Night Eating Syndrome. Justin Wu, Kathy Tran, Kari Schneider

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1 Night Eating Syndrome Justin Wu, Kathy Tran, Kari Schneider

2 What is Night Eating Syndrome? - Night eating syndrome is an eating disorder, characterized by a delayed circadian pattern of food intake. - This is when a person eats a large amount of food after dinner and before going to bed, or a person may awake in the night to eat greater than 25% of their daily calorie intake.

3 Etiology behind NES - At this time there is an unclear etiology, but the research shows there might be a correlation to genetic factors and as well as environment. - - More research needs to be conducted involving family history and stress factors - - Night eaters have significantly greater SERT uptake ratios in the midbrain than those of healthy individuals, this is associated with the pathophysiology of NES

4 Other health concerns - Night Eating Syndrome is not Binge Eating Disorder - There are other factors that influence NES, people that are diagnosed will often have other comorbid psychiatric issues similar to other eating disorders - Bipolar disorder has been associated with NES - Significant factors: stress, depression, panic disorder, OCD, and anxiety can be precursors to developing NES - Some diagnosed patients do not believe NES is a health concern or eating disorder - Most individuals diagnosed with NES are overweight or obese

5 Other health concern continued -Some individuals feel a loss of control while others do not feel a loss of control - NES can be a result of failed dieting during the day -NES affects roughly 1.5% of the population -A sense of shame is also common -May also have a sleeping disorder -Uses food as medication

6 Diagnosis There are 5 features 1. Morning anorexia 2. Eating between dinner 3. Sleep onset/during nocturnal awakening 4. Insomnia 4 to 5 times a week. Belief that eating will help them sleep 5. Depression worsens during the evening

7 Diagnosis -Night Eating Questionnaire -> Consists of 17 questions -> Score 25 and greater is suggestive of Night Eating Syndrome -> 30 and more is considered a definitie case of Night Eating Syndrome -Statistical Manual of Mental Disorders Fifth Edition (DSM-5) -> listed as Other specified Feeding and Eating Disorder

8 Night Eating Questionnaire

Intervention/Treatment - Many people with NES take years to seek help - Lack of specific support groups, rarely addressed eating disorder, runs in families - Most

sleep - While SSRIs are mostly used to improve moods, it may have a direct impact on eating disorders - Bright light therapy - Using 10,000 lux lights in everyday life at the

9 Intervention/Treatment - Many people with NES take years to seek help - Lack of specific support groups, rarely addressed eating disorder, runs in families - Most common/successful treatment for NES is sertraline and other SSRIs - Selective Serotonin Reuptake Inhibitors - Adjusts circadian eating patterns while improving mood for better sleep - While SSRIs are mostly used to improve moods, it may have a direct impact on eating disorders - Bright light therapy - Using 10,000 lux lights in everyday life at the right time to reset circadian rhythm and increase melatonin production - Case studies/clinical trials didn t show weight loss or mood changes, but did improve sleep patterns and cut NES symptoms drastically

Treatment continued (Old techniques/little research) - Behavioral therapy - Behavioral adjustments to reduce/negate NES symptoms - Rewarding small goals over time (one night/week without binging) -

10 Treatment continued (Old techniques/little research) - Behavioral therapy - Behavioral adjustments to reduce/negate NES symptoms - Rewarding small goals over time (one night/week without binging) - Chaining refrigerator door shut at night - Educating patients on NES, nutrition, and other eating disorders - Very long case studies, but few symptom relapses if patient practices behavior therapy long enough - Progressive Muscle Relaxation - Patients practice contracting and relaxing muscles to improve differentiation from stress and relaxation - Better for patients who are stressed/depressed/anxious

11 Recovery - Patients who take sertraline have the least symptom recurrences - After NES symptoms reduce for a long time, weight tends to drop after as well - There are no direct permanent health effects after suffering from NES - Health issues arise from type/amount of food eaten - Currently few clinical trials have long term follow up studies

12 Closing Statements - There is no defined etiology behind NES at this time. - NES is a serious eating disorder that involves a person eating more than 25% of their daily calorie intake at night time before bed. - The most common, successful, and frequently researched method of treatment is Sertraline, a form of SSRI - More research needs to be conducted about Night Eating Syndrome.

13 Questions What is the score that indicates a person is at risk of Night Eating Syndrome, beside the scoring system how can a person self diagnosis? Do people with Night Eating Syndrome have other psychological disorders similar to other disordered eating patterns? If so state a few of the associated risk factors with Night Eating Syndrome. What form of SSRIs is most commonly used to combat NES, and what do SSRIs do?

14 References Allison, K. C., & Tarves, E. (2011). Treatment of Night Eating Syndrome. The Psychiatric Clinics of North America, 34(4), Allison, K. C., Stunkard, A. J., & Thier, S. L. (2004). Overcoming Night Eating Syndrome. Oakland, CA: New Harbinger. Lundgrena, J.D., Rempferna, M.V., Brown, C.E., Goetzc, J., & Hamerac, E. (2010). The prevalence of night eating syndrome and binge eating disorder among overweight and obese individuals with serious mental illness. Psychiatry Research, 175(3), doi /j.psychres Servincera, G.M. & Allisonb, K.C. (2016). Night Eating Syndrome: Report of a family case. Eating Behaviors, 22(na) doi: /j.eatbeh Wong C, Mabourakh D, Levin JL and Shoar S. Night Eating Syndrome: Etiology, Diagnosis and Treatment. Austin J Sleep Disord. 2017; 4(1): Martellini, M. (2016, May 12). Current and emerging drugs treatment for night eating syndrome. Retrieved from Allison, K C. (2006, May 1) A Randomized, Placebo-Controlled Trial of Sertraline in the Treatment of Night Eating Syndrome. Retrieved from McCune, A (2015, September 30. Bright light therapy for the treatment of night eating syndrome: A pilot study. Retrieved from

Perceived Stress, Psychological Functioning, and Sleep in Night Eating Syndrome. Staci M. Person, HBA. Department of Psychology. Lakehead University

Running head: STRESS AND NIGHT EATING SYNDROME Perceived Stress, Psychological Functioning, and Sleep in Night Eating Syndrome Staci M. Person, HBA Department of Psychology Lakehead University Thesis submitted