We all have been through times when we find ourselves hunting for food in the fridge or kitchen cabinets during the odd midnight hours. This phase is rather transient and is often associated with stress. However, the night eating syndrome is a pathological entity. It is a condition that makes you hyperphagic after the sun sets. You will find yourself consuming food during the evening or night hours despite enduring adequate dinner meals.
What is Night Eating Syndrome?
Night Eating Disorder (NES) is a condition characterized by recurrent episodes of excessive eating during the nighttime or after the evening meal. Individuals with NES often consume a significant portion of their daily caloric intake during the night, experience a lack of appetite in the morning, and may feel a loss of control over their eating. NES can contribute to weight gain, disrupt sleep patterns, and impact overall well-being. Scientifically, it can be defined as 25 percent or more of daily caloric intake during the evening hours, post-dinner, associated with not less than two nocturnal awakenings per week to consume food1Salman EJ, Kabir R. Night Eating Syndrome. [Updated 2022 Sep 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.. The syndrome is highly associated with metabolic disorders such as obesity and diabetes.
What Causes Night-Eating Syndrome(NES)?
To date, no one can tell the exact cause of night eating syndrome. It has been postulated that the disease results from neurological and psychiatric disorders and the input of genetic processes. The genetic factor can be proven by a German study that found an association of night eating disorders in children of mothers who, at some point in their lives, exhibited night eating behaviors 2Lamerz, A., Kuepper-Nybelen, J., Bruning, N., Wehle, C., Trost-Brinkhues, G., Brenner, H., Hebebrand, J., & Herpertz-Dahlmann, B. (2005). Prevalence of obesity, binge eating, and night eating in a cross-sectional field survey of 6-year-old children and their parents in a German urban population. Journal of child psychology and psychiatry, and allied disciplines, 46(4), 385–393. https://doi.org/10.1111/j.1469-7610.2004.00363.x.
Stress has been observed to exacerbate the symptoms of NES, and so does depression.
Excessive caloric restriction during the daytime can also be a reason for your body’s urge to feed itself more at night, giving way to night-eating syndrome.
Diagnostic Criteria of Night Eating Syndrome (NES)
The diagnosis of NES is based on at least one or more of the following core criteria:
- Increased caloric intake during the evening and night hours, post-dinner (at least 25% of daily intake)
- At least two nocturnal awakenings per week, post-dinner, due to the urge to eat
- Ability to recall episodes of the evening and nocturnal meal intake
Risk Factors of Night Eating Syndrome
The biggest risk factor for NES is underlying mental and physical stress. The stress can be caused due to:
- Body dysmorphia
- Being bullied
- Physical abuse
- Sexual abuse
- Emotional abuse
- Metabolic disorders such as diabetes mellitus
- Improper dieting
- Major accidents
Night Eating Syndrome Symptoms
It is common for NES symptoms to overlap with the rest of the eating disorders. When diagnosing NES, your doctor will obtain a thorough history to study the night-snacking as well as your sleep pattern. A clinical picture is often drawn by assessing you against the following criteria:
- Missing early morning meals due to a lack of desire or satiety. It is possible not to feel hungry at all until the late hours of the afternoon
- The uncontrollable urge to eat between dinner and bedtime
- Facing difficulties in falling asleep or staying asleep for four or more nights a week
- A strong belief that eating is essential for you to fall asleep
- Depression or worsening of mood, especially at night
- Anxiety, insomnia, and depression or worsened mood also occur during the evening, in addition to the hunger pangs between dinner and sleep.
- Sleepiness or tiredness during the daytime
Night eating syndrome symptoms also include the belief to overcome anxiety with the help of late-night food. NES may also make you feel guilty after having endured the coping meals.
Overcoming Night Eating Syndrome
Night eating syndrome is a disease of major concern owing to its high association with obesity and diabetes.
Fortunately, various treatment programs can help with overcoming night eating syndrome.
Night-eating syndrome treatment is not limited to a single strategy. It is a combination of multiple sessions of cognitive behavioral therapies, medications, and mental exercises, the frequency of which is to be determined by a professional.
Cognitive Behavioral Therapy:
Cognitive behavioral therapy or CBT is a form of psychotherapy wherein you talk to a psychiatrist with whom you can express your troubles, which you consider responsible for your NES symptoms. The therapist formulates questions to prompt specific answers from you to form your diagnosis.
