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Objective To propose criteria for diagnosis of the night eating syndrome (NES). Method An international research meeting was held in April 2008, and consensus criteria for NES diagnosis were determined. Results The core criterion is an abnormally increased food intake in the evening and nighttime, manifested by (1) consumption of at least 25% of intake after the evening meal, and/or (2) nocturnal awakenings with ingestions at least twice per week. Awareness of the eating episodes is required, as is distress or impairment in functioning. Three of five modifiers must also be endorsed. These criteria must be met for a minimum duration of 3 months. Discussion These criteria help standardize the definition of NES. Additional aspects of the nosology of NES yet to be fully elaborated include its relationship to other eating and sleep disorders. Assessment and analytic tools are needed to assess these new criteria more accurately.

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The rising prevalence of obesity is a global concern. Eating behaviour and circadian rhythm are proving to be important factors in the aetiology of obesity. The night-eating syndrome (NES) is characterized by increased late-night eating, insomnia, a depressed mood and distress. It is evident that prevalence is higher among weight-related populations than the general community. The exact relationship between this syndrome and obesity remains unclear. The reasons for the discrepancies found in the literature likely include varying diagnostic criteria and a wide range of study population characteristics. NES does not always lead to weight gain in thus certain individuals may be susceptible to night-eating-related weight gain. Weight loss through surgical and behavioural treatments has shown success in diminishing symptoms. The increasing literature associating obesity with circadian imbalances strengthens the link between the NES and obesity. Circadian genes may play a role in this syndrome. This review will examine different aspects of obesity in the context of the NES.

Night eating syndrome is prevalent among psychiatric clinic outpatients and is likely to co-occur with substance use disorders and obesity.

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The purpose of this study was to characterize the Night Eating Syndrome (NES) and its correlates among non-obese persons with NES, and to compare them to non-obese healthy controls. Nineteen non-obese persons with NES were compared to 22 non-obese controls on seven-day, 24-hour prospective food and sleep diaries, the Eating Disorder Examination and the Structured Clinical Interview for DSM-IV Diagnoses interviews, and measures of disordered eating attitudes and behavior, mood, sleep, stress, and quality of life. Compared to controls, persons with NES reported significantly different circadian distribution of food intake, greater depressed mood, sleep disturbance, disordered eating and body image concerns, perceived stress, decreased quality of life, and more frequent Axis I comorbidity, specifically anxiety, mood, and substance use disorders. These findings are the first to describe the clinical significance of night eating syndrome among non-obese individuals in comparison to a non-obese control group, and they suggest that NES has negative health implications beyond that associated with obesity. Keywordsnight eating syndrome; eating disorders; sleep; mood; stress; clinical significance IntroductionNight Eating Syndrome (NES) is concived as a delay in the circadian pattern of food intake (Stunkard, Grace, & Wolf, 1955). The original definition of NES, based on clinical observation of obese persons, operationalized the syndrome as evening hyperphagia (the consumption of ≥ 25% of total daily food intake after dinner), morning anorexia, and depressed mood that worsens in the evening (Stunkard, Grace, & Wolf, 1955). Since this definition was proposed, over 50 publications on the characterization and prevalence of NES have been presented. Naturally, as the circadian eating patterns of additional populations have been studied, the operational definition of NES has evolved (Birketvedt et al., 1999;O'Reardon et al., 2004). Currently, NES is operationalized as engaging in evening hyperphagia (consumption of ≥ 25% of total daily calories after completion of the evening meal) and/or nocturnal awakenings accompanied by ingestions of food (≥ 3 episodes/week) (Allison, Grilo, Masheb, & Stunkard, Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. (Stunkard, Grace, and Wolf, 1955). Current research supports the association between NES and excess weight for some people. For example, we found (Lundgren et al., 2006) found that obese psychiatric outpatients were five times more likely than non-obese psychiatric outpatients to meet criteria for NES. Also, Andersen and colleagues (2004...

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