If you were to ask anyone to name types of eating disorders, common examples such as bulimia nervosa, binge eating, and anorexia would be top among the list. While the world is slowly starting to understand eating disorders and their severity in people’s lives, some disorders still remain largely unknown. Night Eating Syndrome is one such disorder much of the public remains very unaware and uneducated about.
In this article, we shall be shedding light on this illness by helping you understand night eating syndrome’s facts, what causes it, and how to stop it – if this is possible at all.
What Is An Eating Disorder?
According to the American Psychiatric Association, an eating disorder is a behavioral condition “characterized by severe and persistent disturbance in eating behavior and associated distressing thoughts and emotions.” These disorders can sometimes be very serious to the point where they affect physical, psychological, and social function.
The association goes further to compare eating disorders with addiction because those suffering from these illnesses, like addicts, are usually preoccupied with food, weight or shape, or anxiety about eating or the consequences of eating certain foods. Their behavior also changes in a way that they may start restricting their food intake or completely avoiding certain foods, binge eating, purging by vomiting, or through laxative misuse or compulsive exercise (8).
What Is Night Eating Syndrome?
In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, night eating syndrome is classified as an Other Specified Feeding or Eating Disorder (OSFED). According to a study published in 1999, this disorder was first identified in 1995 by a psychiatrist at the University of Pennsylvania. He defined it as a combination of morning anorexia, evening hyperphagia (consuming 25 percent of the daily food intake after the evening meal), and insomnia.
Upon further investigation of the disorder, researchers found that those suffering from this illness would (1):
- Consume significantly more of their daily energy intake at night
- Wake up 3.6 times per night on average with about 52 percent of this time spent eating
With this in mind, we can safely say that night eating syndrome (aka NES) is an overeating condition in which patients often eat a lot of their daily calorie intake after dinner or during the night where they specifically wake up to eat.
What Are Some Night Eating Symptoms?
If you have been suspecting that you may be suffering from this condition, the criteria for NES are as follows (7):
- Evening hyperphagia. You rarely eat early in the day and end up having most of your food (at least 25 percent) at night, usually past dinner time.
- Nocturnal feedings. You wake up in the middle of the night, at least two times a week, to eat.
If you already meet these criteria, then look out for the following additional symptoms. If you can relate to at least three of those listed below, you are very likely suffering from this disorder.
- Morning anorexia. You rarely have any appetite in the morning.
- A strong desire to eat after between dinner and bedtime, as well as in the middle of the night when you wake up.
- Suffering from insomnia four or five times a week. You also have a strong belief that you have to eat in order to fall asleep (or get back to sleep).
- You may feel more anxious or depressed during the evening or nighttime.
- A clear awareness and recollection that you often eat a lot in the evening and the middle of the night.
Verywellmind.com further states that if these symptoms have been going on for at least three months, then you should really consider seeing someone to help you diagnose this condition.
An important fact to note is that due to its relatively unknown nature, night eating syndrome is often confused with other feeding, eating, and sleep-related disorders, such as binge eating or nocturnal sleep-related eating disorder.
Some simple night eating syndrome facts that you can use to help you differentiate this illness from these other two are:
- Binge-eaters often consume large amounts of food in a short time, usually as an attempt to numb/cope with strong emotions. Those suffering from NES are different in that, not only do they not necessarily eat large amounts in one seating, they often graze. However, they also do not feel the need to numb emotions with food. Instead, they use food as a means to help them get back to sleep.
- Those suffering from sleep-related eating disorders (aka SRED) often eat while sleepwalking or while in a twilight state between sleep and being awake. They are unaware of what they’re doing and may wake up to find dishes or food in their bed while having no memory of eating at all. On the other hand, those suffering from NES eat while fully awake and aware of what they are doing.
What Are The Causes Of Night Eating Syndrome?
