Which combination is listed for appetite management in patients with binge eating?

• A. Orlistat
• B. Cognitive Behavioral Therapy + orlistat or Topiramate and bupropion and SSRI
• C. Metformin
• D. Liraglutide

Answer: (B)

The key idea is that treating binge eating effectively usually needs a combined approach: psychotherapy to change eating behaviors and thoughts, plus medications that help control appetite and urges. Cognitive Behavioral Therapy targets the patterns that trigger binge episodes—identifying cues, managing distress, and reframing thoughts about food—so patients can change how they respond in real-life situations. When you add pharmacotherapy that influences appetite and reward pathways, you get a stronger, more comprehensive plan. Orlistat can aid weight management by reducing fat absorption, while topiramate can suppress appetite and promote weight loss. Pairing these with bupropion, which affects mood and craving circuits, and an SSRI, which helps stabilize mood and reduce impulsive eating, addresses both the psychological and physiological drivers of binge eating. This multimodal combination tends to be more effective than medication or therapy alone. The other options focus on single drugs or on glucose/weight-management drugs that don’t directly couple behavioral treatment with an integrated appetite-control strategy, making them less aligned with a comprehensive appetite-management plan for binge eating.