Night Eating Syndrome: causes, symptoms and treatment of this eating disorder.

We analyze this disorder that consists of eating large amounts of food during the night.

The best known Eating Disorders (ED) are anorexia and bulimia, but in recent years the possibility of including new disorders in the DSM (Diagnostic and Statistical Manual of Eating Disorders) is being considered. (Diagnostic and Statistical Manual of Mental Disorders).).

One of them is the Night Eating Syndromewhich, together with Binge Eating Disorder (which is included in the DSM-V), predominates in obese patients, although it can also develop in patients with normal weight.

One of the main characteristics of this disorder is that the sufferer ingests a large number of calories after dinner, even waking up at night to eat.. During the morning, he/she presents morning anorexiaThe patient eats practically nothing, and during the rest of the day, until nightfall, he/she eats few calories. The Nocturnal Eating Syndrome (NES) causes serious health problems, so it is necessary to treat it as soon as possible.

Characteristics and symptoms of Night Eating Syndrome

In this disorder, the individual eats little throughout the day because the high consumption comes after nightfall, with the consequence of overweight and sleep disturbances.

Some facts

Nutrition experts recommend recommend that the daily intake should be distributed in five meals.. Breakfast and lunch should be the main meals, providing between them 50-60% of the daily calorie intake. The mid-morning snack and the afternoon snack should provide 10-15% each and the evening meal 20%.

Individuals suffering from the night eater's syndrome may consume at least 50 percent of their calories at night.The symptoms of the disease, causing a decompensation with respect to these recommendations.

Symptoms

The Night Eater Syndrome is characterized by the following symptoms:

• Morning anorexiaIndividuals with NES do not eat or hardly eat at all during breakfast.
• Nocturnal hyperphagiaNighttime hyperphagia: They consume at least 25% of their daily calories after dinner. These foods are usually rich in carbohydrates (such as sweets, pastries, pasta or rice).
• Sleep disturbancesThey suffer from insomnia or wake up frequently in the middle of the night to eat at least three days a week.

Causes

Not many investigations exist on this disorder, but in the different analyses carried out in some studies there seems to be a modification of the neuroendocrine pattern. (e.g., cortisol, Pituitary Pituitary Adrenal, melatonin and leptin) involved in the regulatory function of circadian rhythms that modulate various metabolic and psychological functions.

It highlights the high presence of cortisol during the night (but not during the day), the hormone related to stress, so that one of the main causes would be the increase of nocturnal stress.

Other studies, relate this disorder to environmental and sociocultural factors, as well as to a certain genetic predisposition.. Moreover, in some cases, the onset of this syndrome is related to anxiety or depression disorders, which may lead to an increase in food intake to reduce anxious and depressive symptoms.

Treatment

The treatment of this pathology may require a multidisciplinary intervention with different professionals: dietician, endocrinologist and psychologist or psychiatrist..

The dietician should design a diet according to the characteristics of the subject, the endocrinologist should follow up on the hormonal characteristics of the patient, and the psychologist will work on aspects related to feelings, emotions or beliefs and the well-being of the person with Night Eating Syndrome.

Regarding psychotherapy, Cognitive-Behavioral Therapy, Acceptance and Commitment Therapy or Mindfulness can be of great help for the patient to overcome the disorder. In addition, psychology can provide the patient with the tools to learn to cope with the problem and change their attitudes and habits towards food.The patient will need to overcome the anxiety or depression.

In severe cases, pharmacological treatment may be necessary. Certain medications such as SSRIS (Selective Reuptake Inhibitors (SSRIs) Serotonin) have shown their efficacy for treatment.