Night eating syndrome

Night eating syndrome, or NES, is an emerging eating disorder diagnosis, which primarily characterizes an ongoing, persistent pattern of late-night binge eating.^[1][2] NES was originally described by Dr Albert Stunkard in 1955^[3] and is currently proposed for inclusion in the next edition of the Diagnostic and Statistical Manual of Mental Disorders.^[4] The diagnosis is controversial; its validity and clinical utility have been questioned^[5] and there are currently no official diagnostic criteria. It affects between 1 and 2% of the population.^[6] Although it can affect all ages and both sexes, it is more common in young women.^[7] 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.^[8] 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.^[9]

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 25% of^[10] 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 late-night binge-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 selective serotonin reuptake inhibitor, Sertraline (or Zoloft) has shown some ability to help NES sufferers.^[14]

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.^{[citation needed]}

See also

• Nocturnal sleep related eating disorder

References

1. ^ "Night bingeing recognised as a disorder". BBC News. April 20, 1999. http://news.bbc.co.uk/2/hi/health/324054.stm. Retrieved May 20, 2010. 
2. ^ eMedicine - Parasomnias : Article Excerpt by Sat Sharma
3. ^ The night-eating syndrome; a pattern of food intak...[Am J Med. 1955] - PubMed Result
4. ^ PubMed ID 19683608
5. ^ PubMed ID 19621465
6. ^ ANRED: Night Eating Syndrome
7. ^ Nocturnal Eating Syndrome (Sleep Eating) Information
8. ^ JAMA - Abstract: Behavioral and Neuroendocrine Characteristics of the Night-Eating Syndrome, August 18, 1999, Birketvedt et al. 282 (7): 657
9. ^ Sleep-Related Eating Disorders
10. ^ . PMID 19683608. 
11. ^ Night Eating Syndrome Is Associated with Depression, Low Self-Esteem, Reduced Daytime Hunger, and Less Weight Loss in Obese Outpatients - Gluck et al. 9 (4): 264 - Obesity
12. ^ Other Types of Eating Disorders - The Something Fishy Website on Eating Disorders
13. ^ Doughnuts in the Dark - Newsweek Health - MSNBC.com
14. ^ John P. O'Reardon, Albert J. Stunkard, Kelly C. Allison, Clinical trial of sertraline in the treatment of night eating syndrome. International Journal of Eating Disorders, Volume 35 Issue 1, Pages 16 - 26