Night eating syndrome in class II–III obesity: metabolic and psychopathological features

Abstract

Objective: To investigate the relationship of metabolic disorders and psychological features with the night eating syndrome (NES) in individuals with moderate-to-severe obesity. Design: Cross-sectional observation. Subjects: A total of 266 consecutive participants with class II-III obesity, entering an inpatient weight loss program. Measurements: Participants who reported consuming either a large amount of their caloric intake after the evening meal (roughly self-assessed as X25% of daily calories) or the presence of nocturnal feeding at the Night Eating Questionnaire (NEQ) (N ¼ 49) were interviewed by the Night Eating Syndrome History and Inventory (NESHI). Assessment also included the clinical/ biochemical parameters of the metabolic syndrome and several questionnaires of psychopathology. NES was diagnosed by NESHI criteria (evening hyperphagia (X25% of daily food intake after the evening meal) and/or waking at night to eat at least three times a week) in the last 3 months. Results: Twenty-seven participants (10.1%) met NESHI criteria. Differences were not observed between participants with and without NES as to age, body mass index (BMI), prevalence of metabolic syndrome, Binge Eating Scale and Body Shape Questionnaire. NES participants had significantly higher scores of Beck Depression Inventory (BDI) and Impact of Weight on Quality of Life (IWQOL). Among NES cases, the BDI score was indicative of moderate depression in 18.5% of cases and of severe depression in 44.4%. Logistic regression analysis, adjusted for confounders, identified the BDI score as the only variable significantly associated with the diagnosis of NES. Conclusion: Diagnosing NES does not help identify obese individuals with specific medical complications, but indicates more severe psychological distress and depression.

Prevalence of night eating in obese individuals with schizophrenia and schizoaffective disorder

“…Those with NES had lower HDL and higher LDL; this is contrary a previous study which detected no difference in cholesterol [6]. Unexpectedly, our patients with NES had significantly lower rates of diabetes than those without NES (18% vs. 45%), a finding that should be viewed cautiously pending replication.…”

“…There were no differences in rates of metabolic syndrome based on night eating status which is in agreement with previous research in obese population [6]. Those with NES had lower HDL and higher LDL; this is contrary a previous study which detected no difference in cholesterol [6].…”

“…Although NES is not exclusive to the obese, it is proposed to be an important contributor to later-life obesity [5]. The metabolic and dietary associations with NES are not well established, and recent evidence has refuted an association with metabolic syndrome and body mass index (BMI) [6]. No association between NES and total daily calories consumed has been found to date [7].…”

“…Previous studies revealed a point prevalence of 12% in psychiatric outpatients [11], and 25% in overweight individuals with serious mental illness [12]. In the general population, night eating has previously been associated with psychopathology, specifically with depression [6, 13–16]. Several self-report measures for assessing the presence of night eating behaviors and NES have been constructed in recent years [15, 17, 18].…”

Psychological and health comorbidities before and after bariatric surgery: a longitudinal study

“…Also, we have not assessed eating disorders and pathological eating behaviors that are common in this population, especially after surgery. 34 This assessment would require a control group to compare changes taking place over a period of time.…”