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Night Eating Syndrome – It’s Not Just You and Your Fridge

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Understanding and Treatment Approaches for Night Eating Syndrome

Night eating syndrome (NES) is often misunderstood as an eating disorder and is frequently undertreated. While slightly more common among men, NES requires treatment in 1-2% of the general population. Recognizing night eating syndrome symptoms is the first important step for many individuals, since it is often mistakenly viewed as merely eating at unusual times or having no willpower over snacking. Neither is true.

NES is an eating disorder that falls under the EDNOS diagnostic category. EDNOS is the abbreviation for Eating Disorders Not Otherwise Specified, and refers to eating issues that aren’t diagnosed as purely anorexia nervosa, bulimia nervosa, and binge-eating disorder (BED). Eating disorders aggregated into the EDNOS category require professional intervention, and can be just as serious as anorexia, bulimia, or BED.

Recognizing the Symptoms of Night Eating Syndrome

An ongoing and persistent pattern of late-night binge eating is the most general definition of NES.

Night eating syndrome symptoms include:

  • Waking up at night and eating, at least three times a week
  • Lack of appetite in the morning
  • Eating at least 25% daily calories after supper, with some people eating over 50%
  • Being unable to go back to sleep without eating
  • Some individuals do not remember these persistent episodes of eating in the middle of the night
  • Increase in these behaviors when under periods of stress
  • Has been seen in tandem with some individuals with restless leg syndrome (RES)

These types of symptoms have been recognized in medical journals since the 1950’s, but it remains a somewhat controversial eating disorder to identify completely. Dr. Sylvia R. Karasu, MD, discusses these diagnostic challenges and the historical references to NES in her book The Gravity of Weight.

Symptoms and Associated Issues Seen in NES

Medical professionals and scientists do not completely understand the reasons why someone develops NES or what causes this challenging eating disorder. Connections have been made between emotions that alter brain chemistry, and the exacerbation of night eating syndrome symptoms.

Emotions that are often present in someone with NES includes:

  • Depression
  • Anxiety
  • Embarrassment and guilt related to the eating behaviors

Those with NES often have difficulty sleeping, including sleep apnea. Treatment involves the identification and evaluation of the presence and persistence of NES eating patterns, associated mental health issues, and sleep disorders. As with any type of eating disorder treatment, the treatment approach must be tailored to the person with NES.

Treatment Approaches for NES

Cognitive Behavioral Therapy (CBT) is commonly used in treating individuals with NES. This type of therapy is helpful for both the eating behaviors, and the emotional aspects that are present. Medication may be utilized for anxiety, depression, insomnia, restless leg syndrome, and other persistent problems when CBT is completely effective. Family therapy is also important, since family members often mistakenly assume these overeating behaviors are completely by choice.

Coping skills, anger management, and stress management therapy is all extremely helpful for night eating syndrome. The ultimate goal is to break the cycle of night eating, normalize any weight issues that may be present, and treat co-occurring mental health issues.

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