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Binge eating disorder (BED) affects millions of Americans, causing distress and health consequences through recurrent episodes of eating large amounts of food while feeling a loss of control. As telehealth services continue to expand nationwide, many patients wonder: ‘Can I get medication for my binge eating disorder online?’ The short answer is yes—and understanding the current regulatory landscape can help you access care confidently.

What Medications Can Be Prescribed via Telehealth for BED?

While the only FDA-approved medication specifically for BED is Vyvanse (lisdexamfetamine)—a controlled substance with stricter telehealth regulations—several non-controlled medications are commonly prescribed off-label with research supporting their effectiveness:

• Topiramate (Topamax): Originally approved for seizures and migraines, studies show it can reduce binge eating frequency and assist with weight management
• Bupropion (Wellbutrin): An antidepressant that may help reduce food cravings and binge episodes
• Other options: SSRIs like fluoxetine, sertraline, and other non-controlled medications

This article focuses on non-controlled medications like Topamax and Wellbutrin, which have fewer regulatory barriers for telehealth prescribing.

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Current Telehealth Regulations for Non-Controlled Medications

Federal Rules: Green Light for Non-Controlled Medications

The most important thing to understand: Non-controlled medications have never been subject to federal telehealth restrictions. The Ryan Haight Act, which limits controlled substance prescribing via telehealth, does not apply to medications like Topamax or Wellbutrin.

While much attention focuses on DEA’s extensions of COVID-era flexibilities for controlled medications (currently extended through December 31, 2026), these extensions don’t affect non-controlled medications—which remain freely prescribable via telehealth under federal law.

State-by-State Requirements

While federal law permits telehealth prescribing of non-controlled medications, state laws vary. Here’s what you need to know about some key states:

No In-Person Requirements (Most States)

Most states allow fully remote care for non-controlled medications, including:

• California: No in-person exam required if telehealth evaluation meets the standard of care
• New York: No state in-person rule for non-controlled drugs (though they’ve implemented rules for controlled substances)
• Texas: No in-person requirement for non-controlled prescriptions
• Michigan: Telehealth allowed if standard of care is met

States With Periodic In-Person Requirements

A minority of states require occasional in-person visits:

• Alabama: After 4 telehealth visits in 12 months for the same condition, an in-person exam is required within one year
• Georgia: Must attempt an in-person exam annually for ongoing telehealth care
• New Hampshire: Requires an in-person exam at least every 12 months for continued prescribing

Even in these states, the initial evaluation and prescription can typically be done via telehealth, and the follow-up requirement can sometimes be satisfied by a collaborating provider.

Who Can Prescribe BED Medications via Telehealth?

Physicians (MDs and DOs)

Doctors licensed in your state can prescribe non-controlled medications via telehealth in all 50 states.

Nurse Practitioners and Physician Assistants

NPs and PAs can prescribe non-controlled medications in all states, but their level of independence varies:

• Full Practice Authority States: In 34 states plus DC, nurse practitioners can independently evaluate and prescribe without physician oversight, including California, New York, Michigan, and Wisconsin (which joined this group in 2025)

• Collaborative Practice States: In states like Texas, Florida, Alabama, and Georgia, NPs must have a formal agreement with a physician but can still prescribe medications like Topamax and Wellbutrin under this arrangement

At Klarity Health, we connect patients with licensed providers appropriate for their state’s requirements, ensuring all prescriptions meet both federal and state regulations.

What to Expect During a Telehealth BED Evaluation

Initial Consultation

When you seek BED treatment through telehealth, expect a thorough evaluation that includes:

• Assessment of eating patterns to confirm DSM-5 criteria for BED
• Review of medical history, especially conditions that might impact medication choices
• Discussion of prior treatments and their effectiveness
• Screening for contraindications to medication options

A proper evaluation should feel comprehensive—not rushed. Providers at Klarity Health typically spend 30-45 minutes on initial consultations to ensure a thorough assessment.

