Night Eating Syndrome

Night Eating Syndrome: What It Is and Why You’re Not Alone

October 24, 2016

Have you ever woken mid-sleep with extreme feelings of hunger? Ever found yourself eating large portions of food in the evenings or night hours? Waking up multiple times each night grazing on snacks then falling back asleep? If so, you’re not alone. This phenomenon is called Night Eating Syndrome (NES). It is a severe, yet treatable eating disorder.

For those seeking weight loss surgery (WLS), they found that 28 percent of patients have some form of Night Eating Disorder.

What Is Night Eating Syndrome, Symptoms and Impact

The Alliance for Eating Disorder Awareness reports that NES impacts between 1 and 2 percent of the general population. Additionally, 25 percent of severely obese individuals suffer from NES according to the Journal of the American Medical Association (JAMA) (3). As you can see from the data, the number of patients seeking help for NES is growing. The increase in cases has significantly helped researchers learn more about the syndrome (1).

First described by Dr. Albert Stunkard in 1955, a psychiatrist at the University of Pennsylvania. NES is included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and classified under, “Other Specified Feeding or Eating Disorder (OSFED) (2).

Recent research is investigating how our body’s “internal clock” plays an important role in the origin of obesity. The internal clock is referred to as “Circadian Rhythm” in the medical community. We see this clock pattern in NES through its three-part system:

  1. Skipping daytime meals
  2. Evening or mid-sleep eating
  3. Insomnia

The exact cause of NES is still not fully understood. The syndrome is undergoing extensive research in both behavioral and bariatric medicine. Many weight loss surgery patients can relate to waking mid-sleep with these extreme feelings of hunger. It is important to target NES early so bariatric patients can lose the proper amount of weight and keep it off after surgery.

Medical Impact of Night Eating Syndrome

Individuals with NES are often overweight or obese. This increases your overall risk for developing high blood pressure, diabetes and high cholesterol. Long-term obesity increases the risk of cardiovascular diseases and cancer. Other potential health consequences of Night Eating Disorder include gallbladder disease, generalized fatigue, joint pain and sleep apnea.

Psychological Impact of Night Eating Syndrome

Night Eating Syndrome patients often suffer from:

  • Depression
  • Sleep Disorders such as Insomnia
  • Higher risk or history of substance abuse
  • Anxiety

Increased life stress was also strongly correlated to an increase in Night Eating Syndrome symptoms in multiple clinical studies. Therefore NES can be potentially detrimental to both your physical and emotional health and well-being if not addressed quickly (3).

Common Signs and Symptoms

Do any of the following symptoms sound familiar?

  • Binge eating and/or loss of control in the evening/night
  • Grazing behaviors in the evening/mid-sleep
  • Skipping daytime meals
  • Food hoarding
  • Insomnia

If any of the above impact your life on a regular basis, a conversation with your primary care provider about possible treatment may be beneficial.

Treatments for Night Eating Syndrome

Similar to other eating disorders, successful treatment of NES requires a combination of therapeutic efforts from dietary, behavioral, psychological and medical professionals. Typically, the following steps are taken towards a successful and sustainable recovery:

Educate and Identify

  • Educate patient about NES
  • Increase awareness of eating patterns and behaviors
  • Identify triggers that may impact uncontrolled eating
  • Eliminate fault and blame for syndrome

Dietary Interventions for NES

  • Schedule small/frequent meals during the day - set reminders to eat
  • Balanced meals including lean proteins and fiber-rich vegetables
  • Avoid carbohydrate-heavy meals (especially before bedtime)
  • Maintain proper hydration (at least 64 ounces daily)

Treatments

  • Nutrition assessment
  • Exercise
  • Cognitive behavior therapy
  • Support group

Follow-up and Maintenance for Long-Term Success

It is important for long-term success that patients follow up with their treatment team. Follow-up promotes patient accountability, allows for troubleshooting in the “real world,” and provides a support system for long-term recovery and maintenance.

Many people with NES are aware they’re consuming foods in an unhealthy way, and most want to stop. Many times, patients feel powerless against their behaviors, hopeless and unsure about how to make healthy changes. Individuals with NES often feel shame and guilt over their condition, therefore don’t seek help.

Annual checkups and consistent monitoring with your bariatric surgery and primary care team can allow you to start the conversation about NES early before the condition leads to a more serious situation.

Dietary and behavioral health professionals play important roles in the road to recovery with NES. Talk to your doctor about meeting with a Registered Dietitian, Psychologist or other behavioral health provider who specializes in Night Eating Syndrome.

You are not alone, approximately 100 million people have some form of NES and few seek the aid they need (1). Start the conversation today!

References

  1. Bell, L. (2016, April 15). Night Eating Syndrome: Signs and Symptoms. Retrieved September 6, 2016, from http://www.eatingdisorderhope.com/blog/night-eatingsyndrome-signs-and-symptoms
  2. Night Eating Disorder. (n.d.). Retrieved September 06, 2016, from http://www.allianceforeatingdisorders.com/portal/night-eating-syndrome
  3. Stunkard, A. (n.d.). Eating Disorders and Obesity: "Night Eating Syndrome" (2nd ed.). New York, NY: Guilford Publications.
night eating syndrome
kristin

ABOUT THE AUTHOR

Kristin Kelly, RD, LDN, got her start working with child/infant and maternal nutrition in addition to private counseling for adult weight and diabetes management. Kristin’s guiding principle is to enjoy what you like in moderation and mindfulness. She works at Bariatric Specialists of North Carolina and helps to provide realistic and long-term solutions for better eating in the midst of our demanding lives.