Night Eating Syndrome

The little-known eating disorder with big health implications

Lara Rondinelli By Lara Rondinelli, RD, LDN, CDE

While most people have heard about more common eating disorders such as anorexia or bulimia, you may not be as familiar with Night Eating Syndrome (NES). NES is a syndrome that involves a dysfunctional sleep pattern and a disassociation between eating and sleeping — in other words, eating large quantities of food throughout the night, even resulting in waking up to eat food. Previous research suggests that although the prevalence of NES is low in the general population, prevalence rates are significantly higher in the obese population.  

Diagnostic Criteria

NES is an eating disorder in which an individual obsessively consumes more than half of his or her daily caloric intake after eight o'clock in the evening. People with NES may experience feelings of anxiety and guilt, insomnia, or interrupted sleep. It is common for people with NES not to be hungry in the morning due to the large intake of calories during the night. Some people may not remember how much food they consumed in the middle of the night. In addition, some people may be embarrassed to admit to this eating pattern. Not only can this behavior cause problems such as weight gain, but for people with diabetes it can also have a serious impact on blood glucose levels.

Clinical Classification

Experts believe NES may be triggered by a stressful event or caused by hormone imbalances. Although there has been significant progress in the clinical recognition of NES over the last 20 years, it is still not widely recognized. Therefore, the diagnosis may be hard to obtain. Progress is expected to continue due to the fact that NES has just been accepted for inclusion in the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), which is due for publication in 2013. Screening for NES comes in the form of a Night Eating Questionnaire, which evaluates the severity of the condition. If you think you might have NES, discuss this with your doctor — don't be afraid to talk about it. You need help in dealing with this issue and it is not as uncommon as you may think.

Treatment Options

  1. Therapy – Finding a psychologist or social worker that has experience working with NES would be ideal. A therapist can help you devise a treatment plan to avoid night eating, decrease calorie and carbohydrate intake, thus improving glucose control and possibly lowering weight too. In addition, if depression, stress, or anxiety is contributing to NES, a therapist can help you tackle these issues and make recommendations specifically for your individual treatment.
  2. Sleep Study – A sleep study may be useful to determine if you are experiencing any other sleep issues such as sleep apnea or restless leg syndrome, which can cause sleep disruptions.
  3. Exercise – Exercise has numerous health benefits, both physical and emotional. Not only does exercise help with weight control and blood sugar control, it also improves mood, boosts energy, and promotes better sleep. The CDC recommends that adults get at least 2 hours and 30 minutes of moderate-intensity aerobic activity (i.e., brisk walking) every week in addition to muscle-strengthening activities on 2 or more days a week. You can read more here about exercise benefits for those with diabetes here: http://www.dlife.com/diabetes-food-and-fitness/diabetes_and_exercise/regular_physical_activity
  4. Meet with a Registered Dietitian (RD) – A RD can assess your overall diet and make healthy eating recommendations. He or she can help you come up with a plan to make sure your diet is balanced and designed for blood sugar control and weight control, if needed. Food records and follow-ups with your RD can help monitor your progress and determine how you are doing with your goals. Food records should document food intake, times, portion sizes, emotions and number of nighttime eating events. Weight loss and improved glycemic control are possible positive outcomes of successfully dealing with NES.
  5. Medications –Sometimes medications may be used to treat NES. This is something to discuss with your doctor.
  6. Resources – Overcoming Night Eating Syndrome: A Step-by-Step Guide to Breaking the Cycle is a book that will help you identify problem behaviors and teach you how to break these patterns with healthier food choices, more structured mealtimes, and a series of relaxation and visualization techniques.

Check out this recipe for Mashed Sweet Potatoes — this creamy side dish is seasoned to perfection with vanilla, cinnamon, and nutmeg. Perfect for the holiday season!

SOURCES:
1 – Allison KC, Stunkard AJ, Thier SL. Overcoming Night Eating Syndrome: A Step-By-Step Guide to Breaking the Cycle. Oakland, Calif.: New Harbinger Publications; 2004.
2 – Cleator, J., Abbot, J., Judd, P., Sutton, C., and Wilding, J.P.H. 2012. Night eating syndrome: Implications for severe obesity. Nutrition and Diabetes (2).
3 – Leman, Cathy. Night Eating Syndrome. Today's Dietitian. 2010. Volume 12 (1):8
4 – Mayo Clinic. 7 Health Benefits of Exercise. http://www.mayoclinic.com/health/exercise/HQ01676 (Accessed 11/2012).

Read Lara's bio here.

Read more of Lara Rondinelli's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

Last Modified Date: January 31, 2014

All content on dLife.com is created and reviewed in compliance with our editorial policy.

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