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Medication should not be offered as the sole treatment for binge eating disorder

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However, certain periodontal pathogens, including Porphyromonas gingivalis , Klebsiella , Helicobacter pylori , Streptococcus , Veillonella , Parvimonas micra , and Fusobacterium nucleatum can endure harsh acidic environments and migrate to the intestine 24 , particularly in individuals with reduced gastric acid levels, such as those using proton pump inhibitors (PPIs) 25

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Symptomatic awareness of hypoglycemia may be less pronounced in patients with longstanding diabetes, in patients with diabetic neuropathy, using drugs that block the sympathetic nervous system (e.g., beta-blockers) or who experience recurrent hypoglycemia

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