Night Eating Syndrome

What is night eating syndrome?

Night eating syndrome (often called NES) is a kind of eating disorder. People with NES generally eat a lot late at night and have difficulty sleeping as well.

Although night eating syndrome is a distinct disorder, it can also occur alongside other eating disorders such as anorexia nervosa, bulimia nervosa, and/or binge eating disorder.

Night eating syndrome is also similar in some ways to a different disorder called sleep-related eating disorder, but the difference is that unlike people with sleep-related eating disorder, people with night eating syndrome remember eating at night.

It’s normal to have an occasional snack after dinner, but if you’re worried about how much you eat at night and are also having trouble sleeping, you may be dealing with night eating syndrome.

How common is night eating syndrome?

The most recent research on night eating syndrome suggests that about 1.5% of adults experience this disorder. For people who are obese, the rate goes up to about 10%.

Night eating syndrome is about equally common for men and women. People who are dealing with substance use issues, anxiety, and/or depression also seem to be more likely to have night eating syndrome.

What are some symptoms of night eating syndrome?

Night eating syndrome can look different in different people, but some common symptoms include:

• Weight gain or obesity (though not everyone with night eating syndrome is overweight);
• Trouble sleeping;
• Eating a lot after dinner;
• Feeling worried about your eating habits;
• Not being hungry in the morning;
• Feeling like you need to eat in order to sleep;
• Symptoms of depression or anxiety that begin or get worse in the evening.

Additionally, the DSM-5 outlines specific criteria that are used for diagnosing night eating syndrome. According to the DSM-5, a diagnosis of night eating syndrome requires that an individual:

• Report eating at least 25% of their daily food intake in the hours after dinner

and/or

• Wake up to eat at least two times per week.

Plus, the individual must also experience at least three of the following five symptoms as well:

• Absence of appetite in the morning;
• Feeling a strong urge to eat between dinner and going to sleep;
• Insomnia at least four nights per week;
• Believing that eating is necessary in order to fall asleep;
• Feelings of depression that get worse in the evening.

It’s also necessary that the individual remember eating at night. If they do not, the diagnosis would more likely be a related condition called sleep-related eating disorder, in which individuals eat at night but don’t remember doing so.

What to do if you’re experiencing night eating syndrome

If you think you might have night eating syndrome, consider the following options:

• Therapy: Working with a therapist can help you gain insight into your night eating and give you strategies for changing your behavior and improving symptoms. (See below for tips on finding a therapist.)
• Check-ups: Because night eating syndrome can be linked to underlying medical conditions, it’s important to talk to your doctor to rule out medical conditions that may be related.
• Mindfulness practices: Learning skills like meditation and other relaxation techniques may help ease you manage life stress and reduce your urge to eat at night.
• Nutrition counseling: Some people with night eating syndrome may find it helpful to work with a nutritionist to learn new strategies for maintaining a balanced diet and developing positive eating habits.
• Medication: In some cases, medication can be a helpful way to manage night eating syndrome. Though most medications come with side effects, a psychiatric professional can help you manage these side effects and find the most effective treatment.

Best therapy types for night eating syndrome

There are a number of different kinds of psychotherapy that can be helpful for night eating syndrome. Some options to consider include:

• Cognitive behavioral therapy (CBT)
• Mindfulness practices
• Holistic therapy
• Dialectical behavior therapy (DBT)
• Interpersonal therapy

Some studies have also suggested that phototherapy (light therapy) can be a helpful way to treat night eating syndrome, but there is relatively little evidence about whether or not this treatment is effective.

What should I look for in a therapist for night eating syndrome?

Most importantly, you’ll want to find a therapist who is experienced in treating night eating syndrome. This will usually involve:

• Advanced education in a field related to mental health, such as psychiatry, psychology, or social work;
• Licensure to practice in the state where you live;
• Additional training and/or experience in treating night eating syndrome specifically. This might also include advanced training in the specific type of therapy (such as CBT) that you’re interested in pursuing.

Finally, as with any therapy, it’s important to make sure that your therapist is a good fit for your unique needs. Be sure to evaluate the following in your initial calls with therapists:

• How will you pay for therapy? Does the therapist take your insurance or otherwise offer rates that will work with your budget?
• When and where will you attend sessions? Does the therapist offer treatment at a location that is convenient for you and at times that work with your schedule?
• Most importantly, do you feel comfortable talking to this therapist and sense that you have the potential to develop a therapeutic alliance?