FDA Approved Medication to Reduce Binge Eating and/or Purging

Exclusion Criteria

• •Any patient with bipolar disease or schizophrenia or any patient taking a mood stabilizer or antipsychotic medication within the past 3 months
• •Any patient with current or past history of anorexia nervosa (i.e., with a Body mass index of \< 17.5).
• •Any patient with prior (within 30 days) use of Over The Counter (OTC) weight-reducing agents, herbal preparations
• •Any patient who has been prescribed a medication for weight loss within the past 3 months
• •Any psychological weight-loss interventions (i.e., Weight Watchers, Jenny Craig) in which patient has lost weight over the past month (unless willing to discontinue).
• •Any patient currently in therapy with a psychostimulant or who has used a psychostimulant within the past 6 months
• •Any patient with known sensitivity to phentermine or topiramate
• •Any patient who has had a change in thyroid, psychiatric, or blood pressure medications within the past one month
• •Any patient who is taking a potassium-wasting diuretic
• •Any patient who is on a carbonic anhydrase inhibitor such as zonisamide acetazolamide, or dichlorphenamide
• •Any diabetic who is taking insulin or an insulin secretagogue
• •Any patient with liver enzymes at baseline greater than three times the upper limit of normal
• •Any patient with a baseline potassium of less than 3.0 millequivalent/Liter. Patients with baseline potassium levels between 3.0-3.5 miliEquivalents/Liter will be encouraged to ingest high potassium foods such as bananas, oranges, or tomato juice daily during the study
• •Any patient with abnormal baseline thyroid test or with a Thyroid Stimulating Hormone (TSH) greater than 1.5 times the upper limit of normal
• •Any patient who is unwilling or expresses uncertainty about being able to refrain from daily alcohol use (even if at moderate levels) or illegal drugs while taking the study medication.
• •Any adult with recent history of suspected alcohol or substance abuse or substance dependence
• •Any patient who regularly uses marijuana (including medical marijuana) or illegal drugs
• •Any patient who has a history of addiction to a stimulant
• •Any patient who expresses current suicidal ideation
• •Any patient with a history of nephrolithiasis
• •Any patient who is pregnant or who is planning to become pregnant during the study period.
• •Any patient who is currently participating in any other clinical study that involves an active treatment
• •Any patient who is unable to identify a primary care physician
• •Any patient with a history of cardiovascular disease (i.e. recent history of Myocardial Infarction, stroke, shortness of breath, chest pain) that could increase vulnerability to the sympathomimetic effects of a stimulant like drug. If clinical suspicion is high, baseline EKG will be obtained and anyone with abnormal findings will be excluded