According to the Diagnostic and Statistical Manual of Mental Illness (DSM-5), night eating syndrome (NES) falls under the category of OSFED (other specified feeding or eating disorder).
Night eating syndrome is characterized by recurrent episodes of night eating, defined as eating late at night either prior to bed or actually awakening at night to eat. Night eating is not explained by changes in the sleep-wake cycle (night shift work), medication effects, binge eating disorder, substance use disorders, or other general medical disorders. (1) Those with night eating syndrome have episodes of eating more than 25% of their daily caloric intake at night, or when they wake up in the middle of the night. He or she will do this often a few times per week. (5)
NES can look and feel like binge-eating disorder (BED), but they have some notable differences. Those with NES eat fewer meals during the day and eat primarily at night. Studies show that those with BED eat more during the day and tend to have more objective bulimic and overeating episodes, shape/weight concerns, disinhibition, and hunger cravings than NES. (2)
Men are more likely to have NES than BED, and those with NES tend to have a higher body mass index than those with BED, but do not necessarily have to be overweight to meet criteria for the diagnosis. (3) People who suffer from NES are associated with mood, anxiety, and sleep problems. (4)
Although NES was first described in 1955, research has progressed slowly on its etiology, diagnosis, and treatment. The current recommended treatments include medication and cognitive behavioral therapy, but not many of the proposed treatment options for NES have been promising, or illustrated any long-term efficacy. (6)
More research needs to be done to characterize if NES is a sleep disorder, delayed circadian eating rhythm, or a metabolic condition. (6) Adolescents that struggle with depression, high levels of stress, and insomnia are at risk for developing NES as adults. (8) When battling with mental illness and ruminations at night, eating brings a form of comfort. Food triggers pleasure areas within the brain, which temporarily relieve pain from distressing thoughts. Ultimately, this helps people to fall asleep.
The best way to stop eating at night, if you believe there’s an underlying disorder, is to speak to your doctor and seek out treatment for night eating syndrome. Some strategies for treating NES include avoiding daytime restriction, practicing good sleep hygiene, and developing mindful, or intuitive, eating habits.
NES can emerge when people heavily restrict themselves throughout the day (i.e. diet), which can lead to binging at night, as part of the binge/restrict cycle. While intermittent fasting is one recommended way to lose weight, it may cause some individuals to have extreme rebound hunger after restricting all day and then binging at night.
Principles of good sleep hygiene include: (9)
Mindful Eating is just one philosophy on how to maintain a healthy psychological relationship with food. It focuses on making peace with all types of food, while dissolving the stigma of “good” and “bad” foods.
In 1995, dieticians Evelyn Tribole and Elyse Resch outlined and published The 10 Principles of Intuitive Eating to guide patients on their mindful road to recovery. The principles include: (10)
Mindful eating is just one practice that can be helpful to individuals looking to re-examine their psychological relationship to food, particularly in patients recovering from NES or other eating disorders.
