Night Eating Syndrome is an eating disorder that occurs mainly in adults – especially women. This syndrome may have its onset alone or be associated with other eating disorders such as bulimia and bulimia.
What is night eating syndrome?
Night Eating Syndrome (NES) is one of the most common eating disorders. This term refers to eating very little during the day, the first meal usually taking place in the afternoon and a tendency to eat a lot at night.
People with NES often lose their appetite in the morning and hardly feel hungry. Food intake during the day is usually very small. However, at night, cravings urge the patient to eat more and the amount of food provides about ¼ calories of the day. Similar to other types of eating disorders, patients with binge eating disorder experience feelings of shame, depression, and guilt about their eating habits.
Night eating syndrome was first mentioned in 1955 by the psychiatrist Albert Stunkard. Although many studies have been done, this syndrome was only recognized as an eating disorder not long ago. According to statistics, about 1.5% of the world’s population suffers from night eating syndrome and usually occurs in people with obesity.
Signs of night eating syndrome
Nocturnal eating syndrome has quite obvious symptoms. However, people around may not detect abnormalities if they do not pay attention to the patient’s eating behavior. About 25% of patients with this syndrome are associated with some other eating disorder such as bulimia and bulimia.
People with night eating syndrome (NES) will have the following symptoms:
- Consume a large amount of food after dinner and the calories usually make up about a quarter of the total calories for the day.
- Patients often lose their appetite and do not feel hungry in the morning. The first meal usually takes place in the afternoon with a relatively limited amount of food.
- Waking up several times during the night and consistently tolerating food in the belief that the nocturnal behavior will help improve sleep and help you fall back to sleep quickly. The patient may wake up several times each night.
- After a late-night meal, people often experience feelings of guilt, shame, depression, and distress about their eating habits. In particular, these sensations often occur when the patient recalls what he ate at night.
Nocturnal eating syndrome is only diagnosed when nocturnal eating occurs for 3 months or more and the frequency of nocturnal eating occurs at least 2-3 times/week. Some experts believe that NES is a variant of bulimia nervosa and bulimia nervosa.
Currently, nocturnal eating syndromes are classified as other eating disorders (i.e. those that present with an eating disorder but do not meet the diagnostic criteria for typical eating disorders). In addition to the abnormal eating behavior, the patient also experienced emotional disturbances. As a result, some patients with night eating syndrome may develop depression, anxiety disorders, and substance addiction.
Causes of night eating syndrome (NES)
The cause of night eating syndrome (NES) has not been studied. However, certain factors have been identified that may increase the risk of the disease, such as:
1. Circadian rhythm sleep disorder
Persistent nighttime awakenings in patients with NES syndrome have been identified to be associated with circadian rhythm sleep disturbances. This condition is characterized by difficulty falling asleep, waking up too early, waking up several times during sleep, and having difficulty falling back asleep. Circadian rhythm sleep disorders are often associated with biological clock disorders due to stress, overwork, disturbed living hours, etc.
Because the biological clock is disrupted, people with this condition are often slow to consume food. This hypothesis is quite reasonable because patients with night eating syndrome are almost not hungry in the morning and start their meals quite late (usually in the afternoon).
2. Extreme diets
According to some experts, night eating syndrome may be the body’s response to extreme dieting. In fact, many people abstain too much with the desire to have a slim and slim body. However, tolerating too little food during the day will cause the body to lack energy.
So at night, the brain will constantly “give” signals to create cravings and urges to eat more at night. In the long run, eating at night will become a habit. Eating at night will often cause weight gain due to sluggish metabolism and digestion. As a result, the patient will feel guilt, frustration because the weight loss plan has failed, the body will gain weight and become obese.
3. Other factors
Nocturnal eating syndrome can also be related to factors such as:
- Hormonal imbalance
- Have eating disorders such as bulimia nervosa or bulimia
- History of anxiety disorders, substance abuse, and depression
- People with obesity must follow a special diet
- Genetics (experts have found that people with a defect in the PER1 gene have a higher risk of night eating syndrome)
To find out the exact cause of night eating syndrome, experts will have to do more research. However, the studies that have been done show that NES syndrome occurs mainly in people with an irregular lifestyle.
Is night eating syndrome dangerous?
Nocturnal eating syndrome is assessed to be less severe than other eating disorders such as anorexia nervosa, bulimia nervosa and bulimia nervosa. However, about 25% of patients have other eating disorders. People with multiple eating disorders at the same time will have a worse prognosis than those with only night eating syndrome.
Unhealthy eating habits expose patients with NES syndrome to many physical problems. In addition, guilt about eating behavior and anxiety about one’s appearance also increase many psychological problems.
The effects of night eating syndrome on the health and life of patients:
- Obesity: Most patients with night eating syndrome face obesity. The reason is because of unhealthy diet and frequent night eating. Moreover, disrupted sleep also interferes with metabolism and increases the amount of fat stored in the body.
- Chronic health problems: In addition to obesity, night eating syndrome also increases the risk of chronic health problems such as diabetes, high blood pressure, cerebral ischemia, sleep disorders, etc. Patients with pre-existing chronic diseases, night eating syndrome can make the condition worse and increase dangerous complications.
- Increased psychological problems: Eating disorders in general and night eating syndrome in particular cause certain psychological effects. People with this disease always feel guilt and shame about their own behavior. At the same time, always worrying, worrying too much about gaining weight and being fat. If left untreated, these negative emotions can develop to cause problems like stress, depression, and anxiety disorders.
In fact, nocturnal eating syndrome is rarely as threatening to health as anorexia nervosa. However, if not diagnosed early, this disease will lead to many serious consequences. Although not a direct cause of death, night eating syndrome exacerbates existing diseases and increases the risk of sudden death and stroke.
