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Night eating syndrome (NES) may not be as well-known as other eating disorders like anorexia nervosa and bulimia nervosa, but the condition still impacts as many as 1 in every 100 people.1
Thankfully, recovery from NES is possible with the appropriate help, and several types of night eating syndrome treatments are available.
Night eating syndrome is an eating disorder that involves similar symptoms to both binge eating disorder and insomnia. NES is considered an “other specified eating and feeding disorder,” according to the American Psychiatric Association. The conditions in this category are related to eating disorders but do not meet enough criteria to receive another diagnosis.
People with NES may eat large amounts before bed or wake up several times throughout the night and proceed to eat large quantities of food. In fact, people with NES tend to eat a large portion of food throughout the night, with some consuming as much as 25% of their daily food intake during these episodes.2
Unlike sleep-related eating disorder (SRED), a specific type of condition that involves disordered eating behaviors while someone is not fully conscious, NES happens while someone is fully awake and aware of their actions.1 Someone can wake up with the specific intention to eat or feel that when they do wake up, they need to eat to fall back asleep.1
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How to treat night eating syndrome best depends on many factors, including the severity of someone's case. NES is typically treated on an outpatient level. However, as with all eating disorders, it can be addressed along a spectrum of care, including:3
While these levels of care dictate how rigorous a treatment program is, patients can participate in many different types of treatment for night eating syndrome while attending these programs.
The most common treatment for night eating syndrome is psychotherapy, which involves discussing feelings, concerns, and experiences with an analyst and learning new skills and coping mechanisms to replace unhelpful thoughts and behaviors.
Several types of night eating syndrome therapy have been shown to be effective.
Pharmacotherapy, or the use of medication to help control certain disorders, has been the most-tested treatment for night eating syndrome.2
Most prominently, a class of medication called selective serotonin reuptake inhibitors (SSRIs) have been used to help with NES, with many cases showing these drugs to be effective.2 Doctors may also prescribe additional medications to help people with NES treat symptoms of related disorders, including depression or anxiety.
Medications are recommended on a case-by-case basis, and even throughout treatment, patients should have regular check-ins with doctors to measure dosage and progress.
It's important to note that while medications are the most-tested type of night eating syndrome treatment, they are in many cases considered supplementary treatments, with many doctors referring patients to work primarily through psychotherapy and other kinds of night eating syndrome therapy.
Nutrition counseling and meal support can be a particularly important treatment for night eating syndrome since the condition is centered around a specific disordered eating pattern.
Most people struggling with NES will not eat in the mornings but will wake up once or several times during the night to eat. There’s also a correlation between people struggling with night eating syndrome and people who diet because they don’t get enough food to nourish their bodies during the day.2
In these cases, nutrition counseling and meal support can help through the power of education and support.
For patients continually experimenting with diets, nutrition counseling can educate them about the damage diets do to the body and mind, why they don’t work in the long term, and why they often lead to weight gain. It can also offer new strategies to improve patients' relationships with food and their bodies.
Meal support can also help correct eating patterns, encouraging patients to eat more in the morning and throughout the day before they go to sleep.5
Night eating syndrome may seem difficult to overcome, but help is available, and recovery is possible. The approaches above have all been found useful for treating eating disorders, including night eating syndrome.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
