The best known Eating Disorders (ED) are anorexia and bulimia, but in recent years new disorders are being considered for inclusion in the DSM (Diagnostic and Statistical Manual of Mental Disorders ).

One of these is Night Eater Syndrome , which together with Binge Eating Disorder (this is included in DSM-V) predominates in obese patients, although it can also develop in normal weight patients.

One of the main characteristics of this disorder is that the person suffering from it takes in a large amount of calories after dinner, even waking up at night to eat . During the morning, he or she has morning anorexia , that is, he or she hardly eats at all; and during the rest of the day, until the evening, he or she eats very few calories. The Night Eater Syndrome ( NES ) causes serious health problems, so it is necessary to treat it as soon as possible.

Characteristics and symptoms of Night Eater Syndrome

In this disorder, the individual eats little throughout the day because the large consumption comes after the night, with the consequence that overweight and sleep disorders appear.

Some facts

Nutrition experts recommend that daily intake should be distributed over five meals . Breakfast and lunch should be the main meals, providing between them 50-60% of the daily calorie intake. The mid-morning snack and the afternoon snack should each contribute 10-15% and dinner 20%.

Individuals suffering from night eating syndrome may eat at least 50 percent of their calories at night , causing a breakdown in these recommendations.

Symptoms

Night Eater Syndrome is characterized by the following symptoms :

  • Morning Anorexia : Individuals with NES do not eat or hardly eat at all during breakfast.
  • Nocturnal hyperphagia : Consume at least 25% of daily calories after dinner. These foods are usually rich in carbohydrates (such as sweets, pastries, pasta or rice).
  • Sleep disorders : They suffer from insomnia or wake up frequently in the middle of the night to eat at least three days a week.

Causes of Night Eater Syndrome

There is not much research on this disorder, but in the different analyses carried out in some studies there seems to be a modification of the neuroendocrine pattern (for example, cortisol, Pituitary Adrenal Pituitary, melatonin and leptin) that participates in the regulatory function of the circadian rhythms themselves that modulate diverse metabolic and psychological functions.

The high presence of cortisol during the night (but not during the day), the hormone related to stress, stands out, so one of the main causes would be the increase of night stress.

Other studies, relate this disorder to environmental and sociocultural factors, as well as to a certain genetic predisposition . Furthermore, in some cases, the onset of this syndrome is related to anxiety or depression disorders, which may lead to an increase in food intake to reduce anxious and depressive symptoms.

Treatment of Night Eater Syndrome

The treatment of this pathology may require a multidisciplinary intervention with different professionals: dietician, endocrinologist and psychologist or psychiatrist .

The dietician should design a diet according to the characteristics of the subject, the endocrinologist should follow up on the hormonal characteristics of the patient, and the psychologist will work on aspects related to the feelings, emotions or beliefs and the well-being of the person with Night Eater Syndrome.

Regarding psychotherapy, Cognitive Behavioral Therapy, Acceptance and Commitment Therapy or Mindfulness can be of great help for the patient to overcome the disorder. In addition, psychology can provide the patient with the tools to learn to face their problem and change their attitudes and habits towards food , and will be necessary to overcome anxiety or depression.

In severe cases, drug treatment may be necessary. Certain medications such as SSRIs ( Selective Serotonin Re-uptake Inhibitors) have been shown to be effective in treatment.