Night eating syndrome

Night eating syndrome, or NES, is an eating disorder, parasomnia, and mood disorder primarily characterized by a pattern of late-night binge eating.^[1][2] NES has only been recognized by the general community since 1999, even though it was initially described by Dr. Albert Stunkard in 1955. ^[3] It affects between 1 and 2% of the population.^[4] Although it can affect all ages and both sexes, it is more common in young women.^[5] NES is also characterized as a sleeping disorder.^[6] 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.^[7]

This is an ongoing, persistent behavior, not an occasional late snack or skipped meal. People with this disorder are often unaware of their nocturnal meals,^[5] although some feel they won't be able to sleep without eating first, as people fall asleep more easily on a full stomach.^{[citation needed]} Among those who are aware of their night eating, there is often an emotional component; the diet of the night eater is comfort food. People with NES were shown to have higher scores for depression and low self-esteem. Nocturnal melatonin and leptin are decreased ^[8]. Possibly, low serotonin levels may play a role as some cases of NES respond to SSRIs ^[9]. Certain medication and alcohol can make sleepwalking more likely in an individual prone to these episodes. In Australia, Stilnox (a medication distributed in the United States as Ambien) was found to cause sleepdriving and sleepeating as side effects by the Australian drug agency.^[10] However, the connection between Ambien and sleep eating has not been proven by peer-reviewed scientific studies, and the link between the two remains inconclusive.

Symptoms and behavior

People who suffer from night eating syndrome generally:

• Skip breakfast, and go several hours after waking before their first meal.
• Consume at least half 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 binge as evidenced by other eating disorders. Episodes of sleep-eating can be repeated throughout the night, with many separate visits to the fridge or cupboard.
• Suffer from depression or anxiety, often in connection with their eating habits.^[11]
  • These night eating episodes typically bring guilt rather than hedonistic enjoyment.
• Have trouble sleeping in general; see insomnia.^[12]
  • 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 surgery were found to suffer from NES in one study.^[13] The disorder is accompanied by what sufferers describe as an uncontrollable desire to eat, akin to addiction, and is often treated chemically.

The antidepressant drug Zoloft has shown some ability to help NES sufferers.^{[citation needed]}

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 nighttime 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.^{[citation needed]}

See also

• Nocturnal sleep related eating disorder

References