Diagnosis of night eating syndrome
Nocturnal feeding syndrome is fully covered in the DSM-5. Currently, psychiatrists all use this criterion to make a definitive diagnosis. In addition to clinical examination, a number of laboratory tests are also performed to determine the cause and detect complications related to night eating syndrome.
Diagnostic techniques for nocturnal eating syndrome:
- Symptoms Exploitation Questionnaire
After performing some tests, your doctor will make a final diagnosis. Nocturnal eating syndrome is only diagnosed when the patient eats too much at night and this condition must persist for at least 3 months. Also, the patient’s symptoms are not due to chronic health problems, substance abuse, or other mental disorders.
Treatments for night eating syndrome
Nocturnal eating syndrome causes long-term effects on health and quality of life. Similar to other eating disorders, there is no optimal solution for this syndrome. However, through many studies conducted, experts have found that the use of drugs, psychotherapy and phototherapy is really effective in the treatment process.
1. Using drugs
Medication is the first option considered for patients with nocturnal eating syndrome. Currently, this method is not widely applied because the benefits are not high compared to the potential risks. Drugs are often considered when the patient has disrupted circadian rhythms and presents with depression or anxiety.
Drug classes to be considered for patients with night eating syndrome:
- Selective serotonin reuptake inhibitors (SSRIs) include Sertraline, Fluvoxamine, Paroxetine, etc.
- Oral melatonin supplements or provide precursors of the hormone melatonin
The classes of drugs used in the treatment of nocturnal feeding syndrome have a rather slow effect. Usually, the effect of the drug will take place after 6-8 weeks of use and patients will have to take the drug long-term to see the full effect. During the time of taking the drug, the family needs to support the patient to take the medicine regularly and detect adverse effects early.
Psychotherapy is currently the preferred method of treatment for nocturnal eating syndrome. This method has proven effective in changing unhealthy eating habits and correcting distorted, extreme views about appearance.
Psychotherapy is divided into many different methods and each method will have its own advantages and disadvantages. Depending on the specific condition of each patient, the specialist will choose the appropriate therapy. For night eating syndrome, cognitive behavioral therapy and cognitive restructuring are two methods that are highly effective.
- Cognitive behavioral therapy (CBT): CBT is considered the most effective method in the treatment of eating disorders in general and nocturnal eating syndrome. In this therapy, the specialist will help the patient change the negative thoughts that lead to unhealthy eating habits. After CBT intervention, patients can build scientific eating habits, change extreme thoughts about body shape and get rid of feelings of shame and guilt about their own eating behavior.
- Cognitive restructuring: Cognitive restructuring is essentially a part of cognitive behavioral therapy (CBT). This therapy helps patients identify appropriate and inappropriate thoughts. With expert support, patients with night eating syndrome can eliminate inappropriate thoughts, thereby building more positive emotions and behavior. Cognitive restructuring reinforces correct thinking and helps patients build healthy eating habits over the long term.
Psychotherapy is of great help in changing extreme eating habits. At the same time, it helps to relieve emotions and direct the patient to a healthy lifestyle. However, the treatment process often takes a long time, so the family needs to encourage the patient to persevere in completing the treatment.
Phototherapy (light therapy), commonly used to treat seasonal affective disorder, is also considered for patients with night eating syndrome. This method uses artificial light with a mechanism similar to UV rays in sunlight to regulate circadian clocks and improve levels of the hormone melatonin (a hormone secreted at night to help the body relax). and sleep well).
Phototherapy will be performed in the morning to reset the biological clock. The effect of UV rays stimulates metabolism, creating cravings and hunger during the day. This will help patients provide almost full calories through 3 main meals Besides, light therapy also stimulates the pineal gland to produce melatonin at night so that the body can easily fall asleep and sleep well. than.
At the present time, phototherapy has not been widely applied in the treatment of night eating syndrome. In fact, there are very few studies on the effectiveness of this approach. However, light therapy is generally safe, so some cases of poor response are still considered.
4. Support measures
Night eating syndrome not only affects eating habits, but also disrupts sleep and increases many physical health problems. To control this pathology, patients should be examined early and treated under the guidance of the doctor. In addition, it can be combined with some support measures such as:
- Buy only enough food for 3 meals and make sure there is no food left at night. This will help patients limit night eating behavior, thereby helping to improve weight and reduce the risk of some chronic diseases.
- Families should support the person with a healthy and balanced diet plan. Encourage the patient to get up early and start the first meal of the day by 10:00. At first, this is quite difficult because the patient’s body is not used to the lifestyle. However, with effort, patients can adjust their circadian clocks and reduce extreme eating behaviors.
- Limit exposure to negative information related to aesthetics and beauty standards. Instead, patients should spend their free time participating in social activities. The joy from volunteering will help patients reduce their concern about their appearance, and at the same time maintain an optimistic and happy spirit.
- Patients with night eating syndrome often face obesity and a number of related health problems. Therefore, it is recommended to build a low-calorie and sugar-restricted diet to regulate weight. However, according to experts, patients should diet in moderation, avoiding excessive dieting during the day as this will promote an overeating response at night.
- Patients should exercise 30-40 minutes/day to improve their physique and weight. In addition, physical activity also helps in regulating the biological clock, promoting digestion and metabolism. Some studies show that regular exercise helps regulate abnormal cravings. This means that regular exercise can somewhat reduce extreme eating habits in patients with eating disorders.
Nocturnal eating syndrome is a recognized form of eating disorder. However, the understanding of this syndrome is relatively limited. The majority of patients are unknowingly discovered to have NES during a physical examination for obesity and related health problems. To protect your health, you should proactively visit a doctor if you suspect that you have extreme eating habits that last for 1 month or more.