There are at least two problems that involve disordered eating primarily at night: night eating syndrome, which is discussed here, and nocturnal sleep-related eating disorder, which is described on another page on our site. We suggest you read the material on both so you will have a better understanding of these perplexing and distressing problems.
Signs and symptoms
- The person has little or no appetite for breakfast. Delays first meal for several hours after waking up. Is not hungry or is upset about how much was eaten the night before.
- Eats more food after dinner than during that meal.
- Eats more than half of daily food intake during and after dinner but before breakfast. May wake up and leave the bed to snack at night. May not be aware at the time of what they are doing.
- This pattern has persisted for at least two months.
- Person feels tense, anxious, upset, or guilty while eating.
- NES is thought to be stress related and is often accompanied by depression. Especially at night the person may be moody, tense, anxious, nervous, agitated, etc.
- Has trouble falling asleep or staying asleep. Wakes frequently and then often eats.
- Foods ingested are often carbohydrates: sugary and starchy.
- Behavior is not like binge eating which is done in relatively short episodes. Night-eating syndrome involves continual eating throughout evening hours.
- This eating produces guilt and shame, not enjoyment.
How many people have night-eating syndrome?
Perhaps only one to two percent (1-2%) of adults in the general population have this problem, but research at the University of Pennsylvania School of Medicine suggests that about six percent of people who seek treatment for obesity have NES. Another study suggests that more than a quarter (27%) of people who are overweight by at least 100 pounds have the problem.
Discussion
Night-eating syndrome has not yet been formally defined as an eating disorder. Underlying causes are being identified, and treatment plans are still being developed. It seems likely that a combination of biological, genetic, and emotional factors contribute to the problem.
One theory postulates that people with this condition are under stress, either recognized or hidden. Their bodies are flooded with cortisol, a stress hormone. Eating may be the body's attempt to neutralize cortisol or slow down its production. More research needs to be done before this explanation can be accepted or rejected. In any event, stress appears to be a cause or trigger of NES, and stress-reduction programs, including mental health therapy, seem to help.
Researchers are especially interested in the foods chosen by night eaters. The heavy preference for carbohydrates, which trigger the brain to produce so-called "feel-good" neurochemicals, suggests that night eating may be an unconscious attempt to self-medicate mood problems and relieve stress.
NES may run in families. At this time is appears to respond to treatment with the SSRI sertraline (Zoloft, a prescription medication). NES is remarkable for characteristic disturbances in the circadian rhythm of food intake while circadian sleep rhythms remain normal.
If you are seeking help for night-eating syndrome, schedule a complete physical exam with your physician and also an evaluation with a counselor experienced in the treatment of eating disorders as well as sleep disorders. In addition, a dietitian can help you develop meal plans that distribute intake more evenly throughout the day so you are not so vulnerable to caloric loading in the evening.
Evaluation in a sleep laboratory could be worthwhile. Most large hospitals have such facilities. It is not yet clear whether night eating is an eating disorder or sleep disorder or both. The more information available to you and your treatment team, the greater the chances are of developing an effective treatment plan.
Recent research was summarized by Albert Stunkard, MD, University of Pennsylvania School of Medicine, at the NAASO 2003 annual meeting, October 13, 2003. See also the January 2004 issue of the International Journal of Eating Disorders.
For more information, see the excellent material on sleep disorders prepared by SleepDisordersGuide.com.
Please Note: ANRED information is not a substitute for medical or psychological evaluation and treatment. For help with the physical and emotional problems associated with eating disorders, talk to your physician and a mental health professional.
Page updated May 17, 2008
ANRED
Anorexia Nervosa and Related Eating Disorders, Inc.
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