A study investigated two kinds of behavioral interventions intended to resolve night-eating syndrome. One of them was progressive muscle relaxation, and the other was behavioral weight loss. Both methods have shown significant results in decreasing the symptoms of night eating disorders. 3Berner, L. A., & Allison, K. C. (2013). Behavioral management of night eating disorders. Psychology Research and Behavior Management, 6, 1-8. https://doi.org/10.2147/PRBM.S31929
Pharmacological Interventions:
SSRIs (selective serotonin reuptake inhibitors) are widely used to treat night-eating syndrome. They are the first-line pharmacotherapy for curing most psychiatric ailments. SSRIs help elevate mood and overcome symptoms of anxiety and OCD, which cumulatively produce night-eating syndrome. Common examples of anti-depressants include Citalopram, Fluoxetine, Sertraline, and Vilazodone.
Melatonin:
Melatonin is a hormone released by the brain that helps regulate your body’s circadian rhythm. People with night-eating syndrome may also suffer from hormonal imbalances. Lack of sleep or a disturbed one could result from inappropriate melatonin in the system, which could explain insomnia in patients with NES. A drug known as Agromelatine promotes melatonin production by acting on various brain centers, thus rectifying the sleep-wake cycle. Agomelatine also has anxiolytic and anti-depressant properties that further help with symptoms of night eating disorder.
Phototherapy:
Just like the melatonin therapy that restores the sleep-wake cycle, light therapy is also effective in resetting your body’s circadian rhythm. You are exposed to a special light for about 15 to 20 minutes daily during a particular hour to regulate your sleep pattern.
Night Eating Syndrome Cures & Preventions
Night-eating syndrome isn’t a preventable disease. However, you can follow certain steps so as to control it for better health and a sleep-wake cycle.
Cut Down on Sugars:
Try to cleanse your kitchen from highly saturated and sugar-loaded foods. Switch to a healthy and balanced diet. Ensure you consume fruits and greens during your hunger pangs instead of carbs.
Regulate Your Sleep:
Set a regular bedtime routine. Make your room as comfortable as you can for a pleasant sleep. Try not to oversleep during the day so your body is tired enough at night. Remove all screens and electronics from your surroundings when preparing to sleep.
Regulate Your Daytime Routine:
In order to avoid the NES symptoms, follow a healthy daytime routine supplemented with physical exercises, a balanced work schedule, and outings, adequate daylight, as well as moonlight exposure, is necessary for a regulated circadian rhythm, which further helps with symptoms of night-eating syndrome.
Avoid Stressors:
As already stated above, NES is triggered by stress. Hence, avoiding the factors that cause you to binge eat before sleeping as much as possible would be best. For instance, avoid studying during nighttime so that your body can relax and attain sleep. Get done with the household chores during the early evening hours so that the thought of an undone task doesn’t haunt you during your sleep.
Exercise a little (e.g., stretching) before going to sleep. Make a schedule for the daytime routine every day.
Conclusion
Night eating syndrome is an eating disorder that is a combination of stress, genetics, and neurological dysfunction. It is characterized by the urge to consume meals post-dinner, accompanied by at least two or more nocturnal awakenings. The disease has been highly associated with diabetes and obesity. Though not preventable, night eating syndrome can be controlled by a combination of behavioral interventions, melatonin substitutes, anti-depressants, and mental exercises.
Refrences
- 1Salman EJ, Kabir R. Night Eating Syndrome. [Updated 2022 Sep 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.
- 2Lamerz, A., Kuepper-Nybelen, J., Bruning, N., Wehle, C., Trost-Brinkhues, G., Brenner, H., Hebebrand, J., & Herpertz-Dahlmann, B. (2005). Prevalence of obesity, binge eating, and night eating in a cross-sectional field survey of 6-year-old children and their parents in a German urban population. Journal of child psychology and psychiatry, and allied disciplines, 46(4), 385–393. https://doi.org/10.1111/j.1469-7610.2004.00363.x
- 3Berner, L. A., & Allison, K. C. (2013). Behavioral management of night eating disorders. Psychology Research and Behavior Management, 6, 1-8. https://doi.org/10.2147/PRBM.S31929