Night eating syndrome
Encyclopedia
Night eating syndrome, or NES, is an emerging eating disorder
diagnosis, which primarily characterizes an ongoing, persistent pattern of late-night binge eating
.
NES was originally described by Dr Albert Stunkard in 1955 and is currently proposed for inclusion in the next edition of the Diagnostic and Statistical Manual of Mental Disorders
. The diagnosis is controversial; its validity and clinical utility have been questioned and there are currently no official diagnostic criteria.
It affects between 1 and 2% of the population. Although it can affect all ages and both sexes, it is more common in young women. People with NES were shown to have higher scores for depression and low self-esteem, and it has been demonstrated that nocturnal levels of the hormones melatonin and leptin are decreased. NES is often accompanied by or confused with nocturnal sleep related eating disorder
, which is primarily a sleep disorder
rather than an eating disorder, in which people are unaware of having eaten while asleep. There is debate as to whether these should be viewed as separate diseases, or part of a continuum.
To be considered a bona fide disorder, this pattern should continue for two months or more.
were found to suffer from NES in one study. The disorder is accompanied by what sufferers describe as an uncontrollable desire to eat, akin to addiction
, and is often treated chemically.
The selective serotonin reuptake inhibitor, Sertraline
(or Zoloft) has shown some ability to help NES sufferers.
Therapy to increase the natural nocturnal rise in melatonin, reduce the body's adrenal stress response and raise leptin
levels or improve leptin sensitivity are options that may help these patients overcome the disorder. Another key may involve the availability of tryptophan, an important amino acid, in the body. More than 70% of the night time eating to combat anxiety
involved binging on carbohydrates. These foods are believed to increase the amount of tryptophan
available for conversion to serotonin
, the calming neurotransmitter
in the brain that promotes an overall sense of well-being and, in turn, converts to melatonin
.
Eating disorder
Eating disorders refer to a group of conditions defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual's physical and mental health. Bulimia nervosa, anorexia nervosa, and binge eating disorder are the most common specific...
diagnosis, which primarily characterizes an ongoing, persistent pattern of late-night binge eating
Binge eating
Binge eating is a pattern of disordered eating which consists of episodes of uncontrollable eating. It is sometimes as a symptom of binge eating disorder. During such binges, a person rapidly consumes an excessive amount of food...
.
NES was originally described by Dr Albert Stunkard in 1955 and is currently proposed for inclusion in the next edition of the Diagnostic and Statistical Manual of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
. The diagnosis is controversial; its validity and clinical utility have been questioned and there are currently no official diagnostic criteria.
It affects between 1 and 2% of the population. Although it can affect all ages and both sexes, it is more common in young women. People with NES were shown to have higher scores for depression and low self-esteem, and it has been demonstrated that nocturnal levels of the hormones melatonin and leptin are decreased. NES is often accompanied by or confused with nocturnal sleep related eating disorder
Nocturnal sleep related eating disorder
Nocturnal Sleep-Related Eating Disorder , also known as Sleep-Related Eating disorder , sleep eating, or somnambulistic eating, is a combination of a parasomnia and an eating disorder. John W...
, which is primarily a sleep disorder
Sleep disorder
A sleep disorder, or somnipathy, is a medical disorder of the sleep patterns of a person or animal. Some sleep disorders are serious enough to interfere with normal physical, mental and emotional functioning...
rather than an eating disorder, in which people are unaware of having eaten while asleep. There is debate as to whether these should be viewed as separate diseases, or part of a continuum.
Symptoms and behavior
People who suffer from night eating syndrome generally:- Skip breakfastBreakfastBreakfast is the first meal taken after rising from a night's sleep, most often eaten in the early morning before undertaking the day's work...
, and go several hours after waking before their first meal. - Consume at least 25% of their calories after dinner. (Many sources would list this as after 9 or 10 pm; dessert is generally not included, if one is eaten.)
