Night eating syndrome

Snacking after supper is something most of us do at least sometimes. There is something so appealing about a mid-evening bowl of popcorn or ice cream as we unwind and relax before bed.

Most of us also know these extra calories at the end of the day are not all that helpful if we’re trying to lose weight.

For about one and a half per cent of us, night eating is more substantial than a little post dinner snack. Night eating syndrome is a relatively new eating disorder causing distress for those who experience it and often resulting in obesity.

To be diagnosed with this disorder, individuals must consume at least a quarter of their daily calories after supper and may have middle of the night awakenings to eat at least three times a week.

Generally, people with night eating syndrome have little appetite during the day and often consume fewer calories than average over the course of a day. Insomnia, anxiety and mood symptoms are also very common with this condition.

An average day may begin with little or no food consumed by an individual with night eating syndrome. As the day progresses, night eaters become more depressed and agitated and seek out high carbohydrate foods, which may be a form of self medication.

Night eaters tend to eat relatively small snacks (averaging about 270 calories) but do so frequently throughout the night rather than a single large binge as is common in bulimia.

Although it affects not quite two per cent of the general population, numbers are much higher among obese individuals. Between 10 and 15 per cent of obese people experience night eating syndrome and it is considered one of the pathways to obesity.

More than simply indulging a bad habit, people with night eating syndrome have a real clinical illness described as both an eating disorder and a disorder of mood and sleep, which affects levels of sleep and appetite hormones (melatonin, leptin and cortisol) as well as neurotransmitters in the brain.

Viewed as a delay in the circadian rhythm of food intake, imaging studies have shown significant elevation of serotonin transporters in the brains of night eaters. Although the exact cause of this imbalance is not understood it is thought to have a genetic basis.

Elevation of serotonin transporters is triggered by stress and decreases serotonin transmission, which can impair circadian rhythms and feelings of fullness.

Because it is now known that night eaters have decreased serotonin transmission, researchers felt common antidepressant medications selective serotonin re-uptake inhibitors (SSRIs) might alleviate symptoms of night eating syndrome. New studies show the drugs do just that.

News of an effective treatment for night eating syndrome is a welcome announcement with the potential to make a significant impact on obesity rates in our country – and to lessen the significant distress this illness causes to those who experience it.

If you believe you may experience night eating syndrome, talk to your doctor to learn more about the condition and treatment options.

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About the Author

Paul Latimer has over 25 years experience in clinical practice, research, and administration.

After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar.

Since 1983 he has been practicing psychiatry in Kelowna, BC, where he has held many administrative positions and conducted numerous clinical trials.

He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders.

He is an avid photographer, skier and outdoorsman.

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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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