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Contrary to popular belief, eating disorders affect men and women of all ages, not just the stereotypical teenage girl. Rates have risen sharply among boys during the last few decades, and experts estimate that up to 14 percent of Americans now have at least some signs of an eating disorder, which include. Treatment for eating disorders includes cognitive behavioral therapy, nutritional counseling, and medication, frequently in combination. But many patients don't respond adequately, and those treated for binge eating disorder often fail to lose weight. The Food and Drug Administration has approved only one drug—the antidepressant fluoxetine Prozac and generic —for the treatment of an eating disorder bulimia nervosa. Doctors can legally prescribe any medication they deem appropriate to treat a patient's condition. Experts aren't sure why topiramate helps, but they think it enhances networks in the brain that have a calming effect and inhibits networks that are overstimulating. Also, many people with bulimia nervosa are flirting with anorexia nervosa, and topiramate may cause unwanted additional weight loss. There have been studies focused on topiramate for binge-eating disorder, and a few have examined its use in treating bulimia nervosa. Most were lasted a short period of time 12 to 24 weeks, included primarily women, and excluded people with psychiatric problems, which are common among people with eating disorders.

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