Night Eating Syndrome: Causes and Concerns


Do you consume more than a quarter of your daily calories after your evening meal? Do you have trouble falling asleep or suffer from insomnia during the night? Is your appetite for breakfast generally lacking?  If you answered “yes” to all of these questions, you may be suffering from a condition called “night eating syndrome” (NES) — and you’re not alone, given that two million Americans struggle with this condition.

If you have NES, you likely eat too much food in the evening and even overnight. Many people with this syndrome wake up several times a week to snack in the middle of the night before going back to sleep.

Who gets NES? If you’re overweight, you’re more likely to have it (although lean people also get it), and almost a third of adults having weight reduction (bariatric) surgery suffer from it. About 10 percent of people with diabetes also have NES. It’s also associated with feeling depressed, anxious, lonely, angry, or sad. People with NES are more likely to have a history of being sexually or physically abused or neglected by their parents.

What physical changes cause it? NES revolves around your brain, in particular the effects of two hormones, leptin and melatonin, and one brain chemical called serotonin. When these are released inappropriately or inadequately, you can end up eating uncontrollably.

Leptin is a hormone that is actually secreted from the body fat stored under your skin. It’s supposed to signal your brain to stop eating when you have excess body fat. Your fat cells increase their leptin release during the late evening and overnight, but levels drop during the day — which is why most people eat three meals during the day and don’t have desire for food through the night. However, people with NES, whether they are lean or obese, have low leptin levels at night that frequently lead them to eat more then.

The release of second hormone, melatonin, is triggered by the onset of darkness and is usually secreted by your brain around bedtime to help you go to sleep. If your natural levels of melatonin are decreased, as they often are in people with NES, you may have trouble either falling asleep or staying asleep.

Serotonin is a “feel good” brain chemical released when you eat carbohydrates. Having low levels of serotonin in your brain is usually associated with a depressed mood, which also explains why people with NES frequently have mood disorders that trigger eating in the evening and overnight. Carbohydrates serve as “comfort” foods that increase serotonin levels and are usually what people with NES feel driven to eat, along with fat.

What can you do if you have NES? Luckily, there is help for people with this condition. Many people are simply the victims of genetic and hormonal abnormalities that lead to disturbed eating patterns and weight gain. Hormonal disturbances can be addressed, although we can’t change genetics yet. Here are some other treatments you can try:

  • You may benefit from taking prescribed medications to treat depression, especially ones that keep serotonin levels in the brain high for longer.
  • You may also choose to see a behavioral therapist who can help you learn alternate strategies for coping with painful emotions (other than seeking out comfort foods).
  • Addressing eating patterns and sleep disturbances with relaxation training and other behavioral strategies has also been shown to be helpful in treating NES.
  • Improving your sleep with medications (including over-the-counter melatonin supplements) can reduce the desire for nighttime eating.
  • Treating sleep apnea, if it you have it, may improve your ability to sleep without interruption and naturally decrease the drive for nocturnal eating.

For anyone with diabetes, controlling NES is even more important, as this syndrome can lead to poor blood glucose control and early onset of diabetes-related health problems. These individuals need more education about diabetes self-management to help them to understand the psychological, emotional, and physiological factors associated with their unhealthy eating patterns and its impact on diabetes control.

Being physically active, reducing mental stress, eating a more balanced diet, and improving sleep — can lower your risk of gaining excess weight or developing Type 2 diabetes in the first place.

Dr. Osama Hamdy and Dr. Sheri Colberg are the authors of “The Diabetes Breakthrough: Based on a Scientifically Proven Plan to Reverse Diabetes through Weight Loss.”

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