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Despite its significant impact on mental and physical health, pharmacological treatment options remain limited. We present the first network meta\u2010analysis synthetizing evidence on the efficacy, safety, and tolerability of pharmacological interventions for BED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search across PubMed, Embase, Web of Science, Cochrane Library, PsycINFO, and LILACS was conducted to identify randomized controlled trials assessing pharmacological\u2010only interventions for adults with BED. Outcomes included reduction in binge\u2010eating episode frequency, changes from baseline in weight, BMI, and eating disorder scores, along with remission rates, medication discontinuation rates, and adverse events. The DerSimonian\u2010Laird random\u2010effects model was employed to estimate the overall effect size across studies. Heterogeneity was estimated using <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>, Tau\u2010squared (<jats:italic>\u03c4<\/jats:italic><jats:sup>2<\/jats:sup>), and Cochrane's Q <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> tests. Risk of bias was assessed using RoB2 Tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among findings with high\u2010certainty evidence, topiramate showed the greatest efficacy for reducing binge\u2010eating episodes (mean difference [MD]\u2009=\u2009\u22121.72) and promoting remission (odds ratio [OR]\u2009=\u20093.99), followed by lisdexamfetamine (MD\u2009=\u2009\u22121.50; OR\u2009=\u20093.33) and dasotraline (MD\u2009=\u2009\u22120.97; OR\u2009=\u20091.97). Lisdexamfetamine had the highest odds of adverse events, including anxiety, insomnia, diarrhea, and headache. Most studies failed to use validated assessment instruments and inconsistently defined remission periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Topiramate, lisdexamfetamine, and dasotraline show significant potential in treating BED. However, the landscape of pharmacotherapy for BED lacks robust evidence and methodological standardization. Larger trials with expanded sample sizes and using validated scales are needed to guide clinical practice for this highly prevalent and damaging disorder.<\/jats:p><\/jats:sec>","DOI":"10.1111\/obr.13936","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:59:19Z","timestamp":1746752359000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Pharmacotherapies for Binge Eating Disorder: Systematic Review and Network Meta\u2010Analysis"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8702-5436","authenticated-orcid":false,"given":"Gabriel\u00a0P.\u00a0A.","family":"Costa","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Ribeir\u00e3o Preto  Ribeir\u00e3o Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz\u00a0R.","family":"Assun\u00e7\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Endocrinology University of S\u00e3o Paulo  Ribeir\u00e3o Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Belfort\u2010DeAguiar","sequence":"additional","affiliation":[{"name":"Division of Diabetes University of Texas Health San Antonio  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9622-3361","authenticated-orcid":false,"given":"Julio\u00a0C.","family":"Nunes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Yale University School of Medicine  New Haven Connecticut USA"},{"name":"Department of Psychiatry, West Haven Veteran Affairs  West Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425787"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/bf01575455"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010015\u20100445\u20106"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010022\u201000344\u2010y"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsycho.2016.12.013"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2006.03.040"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2012.11.020"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22847"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23004"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.paid.2015.10.042"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eatbeh.2015.01.007"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.23065"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2017.02125"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12768"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/yco.0000000000000360"},{"key":"e_1_2_8_17_1","unstructured":"Association AP \u201cPsychologist Workforce Projections \u201d (2018)."},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2020.10.006"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2015.1053465"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.7326\/m15\u20102455"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.7326\/m14\u20102385"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38636.593461.68"},{"key":"e_1_2_8_24_1","unstructured":"WebPlotDigitizer \u201cVersion 4.6 \u201d (2022) accessed October 25 2023 https:\/\/automeris.io\/WebPlotDigitizer."},{"key":"e_1_2_8_25_1","unstructured":"J. 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