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Night Eating Syndrome

Summer holidays are around the corner. In these months, lifestyle and habits leads people to spend most of the night hours eating, especially when they are enjoying the company of their friends.  This confuses the body’s biological clock. If this occurs continuously, it disrupts the sleeping instinct and may become a chronic condition which is referred to as Night Eating Syndrome (NES).

People with NES don’t eat properly during meal times and consume more food is at night. Furthermore, people with NES usually consume more pre-prepared ready-to-eat food, which is less healthy. Night eating becomes a self-perpetuating cycle that can be difficult to break. This is dangerous as NES is an eating disorder syndrome, which is clinically significant because of its association with obesity, diabetes and heart disease.

Signs and Symptoms
Night eating syndrome  is characterized by more than 50% of caloric intake being consumed after 7 PM; this is accompanied by difficulty getting to sleep or staying asleep, lack of  appetite for breakfast, nighttime awakening (one or more episodes per night) with full alertness and frequently accompanied by ingestion of snacks. To receive a diagnosis of NES, symptoms must persist for at least three months.

In order to find out whether you have NES answer two simple questions; “Are you troubled by overeating in the evening or night?” and “Do you get up at night to eat?”  If the answer is yes, you may have NES.

How Common is NES?
It has been documented that 1.5% of the general population globally suffers from NES. About 26% of people who are overweight by at least 100 pounds have this problem. According to studies 52% of all obesity follows the onset of NES. Similarly, 50% of the night-eaters are overweight.

Causes of NES
Combination of biological, genetic and emotional factors contribute to the problem. It is difficult to pinpoint the causes of NES because it combines elements of depression, an eating disorder, and a sleep disorder.

Three hormones play a significant role in causing this eating disorder.

  1. Melatonin - 5the hormone helps us to fall asleep and stay asleep at night-is reduced in NES sufferers
  2. Leptin- the hormone that suppresses appetite - doesn’t rise to normal levels in night eaters. This suggests that their hunger pangs may be extreme enough to disturb sleep
  3. Cortisol- often called the “stress hormone” is elevated for those with NES.  This hormone entices them to wake up and snack again

In summary, these hormones do not serve their usual functions of maintaining sleep and suppressing hunger and as a result the person’s stress hormone increase. Unlike binge eating disorder, where 2000-3000 kcal may be consumed in one episode, people with NES tend to be snackers who don’t consume more than 400 kcal during each awakening throughout the night. Unlike binge eating disorder, many researchers tend to view NES as more of a stress disorder than an eating disorder.

Treatment includes pharmacotherapy, cognitive behavior therapy, and interventions that reduce the impact of stress. As NES involves eating, qualified nutritionists and dietitians should be actively participating in addressing it.  The nutritionist/dietitian can develop meal plans that contribute dietary intake more evenly throughout the day and avoid caloric loading in the evening.

Indeed, the counseling provided by a nutritionist could be the only intervention required to break out of this syndrome. After the behavioral aspects are resolved, a dietitian will be able to provide an eating plan geared to minimize night time hunger or counsel patients on better food choices during awakening at night.

NES is a dangerous vicious cycle that is a very easy to adopt but very difficult to break. Think twice before eating at night.


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