- Late-night binges almost always consist of consuming carbohydrates. However, this eating is typically spread over several hours, which is not consistent with a typical eating bingeBinge eatingBinge eating is a pattern of disordered eating which consists of episodes of uncontrollable eating. It is sometimes as a symptom of binge eating disorder. During such binges, a person rapidly consumes an excessive amount of food...
as evidenced by other eating disorders. Episodes of late-night binge-eating can be repeated throughout the night, with many separate visits to the fridge or cupboard.
- Late-night binges almost always consist of consuming carbohydrates. However, this eating is typically spread over several hours, which is not consistent with a typical eating binge
- Suffer from depressionClinical depressionMajor depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
or anxietyAnxietyAnxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
, often in connection with their eating habits.- These night eating episodes typically bring guilt rather than hedonistic enjoyment.
- Have trouble sleeping in general; see insomniaInsomniaInsomnia is most often defined by an individual's report of sleeping difficulties. While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions:...
.- Are more likely than the general public to sleepwalkSleepwalkingSleepwalking, also known as somnambulism, is a sleep disorder belonging to the parasomnia family. Sleepwalkers arise from the slow wave sleep stage in a state of low consciousness and perform activities that are usually performed during a state of full consciousness...
.
- Are more likely than the general public to sleepwalk
To be considered a bona fide disorder, this pattern should continue for two months or more.
Treatment
Night eating disorder tends to lead to weight gain; as many as 28% of those seeking gastric bypass surgeryGastric bypass surgery
Gastric bypass procedures are any of a group of similar operations that first divides the stomach into a small upper pouch and a much larger lower "remnant" pouch and then re-arranges the small intestine to allow both pouches to stay connected to it. Surgeons have developed several different ways...
were found to suffer from NES in one study. The disorder is accompanied by what sufferers describe as an uncontrollable desire to eat, akin to addiction
Behavioral addiction
Behavioral addiction is a form of addiction which does not rely on drugs or alcohol. Increasingly referred to as process addiction or non-substance-related addiction ) behavioral addiction includes a compulsion to repeatedly engage in an action until said action causes serious negative consequences...
, and is often treated chemically.
The selective serotonin reuptake inhibitor, Sertraline
Sertraline
Sertraline hydrochloride is an antidepressant of the selective serotonin reuptake inhibitor class. It was introduced to the market by Pfizer in 1991. Sertraline is primarily used to treat major depression in adult outpatients as well as obsessive–compulsive, panic, and social anxiety disorders in...
(or Zoloft) has shown some ability to help NES sufferers.
Therapy to increase the natural nocturnal rise in melatonin, reduce the body's adrenal stress response and raise leptin
Leptin
Leptin is a 16 kDa protein hormone that plays a key role in regulating energy intake and energy expenditure, including appetite and metabolism. It is one of the most important adipose derived hormones...
levels or improve leptin sensitivity are options that may help these patients overcome the disorder. Another key may involve the availability of tryptophan, an important amino acid, in the body. More than 70% of the night time eating to combat anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
involved binging on carbohydrates. These foods are believed to increase the amount of tryptophan
Tryptophan
Tryptophan is one of the 20 standard amino acids, as well as an essential amino acid in the human diet. It is encoded in the standard genetic code as the codon UGG...
available for conversion to serotonin
Serotonin
Serotonin or 5-hydroxytryptamine is a monoamine neurotransmitter. Biochemically derived from tryptophan, serotonin is primarily found in the gastrointestinal tract, platelets, and in the central nervous system of animals including humans...
, the calming neurotransmitter
Neurotransmitter
Neurotransmitters are endogenous chemicals that transmit signals from a neuron to a target cell across a synapse. Neurotransmitters are packaged into synaptic vesicles clustered beneath the membrane on the presynaptic side of a synapse, and are released into the synaptic cleft, where they bind to...
in the brain that promotes an overall sense of well-being and, in turn, converts to melatonin
Melatonin
Melatonin , also known chemically as N-acetyl-5-methoxytryptamine, is a naturally occurring compound found in animals, plants, and microbes...
.