One of the less well-known eating disorders is night eating syndrome. This condition is classified in the DSM-5 as an Other Specified Feeding/Eating Disorder, which includes symptoms surrounding food and body image that cause significant distress or functional impairment in one’s life, but do not meet the full criteria for other eating disorders. Although this disorder is not as commonly diagnosed or identified as other eating disorders, it can be just as distressing and damaging, and can severely impair one’s functioning.
You may read the night eating diagnosis and wonder, how is this different from having a midnight snack? Or waking up because you are starving? Here are some considerations for night eating syndrome:
Repeated instances of night eating. The individual consumes an excessive amount of food throughout the night or in the late evening. They may consume this excessive amount after the evening meal, and even wake up throughout the night to eat before going back to sleep. Much of the person’s daily caloric consumption occurs during their night eating episodes.
Awareness and recollection of behaviors. An individual does not demonstrate night eating syndrome symptoms if their eating occurs while they are sleepwalking or as an effect of taking a sleep-aid. The person with the syndrome is aware that they are eating during the night eating episode and have a recollection of it afterwards, including associated feelings of guilt or shame.
No attributable external influence. Night eating behaviors are not the result of changes in the person’s sleep-wake/circadian cycle, including jet lag, or a consequence of engaging in nighttime social activities surrounding food. Moreover, these behaviors are not better explained by substance use, medications, or another medical or mental disorders.
Functional Impairment. Night eating can cause the individual significant distress, including feelings of guilt, anxiety, depression, and helplessness surrounding behaviors and their impact. The individual may experience body dissatisfaction as a result of weight gain from behaviors, or anticipate body image and health concerns. Behaviors and associated feelings may also impair functioning by interfering with the individual’s self-esteem, social engagement, and occupational performance.
Separate from binge eating disorder. Night eating syndrome behaviors may be confused with those of binge eating disorder. However, unlike the latter, night eating does not occur in a short, discrete amount of time but occurs throughout a period of time and exclusively during the night. Similar to binge eating disorder, night eating syndrome includes a compulsivity that is hard to control.
Potential Causes. Various theories surround the development of night eating syndrome, including both emotional and physical stressors. Many night eaters engage in behaviors to counteract insomnia or self-medicate to deal with emotional dysregulation. Low caloric intake during the day can lead to overcompensation through excessive eating during the evening, which may only fuel the night eating again as the individual does not feel hungry during the day. Behaviors may also be a reaction to stress, or a response to hormonal discrepancies that cause the person to feel hunger at inappropriate times.
Treatment Is Available
Night eating syndrome can be a confusing, helpless, and distressing occurrence for individuals who experience it. Fortunately, treatment is available and can include psychoeducation, cognitive behavioral therapy, dietetic guidance, sleep disorder management, and treatment of other underlying psychiatric concerns (depression, anxiety). Having a team of providers, including a psychologist, registered dietician, psychiatrist, and sleep specialist can be helpful in coordinating the client’s care.
Bahar Moheban, M.A. is a clinical psychology doctoral student and registered psychological assistant in Torrance under the supervision of Dr. Nazanin Moali. She offers individual and group psychotherapy to adults and adolescents with disordered eating and body image concerns. If you are seeking recovery from night eating syndrome or other distressing behaviors around eating and body image, contact Bahar for a counseling appointment.