Night Eating Syndrome

  • Signs and symptoms
    • The person has little or no appetite for breakfast. Delays first meal for several hours after waking up. Is not hungry or is upset about how much was eaten the night before.
    • Eats more food after dinner than during that meal.
    • Eats more than half of daily food intake during and after dinner but before breakfast. May leave the bed to snack at night.
    • This pattern has persisted for at least two months.
    • Person feels tense, anxious, upset, or guilty while eating.
    • NES is thought to be stress related and is often accompanied by depression. Especially at night the person may be moody, tense, anxious, nervous, agitated, etc.
    • Has trouble falling asleep or staying asleep. Wakes frequently and then often eats.
    • Foods ingested are often carbohydrates: sugary and starch.
    • Behavior is not like binge eating which is done in relatively short episodes. Night-eating syndrome involves continual eating throughout evening hours.
    • This eating produces guilt and shame, not enjoyment.
  • How many people have night-eating syndrome?

Perhaps only one to two percent (1-2%) of adults in the general population have this problem, but research at the University of Pennsylvania School of Medicine suggests that about six percent of people who seek treatment for obesity have NES. Another study suggests that more than a quarter (27%) of people who are overweight by at least 100 pounds have the problem.

  • Comments

Night-eating syndrome has not yet been formally defined as an eating disorder. Underlying causes are being identified, and treatment plans are still being developed. It seems likely that a combination of biological, genetic, and emotional factors contribute to the problem. Stress appears to be a cause or trigger of NES, and stress-reduction programs, including mental health therapy, seem to help.

Researchers are especially interested in the foods chosen by night eaters. The heavy preference for carbohydrates, which trigger the brain to produce so-called “feel-good” neurochemicals, suggests that night eating may be an unconscious attempt to self-medicate mood problems.

NES may run in families. At this time is appears to respond to treatment with the SSRI sertraline (a prescription medication). NES is remarkable for characteristic disturbances in the circadian rhythm of food intake while the circadian sleep rhythm remains normal.

If you are seeking help for night-eating syndrome, you would be wise to schedule a complete physical exam with your physician and also an evaluation with a counselor trained in the field of eating disorders. In addition, a dietitian can help develop meal plans that distribute intake more evenly throughout the day so that you are not so vulnerable to caloric loading in the evening.

Recent research was summarized by Albert Stunkard, MD, University of Pennsylvania School of Medicine, at the NAASO 2003 annual meeting, October 13, 2003. A formal paper will be presented in the January issue of the International Journal of Eating Disorders.