Night Eating Syndrome: What is it and what treatments are available?
Written by CCTC Staff Writer
Many people make dinner the biggest meal of the evening, and “snack” a lot between dinner and bed. Some people might have a “midnight snack” once in a while if they can’t sleep (or get back to sleep if they are disturbed.) And while neither of these things are necessarily bad on their own, they could indicate night eating syndrome, a little known (but just as serious) eating disorder.
Read on to learn more about:
What night eating syndrome is (and what it is not)
Underlying causes of the disorder
How to tell whether someone has night eating syndrome
Why this eating disorder is important to address
Night eating syndrome treatments out there
Steps you can take to overcome night eating syndrome today
Evenings do not have to be a time of distress over food and sleep. With the right course of treatment, you can regulate your relationship between food, sleep, and mood.
Related: This is how to tell whether you’re getting quality sleep, and the best sleep practices for eating disorder recovery.
What is Night Eating Syndrome?
Night eating syndrome is an eating disorder characterized by eating the majority of one’s daily caloric intake in the late evening or throughout the night. It is associated with an underlying “dysregulation” of the body’s internal clock, which results in suppressed appetite in the morning and increased hunger in the evening.
Night eating syndrome is part eating, part mood, part sleep disorder. People suffering from this disorder often have difficulty going to sleep, or getting back to sleep, and eat to help with these issues. It is categorized under Other Specified Feeding/Eating Disorder (OSFED).
Night eating syndrome is highly prevalent, yet underdiagnosed and undertreated. About two percent of the population has this disorder, making it twice as common as anorexia nervosa and almost as prevalent as binge eating disorder.
It is different from binge eating disorder in that the consumption of large quantities of food over a shorter span of time is specifically related to sleep, and specifically done in the evening before bedtime.
Diagnosing Night Eating Syndrome
While night eating is normal for many people, and you might even overeat late at night on occasion, night eating syndrome has specific diagnostic criteria.
To meet diagnostic criteria, you must have three out of the five following symptoms:
“Morning anorexia”: a lack of desire to eat in the morning
“Evening hyperphagia”: eating over twenty-five percent of one’s daily caloric intake in between dinner and bedtime, often in the form of grazing, which is different from planned snacks
Insomnia: difficulty falling asleep or staying asleep
Depressive or anxious moods that worsen at night
The belief that you need to eat to fall asleep, or to get back to sleep if you awake in the night
You must also be aware that you are eating at night; otherwise, you may be facing sleep-related eating disorder, where individuals are eating while unconscious and in deep sleep. Along with awareness of night eating episodes. People with night eating syndrome are aware of personal distress and face impairment in functioning due to their behaviors.
To be diagnosed with night eating syndrome, the night eating should not be a secondary symptom to another physical or psychological disorder, medications, or substance use.
Common, Everyday Symptoms of Night Eating Syndrome
You might have the disorder if you:
Eat more than half of daily food intake during and after dinner but before breakfast.
Have episodes of nocturnal eating at least twice a week.
Eat mostly carbohydrates (sugars and starches) as a way to relax, soothe yourself, and/or tire yourself out.
Follow this eating pattern for at least three months.
Believe that eating late at night will help you sleep better.
Don’t eat very much or feel hungry in the morning.
Feel shame about eating so much, or so late at night.
Have failed frequently at dieting.
Experience unusually high concern about weight and body shape.
Feel tense, anxious, upset, and/or guilty while eating.
Many people think they can’t have this disorder because they don’t wake up and eat throughout the night. In reality, only a small percentage of people wake up multiple times to eat throughout the night. More commonly, people with night eating syndrome because their late-night eating is more about a loss of “willpower” than a full-blown eating disorder.
Underlying Causes of Night Eating Syndrome
While there has not been an extensive amount of research done on night eating syndrome, several theories about what causes the disorder have been presented.
Someone may develop night eating syndrome due to:
Stress or restlessness that makes relaxing for the night very difficult
Disturbances in sleep and wake times (e.g. waking up for an overnight job or while caring for a newborn child)
Putting off eating throughout the day (e.g. “forgetting to eat” or being unable to eat due to your occupation)
Depression or anxiety, which often worsens in the evening
Hormonal shifts throughout the day, which affect hunger cues
Consequences of Night Eating Syndrome
If a person is still getting the proper amount of nutrition within a twenty-four hour timespan, does it really matter when they eat? It does matter.
Putting off food until late at night:
Distorts your hunger and fullness cues (possibly more than they already are)
Causes (or perpetuates) problems with sleep, and problems with sleep affect every area of life
Causes sufferers to feel immense guilt and shame
May cause sufferers to feel the need to “be good” the next day, eat minimal amounts of food throughout the day, and then overeat again at night
Causes heightened levels of emotional distress
Can worsen feelings of anxiety and depression, especially late at night
Has been linked to binge eating
Sleep helps your body reset, manage stress, convert short-term memories into long-term ones, heal itself, improve concentration, and more. If you can’t get good, quality sleep, you will suffer in all areas of life.
Night Eating Syndrome Treatments: What are your options?
Treatments for night eating syndrome include:
Psychoeducation about the disorder, healthy eating habits, and sleep hygiene
Maintaining a regular eating schedule, with structured meals and snacks if you don’t have regular hunger cues
Reframing your thoughts around food and food guilt
Creating a new bedtime routine to stop harmful food and sleep related behaviors
Establishing a regular sleep and wake time
Treating any comorbid symptoms/disorders (depression, anxiety, etc.)
Bright light therapy to regulate sleep/wake hormones (which is also used to treat seasonal affective disorder)
Related: This is the relationship between eating disorders and seasonal affective disorder — and how to deal with both.
What if you can’t recover on your own?
At first, individuals usually try to adjust their behaviors around food and sleep on their own. This is especially due to the shame that comes with eating late at night, as well as the idea that their problem isn’t really “serious enough” to see a professional about.
And in some cases, people can make strides towards eating disorder recovery through learning about the disorder, committing to new habits, and seeking out support. But recovery from night eating syndrome can be especially difficult.
Most people are already asleep right around the time you may be struggling, so you may not have anyone to reach out to when you feel the urge to engage in excessive night eating. It’s also incredibly difficult to get into a regular sleep routine — and trying to establish new habits around food at the same time only increases the level of struggle.
So reach out to an eating disorder professional for help. They can help you come up with strategies to overcome barriers to sleep and regular eating. You can also work through symptoms of depression and anxiety, and feelings of guilt and shame around food.
In some cases, a professional may recommend a higher level of care, such as a partial hospitalization or residential treatment program, to help you stop behaviors and establish healthy new routines as soon as possible.
Related: This is exactly what to expect from an eating disorder treatment program, plus tips to cope with the process.
It’s completely possible to overcome Night Eating Syndrome.
You can wake up and eat breakfast normally, without the feelings of guilt and shame that come from eating so much and staying up so late the previous night.
You can come home from work, relax, unwind, and not stay up until three a.m. watching TV and eating more than you intended to.
You can have a happy, healthy relationship with food and sleep — you just have to put in the work to recover from your eating disorder.
It starts with admitting you have a problem.
If you or a loved one is suffering from an eating disorder, take the first step today and talk to someone about recovery or simply learn more about the holistic eating disorder recovery programs we offer.