, the studies are heterogeneous, which is why off-label use in clinical practice is limited exclusively to individual cases. Bulimia nervosa: fluoxetine has been shown to be effective in reducing binge eating and compensatory behaviors. Fluoxetine is also the only medication approved in Germany for the treatment of an eating disorder. Binge-eating disorder: by far the greatest evidence exists for lisdexamfetamine. But this is not approved in Germany for the treatment of binge-eating disorder.Discussion In recent years the number of randomized controlled trials on psychopharmacotherapy for eating disorders has greatly increased. In Germany, fluoxetine is still the only approved drug for the treatment of bulimia nervosa; however, psychopharmacotherapy for eating disorders should always be embedded in a treatment plan with psychotherapy and nutritional management as well as appropriate medical monitoring. Overall, there is a need for further research.

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Crossref · 10.1007/s00115-025-01804-y

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  • Evidence on the specific efficacy of pharmacotherapy in eating disorders remains limited and inconclusive, while various studies agree that these drugs are part of first-line therapeutic approaches, especially when eating disorders are accompanied by comorbidities such as anxiety or depression.

    “Although the evidence on the specific efficacy of pharmacotherapy in eating disorders (EDs) [32] remains limited and inconclusive, various studies agree that these drugs are part of first-line therapeutic approaches, especially when EDs are accompanied by comorbidities such as anxiety or depression.”

    From Immersive Virtual Reality in Psychotherapeutic Interventions for Youth with Eating Disorders: A Pilot Study in a Rural Context (2025) · cites this paper as [32]

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Authors
Bauman, T., & Voderholzer, U.
Affiliations
  • Schön Klinik Roseneck (DE)
  • University Medical Center Freiburg (DE)
Corresponding author
Bauman, Tabea
ORCID
Voderholzer, Ulrich
Venue
Der Nervenarzt
Publisher
Springer Science and Business Media LLC
Published
2025-02-20
Volume
96
Issue
3
Pages
230-237
ISSN
  • 0028-2804 (ISSN-L)
  • 1433-0407
DOI
10.1007/s00115-025-01804-y
OpenAlex
W4407773686
Cited by
4
References
53
Citations by year
2025: 4
FWCI
0.88
Type
journal article
Language
de
Open access
closed
Licence
Locations
  • Der Nervenarzt (publishedVersion)
  • PubMed (publishedVersion)
  • FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
eating disorders, psychopharmacological treatment, anorexia nervosa, bulimia nervosa, binge eating disorder, olanzapine, fluoxetine, lisdexamfetamine, antidepressants, antipsychotic drugs, weight gain, off-label drug use, treatment guidelines, comorbid depression
MeSH terms
Anorexia Nervosa, Antidepressive Agents, Feeding and Eating Disorders, Fluoxetine, Germany, Humans, Psychiatry, Psychotherapy, Psychotropic Drugs, Antipsychotic Agents, Treatment Outcome, Practice Guidelines as Topic, Evidence-Based Medicine, Bulimia Nervosa, Binge-Eating Disorder

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