You are here
Nighttime grazers may be suffering from disorder
It starts with “morning anorexia,” skipping breakfast more days than not and by dinner time all bets are off. People eat and graze compulsively, from dinner to bedtime, and even wake in the middle of the night to eat more. Half a century after it was first described, night-eating syndrome—a phenomenon where people consume at least one-quarter of their daily calories after the evening meal—is poised to become the newest eating disorder. Experts are pushing for the condition to be included in psychiatry’s official nomenclature as a distinct syndrome that, according to estimates, affects hundreds of thousands of Canadians.
It’s more than just snacking. Night eaters often have zero interest in eating until dinnertime, and then, once they start, cannot stop. They feel an intense, excessive drive to eat until they go to sleep. They sneak food from the refrigerator. They wake two or more times a night and feel a compulsive need to eat to get back to sleep—spoonfuls of peanut butter, ice cream, a box of miniature doughnuts, their kids’ school snacks or just more of what they were eating earlier. They feel shame and guilt and the more that day progresses into night, the more moody, depressed and anxious they grow. Unlike SEED, or sleep-related eating disorder, in which people eat while in a sleepwalking state—and not just food but bizarre things such as coffee grounds and pet food—night eaters are completely aware of their behaviour and can recall what they ate the following morning. While it’s not typically as big as a binge, “They just feel like they can’t stop eating this way,” said Kelly Allison, an assistant professor of psychology in psychiatry at the University of Pennsylvania School of Medicine, who is researching treatment for night-eating syndrome. “After a while, it becomes habitual,” she said. “It’s part of what they do.”
An estimated 1.5 per cent of the general population is affected, though the incidence is higher in the overweight: six to 16 per cent of people in weight-loss programs, and up to 42 per cent of bariatric or weight-loss surgery patients report symptoms of night eating. And while more “traditional” eating disorders such as anorexia or bulimia are more common among women, Allison says night-eating syndrome affects both sexes nearly equally. According to a new guide for health professionals on weight management published recently by the Canadian Obesity Network, night eaters consume more than three times as many calories after dinner than people without the syndrome. “It can get started in a period of high stress, where you’re not able to eat on a regular schedule, and it just takes on a life of its own,” Allison said.
Abnormal dieting can also trigger night-eating syndrome
“People wake up every morning and say, ‘This is going to be the day I lose weight,’ and they think that in order to lose weight it means they don’t eat,” said Dr Valerie Taylor, psychiatrist-in-chief at Women's College Hospital in Toronto. By nighttime, they feel like they’re starving.
Brain-imaging studies have shown significant elevations of serotonin transmitters in the midbrains of night eaters, suggesting a genetic vulnerability that can then be triggered by stress. Serotonin is a brain chemical involved in mood, appetite and sleep. Certain antidepressants have shown to be helpful, “but we need larger studies,” Allison said. She and her colleagues have also conducted a pilot study that found cognitive behaviour therapy can help reduce “nocturnal ingestions”—middle-of the-night eating.
Experts arguing for night eating syndrome’s inclusion in the next edition of the Diagnostic and Statistical Manual of Mental Disorders say it would help raise a new consciousness about a problem that is often not taken seriously. Taylor says the field should be cautious about moving too quickly. “Is it something worth looking at? Absolutely,” said Taylor, mental health chair at the Canadian Obesity Network. But she added that more research was needed to decide whether it should be a diagnosis unto itself, or whether it was a version of bulimia, binge eating or a sleep disorder. (The Montreal Gazzette)
User comments posted on this website are the sole views and opinions of the comment writer and are not representative of Guardian Media Limited or its staff. Guardian Media Limited accepts no liability and will not be held accountable for user comments.
Please help us keep out site clean from inappropriate comments by using the flag option.
Guardian Media Limited reserves the right to remove, to edit or to censor any comments. Any content which is considered unsuitable, unlawful or offensive, includes personal details, advertises or promotes products, services or websites or repeats previous comments will be removed.