Night Eating Syndrome
Night eating syndrome is a disorder in which a person consumes more than half of his or her daily calories after eight o'clock in the evening. It is characterized by overeating at night, accompanied by agitation and insomnia, and a lack of appetite in the morning. People with NES have recurrent awakenings from sleep requiring them to eat to be able to fall back asleep. The disorder affects both men and women but is more common in women. Approximately 10 to 15 percent of people with eating disorders are affected by sleep-related eating disorders.
According to Dr. Albert Stunkard at the University of Pennsylvania's Weight and Eating Disorders program, NES is a disorder of mood and sleep as well as an eating disorder. For this reason, treatment options vary.
The first step in night eating disorder treatment is to consult a physician to obtain a proper diagnosis. Your physician can then determine the cause of your disorder and develop a strategy to manage it. Counselors and nutritionists can also offer helpful advice. While medication can be helpful, a person might need additional treatments to release stress and anxiety, such as stress management classes, assertiveness training, psychological or nutritional counseling and limiting intake of foods containing alcohol and caffeine.
Night Eating Disorder Treatment
Night eating syndrome can have several different causes, and there are different treatments for each cause. It can be the result of hormone imbalances, excessive stress and underlying mood and eating disorders such as anxiety, depression, self-starvation and food addiction.
Hormone Supplements – Hormone imbalances, including low levels of the hormones melatonin, leptin and serotonin, can disrupt normal sleeping cycles and negatively affect eating patterns. If your physician finds a chemical imbalance, hormone supplements can help your body create normal sleeping cycles. Dr. Albert Stunkard feels that night eating may be a way that people experiencing stress, anxiety or depression may be trying to self-medicate. Snacking, especially on carbohydrates, will help increase serotonin levels in the brain, which helps induce sleep.
Medications – If underlying depression and anxiety are the cause, antidepressants called SSRI's, or selective serotonin reuptake inhibitors, may be prescribed. Both depression and anxiety can lead to emotional binge eating. Typically people turn to carbohydrate-rich foods which stimulate the production of serotonin to help them sleep. An antidepressant will help increase serotonin levels, lessening the need for food binges.
Psychotherapy – A psychotherapist can help with uncovering the underlying issues that are causing the disorder and help you learn to cope with these issues in a new way that doesn't involve food. Group therapy, too, can offer opportunities to discuss your problems and find support in managing night eating.
Nutritional Counseling – A nutritionist can offer night eating disorder treatment by teaching you the proper eating and exercise skills needed to live a healthier lifestyle. Registered dietitian Anne Fletcher recommends an evening snack of 300 calories or less as part of the total day's calories as a way to keep blood sugar levels stable throughout the night. She also recommends adding a "meal-termination" ritual as a way of finalizing a meal. It could be something like a cup of tea, brief prayer of thanks or even a short walk in the evening after a meal. The ritual helps transition from the behavior of eating to the behavior of sleep and rest.
Topiramate – A small study reported in the May, 2003 issue of Sleep Medicine found that topiramate, or Topamax, an anticonvulsant drug used primarily for prevention of migraines and treatment of epilepsy, was helpful in treating NES. Though the mean dose was 218 mg, three patients found improvement at 100 mg of the drug. Notable weight loss was observed in all patients.
Do keep in mind that the information provided above is not meant as a substitute for diagnosis from a medical professional. If you suspect that you may be suffering from night eating disorder, or would like to explore the night eating disorder treatment options, contact a certified physician in your area.