Night Eating Syndrome (NES)

Spotting all the signs and symptoms in an individual can be challenging. Here are the most common signs that have been a good indicator of NES for clinicians.

• Eating large amounts of food during the evening and night time hours
• Eating abnormally large portions of food during night-time meals
• Eating when not hungry
• Feeling out of control when eating at night
• Feeling guilt or shame related to night eating
• Difficulty sleeping and waking up frequently during the night to eat
• Frequently skipping meals during the day or only consuming small amounts during the day
• Weight gain or difficulty managing weight
• Low energy and decreased motivation

NES is a more recently recognised eating disorder, first described in 1955 by Stunkard (et al).

In 2013, the American Psychiatric Association’s fifth edition of their Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognised Night Eating Syndrome as an independent diagnosis in the ‘Eating Disorders’ chapter. Previously, Night Eating Syndrome had been included in the category of Eating Disorder Not Otherwise Specified (EDNOS). This change marks an essential shift in medical understanding of Night Eating Syndrome, recognising it as a distinct condition with its own unique criteria for diagnosis.

The exact cause of NES is unknown. Many experts believe that psychological, biological and environmental factors play a role in the development of this disorder. It may be related to disrupted circadian rhythms (disruptions in sleep cycles), underlying psychological issues such as depression, anxiety, body dissatisfaction, or distorted views about food and weight. Research suggests that some people may have a genetic predisposition to night eating or have learned the behaviour from other family members. Hormone imbalances or changes in serotonin levels in the brain may also be involved.

NES can be diagnosed by consulting a health professional such as a physician, psychologist, or registered dietitian. Individuals can also be screened for NES using standardised questionnaires that assess various aspects of night time eating behaviour and its associated health complications. Blood tests may also be used to rule out any underlying medical conditions that might be causing or contributing to the night eating.

How can Night Eating Syndrome be treated?

NES can be treated with a combination of lifestyle changes, psychotherapy and medication. This is best treated at a rehabilitation facility such as Banbury Lodge, where therapy, education around food and mindfulness techniques can help you develop healthier eating habits and learn the tools to combat damaging behavioural patterns.

Lifestyle changes can help you overcome Night Eating Syndrome. Below is a list of tips and recommendations in order to give you the best possible chance of overcoming the disorder.

• Keep a regular eating schedule. Eat breakfast, lunch, and dinner at approximately the same time each day and avoid late-night snacking or meals.
• Identify triggers that cause you to eat late-night snacks or meals and try to address them. For example, if you find yourself reaching for food when you feel stressed or anxious, find a healthier way to cope with your emotions like going for a walk or talking to someone.
• Avoid keeping tempting snacks in your kitchen. If you have unhealthy snacks around, it may be more difficult to resist the urge to eat them late at night.
• Get enough sleep. Sleep deprivation can increase cravings for unhealthy foods and make it difficult to resist late-night snacking. Aim for 7-9 hours of quality sleep every night.
• Eat regular meals throughout the day. Hunger can lead to overeating late at night, so make sure you’re eating adequate portions of healthy foods throughout the day.
• Talk to a therapist or dietitian if you need help controlling your night eating syndrome. Your healthcare provider can help you develop a plan to address your nighttime eating habits and create healthier eating patterns.

Psychotherapy can help treat NES by teaching the individual positive coping skills for dealing with stress and improving their self-esteem. Through psychotherapy, individuals can develop strategies to better manage stressful situations and feelings, increase their insight and understanding of the issues related to their night eating disorder and create healthier eating habits. Cognitive-behavioural therapy (CBT) can be especially useful in helping individuals with NES learn how to identify distorted thoughts and behaviours associated with their disorder and replace them with constructive ones. Additionally, cognitive-behavioural therapy can teach individuals new ways of thinking while building a greater sense of self-worth, which can reduce the triggers of comforting food cravings that occur due to emotional states. Other types of psychotherapy, such as interpersonal therapy or dialectical behaviour therapy, can also be beneficial in addressing night eating syndrome.

Medication may be used to treat NES if the symptoms are severe or do not respond to other treatments. Medication usually prescribed is an antidepressant which is thought to help regulate sleep/wake cycles and reduce cravings for food at night. Selective serotonin reuptake inhibitors (SSRIs) may also be prescribed for people with NES as they can reduce binge-eating episodes. Other forms of medication, such as stimulants, anti-seizure medications and anti-anxiety drugs, may be used in cases of extreme night eating disorders.

Night eating syndrome is not necessarily dangerous itself, but it can lead to other health-related issues like obesity and diabetes, which can be dangerous. As NES is classed as an eating disorder, it is viewed as being part of behavioural addiction, something that would need to be treated as soon as possible.

People with the disorder may suffer from depression and anxiety, which can affect their overall quality of life. Additionally, they may have difficulty with concentration and performance in daily activities due to their disrupted sleep routine and unhealthy eating habits.

Seeing your loved one go through NES can be difficult, but it’s essential that you offer help to them. Through education and careful planning, it’s possible to help them on their journey to recovery.

Educate yourself about NES
It is crucial to become informed about the disorder, the underlying causes and some possible treatments. This will help you to better understand and support your loved one.
Show compassion
Offer your loved one emotional support and understanding. Let them know that it is not their fault that they have developed this disorder and that you are always there to provide support and assistance.
Create a plan of action
It is important to create a program in consultation with your loved one that includes strategies for managing their symptoms and avoiding triggers for night eating. Consider engaging with a mental health professional, such as a dietitian or therapist, who specialises in eating disorders, to provide additional guidance and support.
Monitor meal times
Monitor meal times, meals, snacks and beverages consumed throughout the day to ensure proper nutrition. Encourage them to have regular meals throughout the day and discourage snacking during the night time hours.
Encourage physical activity
Encourage your loved one to engage in some form of physical activity, even if it is just a short walk around the local area or doing some yoga in their bedroom. Exercise is beneficial for people with NES, as it can help reduce cravings and promote relaxation in a safe environment.

People with NES should get expert help because it can be an indicator of underlying mental health issues, such as depression and anxiety. Night eating can also become a dangerous habit if it leads to excessive calorie consumption and weight gain. With expert help, individuals can learn to manage their symptoms and develop healthier coping mechanisms to address.

Yes. With the proper treatment and support, it is possible to stop having night eating syndrome. It is essential to consult with a mental health professional at Banbury Lodge to develop an individualised treatment plan that is specific to your needs.

If you think you may have NES, it is vital to seek professional help.

Banbury Lodge Clinic can help with the disorder by providing a rehabilitation treatment programme. This could include individual psychotherapy, group therapy, nutrition therapy and medication management. The team will work with the individual to develop a tailored treatment plan to address their needs and help them break their night eating disorder. Education about healthy eating and meal planning can also empower the individual to take more control of their eating habits. The clinic can provide support to help the individual manage their emotions and make positive lifestyle changes.