If you are wondering why night eating syndrome happens, the truth is that doctors and scientists are not entirely sure what causes this disorder. Despite this, they do have some suspicions, which include:
- A delay in the circadian rhythm of eating. Where your appetite is suppressed in the morning and increases during the evening hours.
- Genetics. According to webmd.com, some researchers have found a link between NES and the gene PER1. This gene is said to have a hand in controlling your body clock and a defect in the gene believed to cause NES. This theory, however, still needs more research to establish.
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Night Eating Syndrome Treatments: Can The Disorder Be Cured?
According to a study published online in 2001, people suffering from NES are more likely to have higher levels of depression, lower self-esteem, and find it harder to lose weight than others (4). Not only does this condition mess with your mental health, but it also affects your physical and social life. In light of this, overcoming night eating syndrome will help patients achieve happier and healthier lives. But can it be done?
To this day, the understanding of NES is still very little, which presents quite the challenge in not only diagnosing the illness but also treating it as well. While night eating syndrome cures are still unknown, doctors have found some ways to help people living with NES manage their disorder better. These ways include:
In an attempt to find a cure for NES, some researchers have turned to pharmacotherapy as a way to treat or at least manage night eating syndrome. Two studies done using antidepressants have shown some promise in the management of this eating disorder. The studies in question used paroxetine or fluvoxamine and sertraline on their patients (7).
In a case report of four patients using paroxetine or fluvoxamine, all the patients reported a significant decrease in many core night eating symptoms (6). In the study using sertraline, not all subjects reported improvement. Those who did, however, found a significant reduction in the number of awakenings and nocturnal ingestions per week, and in the percentage of caloric intake consumed after the evening meal (2).
Cognitive Behavioral Therapy
In a 2010 clinical trial, patients of NES were put through a 10-session cognitive behavior therapy for this disorder. This pilot study therapy aimed to delay circadian eating rhythms by shifting food intake to earlier in the day while simultaneously interrupting the overlearned relationship between nighttime eating, faulty cognitions, and sleep onset.
Strategies used included:
- A combination of behavioral weight management components- monitoring food consumption, regulating meals and snacks, restricting daily caloric intake.
- Cognitive therapy components like identifying, evaluating, and restructuring maladaptive thoughts.
After their sessions were completed, the subjects showed significant decreases in caloric intake after dinner, the number of nocturnal ingestions, and reduced weight. They also reported that they woke up fewer times at night in the week, were feeling less depressed, and that the overall quality of their lives had improved (3).
The Bottom Line
While the research for night eating syndrome remains in its infancy, some solutions to this disorder have been found and continue to help patients everywhere. If you have noticed that you have the above-mentioned NES symptoms, please speak to your doctor so they may find you a viable management option that will help improve your symptoms and life in general.
This article is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional advice or help and should not be relied on to make decisions of any kind. A licensed physician should be consulted for the diagnosis and treatment of any medical conditions. Any action you take upon the information presented in this article is strictly at your own risk and responsibility!
- Behavioral and neuroendocrine characteristics of the night-eating syndrome (1999, pubmed.ncbi.nlm.nih.gov)
- Clinical trial of sertraline in the treatment of night eating syndrome (2004, pubmed.ncbi.nlm.nih.gov)
- Cognitive behavior therapy for night eating syndrome: a pilot study (2010, pubmed.ncbi.nlm.nih.gov)
- Night eating syndrome is associated with depression, low self-esteem, reduced daytime hunger, and less weight loss in obese outpatients (2001, pubmed.ncbi.nlm.nih.gov)
- Optimal management of night eating syndrome: challenges and solutions (2015, ncbi.nlm.nih.gov)
- Successful treatment of nocturnal eating/drinking syndrome with selective serotonin reuptake inhibitors (2003, pubmed.ncbi.nlm.nih.gov)
- Treatment of Night Eating Syndrome (2012, ncbi.nlm.nih.gov)
- What Are Eating Disorders? (2021, psychiatry.org)