Red Flags for Potential Contraindications

Your provider will carefully screen for conditions that might make certain medications unsafe:

• History of anorexia or bulimia: Bupropion (Wellbutrin) is contraindicated due to increased seizure risk
• Seizure disorders: May rule out bupropion and require caution with topiramate
• Pregnancy or planning pregnancy: Topiramate has known risks for birth defects
• Severe medical instability: May require in-person evaluation first

Medication Management and Follow-up

After your initial assessment, your provider will:

1. Discuss medication options, including benefits, risks, and side effects
2. Explain that these medications are prescribed ‘off-label’ for BED
3. Start at appropriate doses (usually low, then titrate as needed)
4. Schedule regular follow-up appointments to monitor progress

For non-controlled medications like Topamax and Wellbutrin, providers can often prescribe up to a 90-day supply with refills, though follow-up visits are still important to monitor effectiveness and side effects.

Quality and Safety in Telehealth BED Treatment

Legitimate vs. Questionable Telehealth Practices

The telehealth industry has matured significantly, with established quality standards. Signs of a legitimate telehealth provider include:

• Thorough evaluations that match in-person care standards
• Clear documentation and medical record-keeping
• Discussion of multiple treatment options, including therapy
• Appropriate follow-up scheduling
• Prescriptions sent to legitimate pharmacies (not shipped directly from the provider)

Klarity Health prioritizes thorough evaluations, appropriate treatment options, and regular follow-up care—never compromising clinical standards for convenience.

Multidisciplinary Approach

While medication can be helpful, BED typically benefits from a comprehensive approach. Quality telehealth providers will often:

• Discuss psychological therapy options (CBT is particularly effective for BED)
• Provide nutritional guidance or referrals
• Consider lifestyle modifications alongside medication
• Monitor for improvement in both binge behaviors and psychological well-being

Recent Developments and Future Outlook

The regulatory landscape continues to evolve, with trends generally favoring telehealth access:

• More states granting full practice authority to nurse practitioners
• Permanent telehealth rules replacing temporary COVID flexibilities
• Insurance coverage expanding for telehealth services

These changes are mostly maintaining or expanding access to telehealth for non-controlled medications like those used for BED.

Conclusion: Accessing BED Treatment via Telehealth

If you’re struggling with binge eating disorder, telehealth offers a legitimate, convenient path to medication treatment. Non-controlled medications like Topamax and Wellbutrin can be legally prescribed via telehealth in all 50 states, though specific requirements may vary.

At Klarity Health, we connect patients with licensed providers who understand both the clinical and regulatory aspects of BED treatment. Our providers conduct thorough evaluations, prescribe appropriate medications when indicated, and provide ongoing support—all while navigating the complex regulatory landscape so you don’t have to.

Ready to explore treatment options for binge eating disorder? Consider scheduling a telehealth consultation to discuss whether medication might be right for you, along with other evidence-based approaches to managing BED.

Citations

1. U.S. Department of Health and Human Services. (2026). ‘DEA Extends Telehealth Flexibilities Through December 31, 2026.’ www.hhs.gov/press-room/dea-telemedicine-extension-2026.html

2. Sheppard Mullin Health Law Blog. (2025). ‘Telehealth and In-Person Visits: Tracking Federal and State Updates to Pandemic-Era Telehealth Exceptions.’ www.sheppardhealthlaw.com

3. Center for Connected Health Policy. (2025). ‘Online Prescribing Policy Database.’ www.cchpca.org/topic/online-prescribing/

4. Texas Board of Nursing. (2025). ‘Advanced Practice Registered Nurse FAQs.’ www.bon.texas.gov/faqpracticeaprn.asp.html

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Source:

• https://www.hhs.gov/press-room/dea-telemedicine-extension-2026.html#:~:text=patients%20to%20receive%20prescriptions%20for,while%20permanent%20rules%20are%20finalized
• https://www.sheppardhealthlaw.com/2025/08/articles/telehealth/telehealth-and-in-person-visits-tracking-federal-and-state-updates-to-pandemic-era-telehealth-exceptions/#:~:text=extended%20telemedicine%20prescribing%20waivers%20through,prescribing
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• https://blog.healthjobsnationwide.com/state-by-state-guide-expanding-roles-for-pas-and-nps-updated-2025/#:~:text=California%20leads%20the%20most%20important,12