What Is Night Eating Syndrome (NES)?

NES, or Night Eating Syndrome is another relatively new diagnosis among all the different eating disorders.

It was first recognised by Dr Albert Stunkard in 1955, and has been estimated to effect between 1% and 2% of the population.

The diagnosis of NES has been much debated and is currently under consideration for inclusion into the DSM1V, which is the official psychiatric diagnostic ‘manual’.

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The main characteristics of Night Eating Syndrome are:

A pattern of late night Binge Eating that has continued for three months or more
Over half the individuals daily calories are consumed after their evening meal, and mostly after around 8pm
Missing breakfast and often not eating until several hours after waking
Insomnia: Difficulty getting to sleep, and also patterns of waking in the night only to have difficulty getting back to sleep unless having something to eat again
The late night binge eating is usually spread over several hours
NES Sufferers are more likely to experience sleep walking than the general population
There is a higher than normal incidence of anxiety, depression and low self esteem.
Experience feelings of not being in control of their eating, and feelings of having a ‘food addiction’
Feelings of guilt or shame regarding the problem
Snacks eaten in the evening are often high in carbohydrates

Night Eating Syndrome can sometimes be connected with (and understandably confused with) ‘Nocturnal Sleep Related Eating Disorder’. This is a sleep disorder where the individual is actually unaware that they are eating in their sleep (like sleep walking). There is debate in the medical community as to how much the two conditions may be related.

Biochemical Imbalances.

Recent studies have shown that sufferers of NES show decreased evening levels of the hormones Melatonin and Leptin. The significance of this is that Melatonin is a hormone that promotes sleep, and Leptin is a chemical that suppresses appetite. And while in normal situations both of these should be elevated in the evening, the reverse seems to be the case with NES sufferers.

This could well go some way to explaining the sleeplessness and increased appetite!

Another hormonal imbalance concerns Cortisol. In sufferers of night eating disorders, Cortisol levels are found to be raised. Cortisol is a stress hormone and in normal circumstances this would be lower in the evening. However, whether raised Cortisol levels are a contributory cause of the condition, or an effect resulting from the increased stress levels created by the disorder, is unclear.

Treatment for NES currently often involves taking presribed SSRIs (Selective Serotonin Re-uptake Inhibitors) which are forms of antidepressant including Fluoxetine (Prozac). These have been found useful due to their effect on the Serotonin levels in the brain. Serotonin promotes calm and helps counteract cravings and is involved in the production of Melatonin which aids sleep.

And this ties in with a theory that by binge eating mainly on high carbohydrate foods, the Night Eating Syndrome sufferer is (subconsciously) self-medicating themselves, as when carbohydrates are eaten, they allow an amino acid called Tryptophan to cross the blood / brain barrier to be used in the production of Serotonin.

Along with any medication, then therapy or counselling should also be involved aimed at helping the client address: