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Saturday, September 22, 2007

Night Eating Syndrome (NES) -- Sign Diagnose, Symptoms, Triggers, Prevention and Treatment

Do You Have Night-eating Syndrome?
  • You eat 50 percent or more of your daily food intake after dinner
  • You have no appetite for breakfast
  • You have trouble falling and/or staying asleep
  • When you wake up during the night you often eat
  • The foods you eat at night are mostly carbohydrates
When you’re spending more time each night in the kitchen than in the bedroom, you may have a newly identified eating disorder. Called night-eating syndrome (NES), the condition is characterised by a lack of appetite for breakfast; the consumption of more than 50 percent of daily calories after the evening meal, and waking up, at least, once a night to consume high-carbohydrate snacks. To receive a diagnosis of NES, symptoms must have continued for a minimum of three months.

If you have any combination of these signs, consult your doctor.

What is Night Eating Syndrome?

A new eating disorder spells a nightmare for those who suffer from it. Night eating syndrome is an eating disorder that has only been recognized as such since 1999, and affects between 1 and 2% of the population. NES is also characterized as a sleeping disorder. NES is often accompanied by or confused with sleep-related eating disorder (SRED), although the two are distinct.

Night Eating Syndrome is a disorder where the affected individual wakes multiple times during the night and is unable to fall back asleep unless they eat something. Foods eaten during the binge are often high caloric in content and unhealthy. The night eating behavior seems totally beyond the effected individual's control. For these individuals, 35% or more of their calories are eaten after dinnertime. Following the night binge, the person is often not hungry in the morning. Individuals suffering from Night Eating

This is an ongoing, persistent behavior, unlike the occasional late snack or skipped meal that most people have from time to time. In fact, people with this disorder are often unaware of their nocturnal meals, although some feel they won't be able to sleep without eating first. ( Note: a person falls asleep more easily on a full stomach. ) Among those who are aware of their night eating, there is often an emotional component; the diet of the night eater is comfort food.

What are the symptoms or behavior of NES?

People who suffer from night eating syndrome generally:
  • Skip breakfast, and go several hours after waking before their first meal.
  • Consume at least half their calories after dinner. (Many sources would list this as after 9 or 10 pm; dessert is generally not included, if one is eaten. ). Late night binges almost always consist of carbohydrates. However, this eating is typically spread over several hours, which is not consistent with a typical eating binge as seen in other eating disorders.
  • Suffer from depression or anxiety, often in connection with their eating habits. These night eating episodes typically bring guilt rather than hedonic enjoyment.
  • Has trouble sleeping in general; see insomnia. Is more likely than the general public to sleepwalk.

To be considered a bona fide disorder, this pattern should continue for two months or more. Syndrome are often caught in the vicious cycle of binge eating during the night and eating less during the day.

Are there Specific Triggers for NES ?

Triggers for Night Eating Syndrome include
  • depression
  • anxiety
  • interpersonal stressors
  • boredom
  • prolonged dieting
  • body image dissatisfaction

Night eating may temporarily relieve the stress of these unwanted feelings, but for the night eater these episodes are unfortunately followed by feelings of guilt, shame, disgust, and further depression. For the person suffering from NES, the eating episodes usually occur in secret and any evidence is often hidden from others. Similar to Anorexics, Bulimics, and Compulsive Overeaters, individuals suffering from NES are often struggling and unhappy with their weight. It is estimated that up to one percent of the population may be suffering from NES. Like Anorexia Nervosa Bulimia Nervosa, and Compulsive Overeating, NES is a disease and cannot be cured with willpower alone.

How is NES different from Binge Eating and Bulimia?

It is different from binge eating and bulimia. Individuals with night eating disorder consume relatively small snacks (with high calorie content) at night but far more frequently. Individuals with binge eating disorder and/or bulimia have very large and infrequent binges.

Can NES be Treated?

Yes. If you suspect that a family member has NES. Suggest that your family member see an eating disorder expert. Be prepared for denial, resistance, and even anger. A doctor and/or a counselor can help them battle their eating disorder. Treatment involves counseling, and paying attention to medical and nutritional needs.

The treatment should be tailored to the individual and will vary according to both the severity of the disorder and the patient's particular problems, needs, and strengths.

NES tends to lead to weight gain; as many as 28% of those seeking gastric-bypass surgery were found to suffer from NES in one study. In fact, while sufferers are not always overweight, one in four people who are overweight by 100 lbs or more are thought to suffer from night eating syndrome. The disorder is accompanied by what sufferers describe as an uncontrolable desire to eat, akin to addiction, and is often treated chemically.

Therapy to increase the natural nocturnal rise in melatonin, reduce the body's adrenal stress response and raise leptin levels or improve leptin sensitivity are options that may help these patients overcome the disorder. Another key may involve the availability of tryptophan, an important amino acid, in the body. More than 70% of the nighttime eating to combat anxiety involved binging on carbohydrates. These foods are believed to increase the amount of tryptophan available for conversion to serotonin, the calming neurotransmitter in the brain that promotes an overall sense of well-being and, in turn, converts to melatonin.

The antidepressant drug Zoloft has shown some ability to help NES sufferers.

NOTE: Addressing hormonal and biochemical imbalances in patients with chronic eating and mood disorders can be crucial for uncovering fundamental causes and contributing factors that underlie cyclical, habitual patterns of insomnia, overeating, and depression.

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