Night eating syndrome: How to treat it?

Abstract

Night eating syndrome (NES) is characterized by caloric intake ≥ 25% of total daily after dinner and/or by two or more weekly nocturnal awakenings accompanied by food ingestion. Causes of NES are not entirely clear and seem to involve a desynchronization between the circadian rhythms of food ingestion and sleep, resulting in a delayed pattern of food intake. Estimates of the prevalence of NES in the general population are around 1.5%, and although much higher frequencies have been described in obese individuals, a causal relationship between NES and obesity is not clearly established. Since the first NES reports, several treatment modalities have been proposed, although, in many cases, the evidence is still insufficient and there is no consensus on the ideal approach. In order to conduct a critical review of proposed treatments for NES since its original description, a systematic search of articles published in journals indexed in Medline/ Pubmed database in the period 1955-2015 was performed. Seventeen articles addressing non-pharmacological and pharmacological therapies met the selection criteria. Based on the articles analyzed, we conclude that serotonergic agents and psychological interventions, particularly cognitive behavioral therapy, have been shown to be effective for the treatment of NES. A combination of non--pharmacological and pharmacological therapies must be considered in future studies on the treatment of these patients.

An Updated Review of Night Eating Syndrome: An Under-Represented Eating Disorder

“…Treatments targeting the regulation of circadian rhythms, mood, stress, and faulty cognitions have been considered. Pinto et al [ 53 ] conducted a critical review of treatment for NES and concluded that serotonergic agents and psychological interventions, particularly cognitive behavioral therapy (CBT), have shown effectiveness [ 52 ]. However, Muscatello et al contends that there is still a paucity of research in this area, with treatment for NES remaining an emerging field [ 17 ••].…”

“…It is therefore thought to be connected to NES. Decreased serotonin levels have been hypothesized to lead to the alteration of circadian rhythms and increase risk of evening hyperphagia [ 53 ]. Night eaters have also been found to have higher levels of serotonin transporter in the temporal lobe, which contributes to changes in circadian rhythms and appetite [ 54 ].…”

Risk assessment of night-eating syndrome occurrence in women in Poland, considering the obesity factor in particular

“…This finding is consistent with that reported by Pinto et al and Rand et al, who estimated the prevalence of this condition to be 1.5% in the world. 1 , 20 In a study by de Zwaan et al, conducted on the general population in Germany, prevalence of NES symptoms was indicated at 1.1%. 21 Similar results were obtained in the study conducted by Zadjali et al on the population of Oman where the criteria of NES were fulfilled by 1.5% of the studied people.…”

‘In the night kitchen’: A scoping review on the night eating syndrome

“…Pharmacological treatment. Serotonergic system, the main regulator of a wide variety of physiological functions and behaviors such as eating, sleep and mood is thought to be intrinsically involved in NES; mainly, a decrease in serotonin levels would lead to the alteration of circadian rhythms and to a high risk of evening hyperphagia and nocturnal eating (Allison et al, 2005a;Pinto et al, 2016;Stunkard et al, 2009a). Moreover, as previously reported, in night eaters higher levels of SERT in the temporal lobe have been documented (Lundgren et al, 2008b); this finding supports the presence of dysfunctions in postsynaptic serotonergic transmission, that contributes to changes in circadian rhythms and appetite (Stunkard et al, 2009b).…”