Night eating syndrome (NES) is a condition where a person primarily eats at night. The eating disorder is more complex than snacking before bed. Those with NES experience varying levels of guilt or shame while eating and feel a lack of control, often causing them to continue eating past the point of feeling full.
NES does not always receive the same attention as other eating disorders. However, it is a severe condition affecting roughly one in ten people in the United States. (1)
NES is a condition that may cause physical, emotional, and behavioral changes. There are certain signs another person may observe in someone with NES. Not everyone will show the same signs of the condition, but there are a few common factors that may indicate a person has NES.
Loved ones may notice physical changes in a person with NES. Those physical signs may include:
Some people with NES feel a loss of control over their eating behaviors, leading to shame. This shame may make them uncomfortable to eat in front of others, and they may hoard food to eat in private. It's common for a person with NES to have a drawer of snacks in their dresser or nightstand, especially if they live with other people and want to hide their night eating. People with NES living alone may also hoard food and hide it in places where guests may not come across it.
A person with NES may go most of the day without eating, and when they eat, they will consume their food rapidly. They may feel guilty about eating or not want people to notice them, so they will eat quickly. In other cases, eating quickly may be due to feeling out of control in their eating behaviors. Rapid eating can cause bloating, gas, and other digestion issues. (2)
NES may also result in changes to a person's emotions or behaviors. Some signs of NES that family, friends, and medical professionals may observe are:
Depression for those living with NES tends to worsen at night, but they can experience it at any time of day. Depression is more than feeling sad. It's a severe medical condition that impacts feelings and behaviors. (3) Depression for someone with NES may range from severe to mild. An individual may experience sadness, irritability, a loss of interest in hobbies, changes in appetite, feelings of worthlessness, or difficulty concentrating. Depression may also lead to social isolation, especially at night. A person with NES may prefer to spend between dinner and bedtime alone.
People living with NES tend to experience high anxiety levels. (4) For people with NES, fear can stem from the lack of control over their eating behaviors. As night nears, their anxiety may rise in anticipation of cravings. They may suddenly worry that they will be unable to stop eating, or dread going to bed knowing they're going to have trouble sleeping. Some physical signs of anxiety include sweating, trembling, or fidgeting.
Mood swings are a dramatic change in a person's mood. These mood shifts tend to happen from day to night for individuals with NES. While some people with NES experience depression and anxiety throughout the day, for others, these conditions worsen at night.
It's common for a person with NES to feel happy and energetic at the start of the day, convincing themselves they're not hungry, or they're not going to give into nightly cravings. Then, as the night rolls in, they begin to feel depressed and anxious. They may also have trouble sleeping and believe the only way to sleep is to eat. These shifts in emotions from morning to night turn into a cycle, and the mood swings may become more apparent to friends and loved ones.
Loved ones and medical teams can not identify symptoms of NES by observing a person with the condition. Symptoms are physical, behavioral, and emotional factors the person with the eating disorder experiences and can explain to others to help them understand how they feel.
NES can physically affect the body in several ways. Some physical symptoms someone with NES may experience are:
Fatigue is a common symptom of individuals with NES. Fatigue is when someone is overtired and has low energy. The person may feel physically drained and want to take long naps that interfere with their usual activities throughout the day.
Fatigue in people with NES may happen for many reasons. If they are dealing with depression, they may experience mental and emotional exhaustion and want to sleep during the day. Individuals may also feel overtired because they have trouble sleeping at night. Eating large meals or not eating the proper nutrients to fuel the body can also cause fatigue.
Many eating disorders are associated with gastrointestinal symptoms, including nausea, heartburn, gas, and bloating. (5) People with NES often experience gastrointestinal problems because of rapid eating. When a person eats quickly, they tend to swallow a lot of air. That overconsumption of air can lead to bloating and gas. Eating quickly or past the point of being full can also lead to nausea.
Living with NES can also cause various emotional and behavioral symptoms. A few of those symptoms are:
Since people with NES tend to feel a loss of control mixed with anxiety and depression, it's common for those signs to also come with low self-esteem. Although, a person with NES can experience low self-esteem without showing signs of depression. (6) Low self-esteem in someone with NES can manifest as lack of self-confidence and worrying that they're inadequate or incapable of maintaining the right eating behaviors for themselves.
People with NES tend to not eat during the day, even if they're hungry. Sometimes, the individual will try to convince themselves their signs of hunger are nonexistent. Other times, a person with NES may feel guilty about what they ate the night before and tell themselves they're not hungry or don't deserve to eat.
People with NES may also have difficulty recognizing when they're full. Someone with NES may eat even while full, because they tend to eat quickly, and their body may take longer to process and metabolize food. Another reason is that the individual may be emotionally eating. Since NES can cause many emotions such as depression, shame, and guilt, some people find comfort in eating, making it harder to stop even when they're full. (7)
Those with NES often experience insomnia or interrupted sleep. When someone with NES wakes up in the middle of the night, they may believe the only way to fall asleep is to eat. These wake-ups may occur once or several times throughout the night. (1) A vital distinction between NES and other sleep-related eating disorders is that people with NES are fully awake and conscious while eating.
It's never too early for a person with NES to seek help. NES can lead to various health concerns, such as high blood pressure and diabetes if left untreated. Many treatment options are available for people living with NES, including multiple therapies and medications. The sooner someone living with NES seeks help, the quicker they'll find the resources they need to start their healing journey.
It can be challenging to find support from treatment providers for eating disorders, especially providers who fully understand the many nuances of disordered eating. At Within Health, we have created a virtual, at-home program for anyone struggling with an eating disorder. Our clinical care team will work with you to overcome night eating disorder, or any other disordered eating habits.
If you or someone you know is showing signs and symptoms of NES, Within Health is here to help. Our team of caring professionals is ready to provide compassionate treatment for NES. Please get in touch with our admission team to learn how to get started building a healthy relationship with food and your body today.