Night Eating Syndrome: The Eating Disorder We Need to Talk About

Raise your hand if you struggle with grazing, nibbling, snacking, or binge eating at night, in between dinner and bedtime.

If you do, you’re not alone.

There are a number of reasons why we do this. Oftentimes, it’s because we have more access to food in the evening, or we are relaxing at home.

Some of us eat more at night, perhaps as a way to be social or unwind after a long day. Others may have different reasons.

When Night Eating is a Problem

Several studies suggest that those who struggle with night eating habits tend to become anxious or agitated in the evening, becoming physically hungrier because their “hunger” hormones increase at night. Night eating helps them feel calmer, perhaps even “numbs” them, and helps them feel tired enough to try to fall asleep.

What is Night Eating Syndrome?

If you struggle with eating too much in the evening hours, you may think you have no willpower or lack self-control. Instead of blaming yourself, consider that you may have an eating disorder.

Night Eating Syndrome (NES) is a distinctly unique eating disorder caused by an underlying “dysregulation” of body clocks that impact appetite, sleep/wake times, and overall energy levels. Thus, it is considered a combination of a mood, eating, and sleep disorder.

Eating at Night vs. Night Eating Syndrome

It’s not uncommon for people to snack or eat in the evening, for various reasons. For those with Night Eating Syndrome, you will overeat at night and have sleep challenges, often consuming a quarter of your daily calorie intake after dinner. There are specific factors to help determine and distinguish eating at night versus night eating syndrome, and form an accurate diagnosis.

Binge Eating Disorder vs. Night Eating Syndrome

For those with Binge Eating Disorder (BED), it is more likely that they will “binge” or eat a lot in a single sitting – rather than eating smaller amounts during the evening. A hallmark trait of Binge Eating Disorder includes eating an unusually large amount of food in a specific timeframe.

Sleep-Related Eating Disorder vs. Night Eating Syndrome

For those with sleep-related eating disorder, you may not remember that you ate the night before. With Night Eating Syndrome, you will likely remember that you ate.

Does Your Mood Affect Your Appetite?

Night Eating Syndrome is not a well-known eating disorder. While often underdiagnosed and undertreated, it is fairly prevalent. Around 2% of the population has NES, making it 2 times more common than Anorexia Nervosa and almost as prevalent as Binge Eating Disorder (BED). Moreover, one of the symptoms of NES includes a depressed mood that worsens during evening hours.

What Are the Causes of Night Eating Syndrome?

We do not yet know what causes NES, although some evidence indicates that it may be related to hormonal or sleep-wake cycle issues. Those with NES often struggle with mental health conditions and comorbidities such as depression, anxiety, and substance use disorder or addiction.

Symptoms of Night Eating Syndrome

Nocturnal eating behaviors are common; many people binge eat, on occasion, during the evening. In order to meet the full diagnosis for Night Eating Syndrome, there must be at least 3 of the following 5 criteria:

1. “Morning anorexia” — skipping breakfast or not eating until 12:00 or later on four or more mornings per week
2. “Evening hyperphagia” — eating more than 25% of one’s total daily calories (possibly in the form of continuous “grazing”) between dinner and bedtime
3. Having difficulty falling or staying asleep
4. Experiencing mood or anxiety symptoms that get worse during the evening— leaving one feeling more agitated, irritable, or depressed
5. Believing that one must eat to go to sleep or return to sleep

The Struggle to Eat Less at Night

Many patients overlook the possibility that the might have Night Eating Syndrome because they:

1. Feel “in control” during the day and thus, attribute night eating to losing “motivation” or “willpower”
2. Expect that having NES means that they must wake up in the middle of the night and eat to go back to sleep; in actuality, only a small percentage of NES sufferers do this

People who struggle with night eating behaviors often have feelings of shame and guilt; they attribute their eating patterns to “habit” and become “used to” having poor sleep and mood issues.

How to Treat Night Eating Syndrome

Can we do anything about NES? The answer is YES. Interventions like the following can be helpful:

• Try spacing your meals out throughout the day — even if you have a lack of an appetite during daytime or morning hours. Here at Eating Recovery Center, we work with patients to slowly increase their food intake earlier and earlier throughout the day.
• Establish a different bedtime routine. Switch to a routine that can help you relax and wind down. This often includes things like turning off screens earlier, establishing habits that signal sleep (i.e. reading in low light, drinking decaf tea, or journaling before bed) and getting into bed only when you are sleepy; our patients leave their beds if they are awake for specific time intervals so as not to “train” their bodies to lay awake or be awake in bed; we want you to associate your bed with sleep. Sleep is so important in recovery.
• Incorporate interventions like limiting light in the evening and increasing exposure to bright light in the morning.

While there are no specific evidence-based treatments for NES, some clinicians have experienced success with Cognitive Behavioral Therapy and various antidepressants.

Like many eating disorders or mental health conditions, most people wait too long to get help or assume that help is not available. If you are struggling with Night Eating Syndrome, we encourage you to get help sooner rather than later.

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Eating Recovery Center and Pathlight Mood & Anxiety Center is an international center for eating disorders and mood, anxiety and trauma-related disorders recovery providing comprehensive treatment for Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, depressive disorders, anxiety disorders, and PTSD. We offer the full spectrum of treatment services adults, adolescents and children of all genders, including Inpatient, Residential, Partial Hospitalization and Outpatient programs. For more information about Eating Recovery Center, please visit www.eatingrecoverycenter.com.