Night Eating Syndrome: when night eating becomes a nightmare 

Does it feel like your eating pattern is off? Perhaps you have no appetite in the morning but feel ravenous at the end of the day. You feel like you need to eat even to just fall asleep.  You can even wake up in the middle of the night hungry with the urge to eat.

What we’re talking about here today is a real phenomenon called Night Eating Syndrome. Technically considered an eating disorder, its prevalence is 1.5% of the population. Over time it can lead to weight gain and Obesity. Among patients seeking weight loss treatment, the prevalence can reach as high as 10%.

This eating disorder was first conceptualized in 1955 by the psychiatrist, Dr. Stunkard. Its introduction into the DSM however is only very recent. In fact, current DSM-5 criteria are still research criteria. We anticipate the criteria will be refined further in the future.

Night eating syndrome is nevertheless characterized by morning anorexia (eg. no appetite in the morning), evening hyperphagia (eg. nighttime overeating) and insomnia that is more pronounced during times of stress. It is also associated with poor weight loss success despite effort.

The eating disorder is genetic and characterized by a disruption in the normal neuroendocrine circadian rhythm. However, it’s not the sleeping rhythm that is disrupted. The sleeping rhythm is normal, it’s the appetite rhythm that is delayed. This makes us not hungry in the morning and very hungry in the late evening.

All of this is due to a reduced nocturnal rise of melatonin (which should rise in response to the sun going down). The attenuated response of Melatonin sets a disrupted downstream cascade onto other hormones which sets the stage for night eating.

Over time, Night Eating Syndrome can lead to Obesity as well as Type 2 Diabetes. Among people with Type 2 Diabetes, Night Eating Syndrome is one of those common eating disorders (after Binge Eating Disorder and Bulimia Nervosa).

Night Eating Syndrome has medical treatments available. As always, speak to your doctor about this if you think you might have Night Eating Syndrome.

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