Prescription Medications for Eating Disorders: Anorexia, Bulimia, Binge Eating

Eating disorders have many etiological parents, from anxiety disorders to environmental stimuli. Thus, treating them is not always direct. The FDA has approved two medications for eating disorders: fluoxetine (Sarafem; Prozac) for bulimia nervosa, and lisdexamfetamine dimesylate (Vyvanse) for binge eating disorder. The FDA has not yet approved any medication for anorexia nervosa; the best treatment is returning to a healthy weight under the guidance of cognitive-behavioral therapy.

Eating Disorder Prescription Medication Costs

Fluoxetine, which is also a treatment for mood disorders such as depression, can be relatively inexpensive, running just over $20 on average for thirty capsules. Purchased from a PharmacyChecker-accredited international pharmacy, the same amount of fluoxetine can be as little as $7. The cheapest option by far, though, is to purchase fluoxetine at your local U.S. pharmacy using this U.S. Discount Card, which will put thirty capsules at just $1.56. That’s less than the cheapest cup of coffee! 

Vyvanse, a relatively new medication, is expensive, running over $300 for thirty tablets on average. The FDA did not approve Vyvanse as a treatment for binge eating disorder until 2015. It does not have a generic alternative and, as it is a controlled substance, cannot be purchased from an accredited international pharmacy. (No international pharmacy worth its salt would sell a controlled substance.) The U.S. Discount Card on PharmacyChecker.com only shaves 4% off the drug’s price. The cheapest way to obtain Vyvanse would be to use Takeda Pharmaceuticals’ Vyvanse savings card, which promises costs as low as $30. 

U.S. average retail prices based on GoodRx and drugs.com. U.S. Discount Card prices and International Pharmacy prices based on those listed on PharmacyChecker.com in March 2021.

How does Vyvanse work as treatment for BED? 

Vyvanse is a central nervous system stimulant originally intended to treat attention deficit hyperactivity disorder (ADHD) and attention deficit disorder (ADD). Binge eating disorder (BED) is characterized by “out of control” eating habits, per the American Psychological Association, traditionally with a psychological underpinning. Those suffering from BED will “binge” eat up to three times a week, eating beyond satiety and into the realm of discomfort. The disorder makes those diagnosed with it feel like they have to keep eating even though they are no longer hungry. The disorder usually involves a final course of guilt and depression following binges. 

Vyvanse, or lisdexamfetamine, may treat BED by encouraging the release of serotonin, dopamine, and norepinephrine, which are all involved in managing our relationship to food. As a relatively new medication, the success rate for Vyvanse is not yet clear but did show positive results in clinical trials. The broader issue may be that treating any eating disorder requires a multi-pronged attack. Vyvanse can curb the need to binge biologically, but it may not treat the underlying issues. 

Because lisdexamfetamine likely treats other mood disorders, it is under investigation as a treatment for conditions like schizophrenia and bipolar depression. 

Vyvanse is not a weight loss drug, even though ADHD medications are sometimes associated with weight loss. 

Is there a cure for anorexia? 

There is no cure for anorexia nervosa. In fact, those who undergo treatment for eating disorders often refer to themselves as “recovering” for the rest of their lives. Like treating alcoholism, fighting an eating disorder can be a lifelong battle. Anorexia nervosa does not yet have a medical treatment, although researchers have an eye on cannabinoids. A 2014 randomized trial examined the effects of Dronabinol, a derivative of cannabis, on anorexia nervosa. While the results were promising, the FDA has yet to approve a cannabis-based treatment. Cannabis as a treatment for anorexia notably treats a symptom of anorexia (extreme weight loss) instead of the condition overall. Also, not all anorectic patients see extreme or unhealthy weight loss.

Where is Vyvanse manufactured? Where is fluoxetine manufactured? 

Generic fluoxetine sold in the U.S. is manufactured in India. Prozac sold in the U.S. is manufactured in Switzerland. Vyvanse does not disclose where it is manufactured.