Night Eating Syndrome

by Kerry Potter

I love to write about the interesting nutrition topics that no one wants to talk about (at least in public that is). Like the topics the crazy radio show hosts bring up during morning rush hour traffic; one being nighttime eating. My participants in my outpatient diabetes classes actually brought up this topic last week. They wanted to know if eating in the middle of the night is acceptable. What a strange thing to ask. Why would you eat in the middle of the night? The funny thing is, this is a common problem among many people and is not as rare as I thought.  

There can be many reasons for an individual to overeat during the night or awake to eat, such as boredom and as a tool to deal with other emotions. However, my main focus today is going to be addressing Night Eating Syndrome (NES).

So exactly what is NES and has it gained acceptance in the medical community as a valid issue?

NES is characterized by a lack of appetite in the morning, overeating at night, and waking to eat throughout the night. It is similar to a consistent pattern of waking up in the middle of the night to binge on food. Individuals with NES consume at least 25% of their total caloric intake after dinner or throughout the middle of night. However, it is unlike typical binges seen in binge eating disorder during the day. People who suffer from NES typically spread eating throughout several hours over the night and may awaken two or three times during the night to eat. It is believed that someone with night-eating syndrome has lower melatonin at night. This weakens their REM sleep. Furthermore, they have lower levels of leptin, a hormone that acts as an appetite suppressant.

This syndrome is often overlooked by medical professionals, but has been noted to affect at least 6 million individuals in the United States. Many NES suffers are overweight or obese. Still, there are normal weight individuals that suffer from NES and their symptoms are the same of obese individuals. The syndrome is seen equally in men and women unlike other eating disorders.  And instead of the enjoyment people often feel eating a meal, people with NES often feel anxious, stressed, and embarrassed about the habit. They also suffer from chronic stress on a daily basis.

So how is one to deal with Night Eating Syndrome? Until now, research on the topic has been sparse.

My personal recommendation: start by buying the book Overcoming Night Eating Syndrome by Dr. Allison. This will help you discern if you truly have NES. The book gives a lot of good insight on the different causes of NES and ways to stop the issue before having to seek professional help. Other articles I have read on the topic by Dr. Allison and Dr. Albert Stunkard also recommend courses on stress management, counseling with a therapist, or self-confidence training to alleviate the stress and anxiety that leads to nighttime binging. Although the topic seems kind of silly, I think it can be very detrimental to someone’s health mentally and physically. No issue is too small if it keeps you from living a vibrant life full of energy. I suspect that many of my patients with diabetes could benefit from some of the therapies recommended in the book and may subsequently see a positive impact on their weight as well as their blood sugars.

References

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. Stunkard AJ, Allison KC, Lundgren J. Issues for DSM-V: Night eating syndrome. Am J Psychiatry. 2008;165(4):424.

3. Allison KC, Stunkard AJ.  Self-help for night eating syndrome. In: Latner JD, Wilson GT, eds. Self-Help Approaches for Obesity and Eating Disorders: Research and Practice. New York: Guilford Press; 2007: 310-324.