Are you waking up in the middle of the night unable to fall back to sleep without eating a meal, or find yourself sleep-walking to the refrigerator and noticing in the morning the evidence of your night eating episode?
If you are unable to fall asleep at night until you feel overly full, it may be indicative of a form of disordered night eating, which may be caused by Night Eating Syndrome (NES).
As with other eating disorders, successful treatment of NES typically requires a combination of therapies. Treatment typically begins with educating individuals about their condition so they are more aware of their eating patterns and can begin to identify triggers that influence how they eat. Just identifying that they have NES and knowing that there are effective strategies to changing the behaviors is the important first step toward recovery.
For those who are struggling but embarrassed to mention the behavior, the identification and affirmation of NES can be liberating. For bewildered individuals who awaken to remnants of food and empty containers, this discussion can provide the first steps towards recovery.
Tips for Overcoming Night Eating Syndrome
Light exposure: It is our very primal nature to slow down, hibernate, and increase energy reserves during the winter, and to become more energized and awakened during sunnier times of the year. Nature guides us into this pattern by giving us fewer hours of day light during the winter. Society, however asks us to work in opposition and further extend ourselves as if living in a perpetual summer. In fact, to keep up, we need light. Sunlight actually helps trigger production of serotonin, a neurotransmitter that helps boosts mood, regulates metabolism, and balance other hormones. The hormone melatonin, like serotonin, helps control our sleep and wake cycles, appetite, and mood. Just as light triggers serotonin release, the synthesis of melatonin requires an absence of light. Working together to control your circadian rhythm, you can think of serotonin as the “on” switch that awakens you and melatonin as the “off” switch that allows you to sleep.
Year round, try getting morning sunlight exposure to aid circadian rhythm regulation and help the body awaken and energize. Taking a morning walk, drinking your coffee or tea on the patio, eating lunch outside as weather permits, and even spending time near a window can all increase exposure to sunlight. Even introducing bright colors to indoor environments has shown to help some people.
Sunlight is also our primary source of Vitamin D, which can have antidepressant effects in addition to its known role in maintaining strong, healthy bones. If you are unable to consume enough food sources and your winter climate does not allow enough sun exposure, it may be wise to consult your physician or dietitian about Vitamin D supplements.
Prioritize sleep: If we do not sleep, we will be hungry, especially for carbs and sugar because ghrelin, the hormone that drives hunger goes up and peptide yy, the hormone that makes us feel full, goes down. Just like being stressed can affect circadian rhythms, so can a lake of sleep. Your melatonin starts increasing about two hours before bed to prepare your body for sleep, which can be disrupted by night time snacks, resulting in poor sleep.
Most people need between eight to nine hours of sleep a night. Poor sleep is also associated with higher levels of the hormone cortisol, known as the stress hormone, because it is secreted during times of fear or stress, whenever your body goes into the fight or flight response. Some tips for improving sleep include turning off the TV an hour before you go to bed, and read a book or listen to soothing music instead. Dimming the lights in the evening is also effective so as to stimulate the secretion of the melatonin you need for a good night’s sleep.
Eat breakfast: This is the key strategy to stop the nighttime cravings, and people who eat breakfast are more likely to maintain a healthy weight.
Don’t drink your calories: Sugary beverages spike your insulin and blood sugar and will cause cravings. Let’s also not forget that alcohol can have a similar effect!
Make sure you eat regularly: Have breakfast, lunch, and dinner. The body is a hormonal clock, and we must eat in rhythm to keep it in balance.
Keep your Blood Sugar Levels Well Managed: Many hormones are sensitive to swings in blood sugar, including both melatonin and cortisol. This doesn’t mean eating low-carb, but rather to avoid spikes in blood sugar from high glycemic load foods. Too low carb of a diet can disrupt circadian rhythms by increasing cortisol and affecting insulin sensitivity, plus high starch meals about 5 hours before bedtime have been shown to improve sleep quality.
Have protein, good-quality fat and whole grains at every meal: Well-balanced meals lead to well-balanced blood sugar, and these meals are much more satiating than unbalanced meals. Research shows that when you are deficient in protein your cortisol levels will be chronically elevated. Good quality, unrefined fats, especially those rich in omega-3 fatty acids help lower cortisol and the inflammation it causes. Be sure to have quality grains and seeds such as quinoa, millet, buckwheat and amaranth. Including these as part of your evening meal can actually be calming and may help you sleep better.
Eat foods high in tryptophan: Melatonin is made from serotonin which is made from tryptophan. Nuts, seeds, tofu, cheese, lean red meat, chicken, turkey, seafood, oats, beans, lentils, and eggs are all good sources of tryptophan. Eating more of these foods is a great way to boost production both of serotonin and melatonin. Seafood has the added benefit of having more tryptophan while also having less of the other amino acids which compete with tryptophan to cross the blood-brain barrier. Eating seafood also contributes long-chain omega-3 fats to your diet. These healthy fats help support circadian rhythms by improving neural health in the brain and by improving resilience to stressors (if you’re getting high dietary omega-3s, you secrete less cortisol in response to stress).
Get activity: Time and time again, physical activity has proven to have amazing antidepressant results almost as powerful as medication. Endorphins are released into the bloodstream helping to energize our body and mood. Physical activity can also generate body heat and improve circulation. Getting some kind of activity during the day, even a walk here or there, has been shown in clinical trials to support melatonin production, however, it’s best to be active earlier in the day, since intense activity later in the day can delay your evening melatonin production, keeping you revved up longer in the evening. Furthermore, working out in a bright environment in the evening can also suppresses melatonin. Otherwise, any kind of activity all other times of the day (even better if it’s outside!) will help support circadian rhythms. Note- Individuals with eating disorders are advised to seek medical approval and clearance from their treatment team before beginning an exercise routine because they are at higher risk for compulsive exercise and overtraining. Additionally, their bodies may be physically compromised and unable to manage any additional energetic or caloric expenditure. Once these risks are considered and assessed, you can decide if adding moderate exercise would aid your recovery.
Embrace seasonal variation: It is natural, normal and healthy to sleep more in the winter and less in the summer. But indoor lighting has robbed us of the natural seasonal variations in the amount of sleep we get, our activity levels, and even our appetites. Most of us live as though it’s summer year-round. Adhering to slightly different amounts of sleep according to the seasons, and eating seasonally will help regulate your hormones in a healthy way. This means your carbohydrate intake will likely vary by season too, which will influence cortisol and melatonin through effects on insulin.
Find your pause button and soothe the stress: Stress often leads to overeating. Breathing, yoga, physical activity, aromatherapy and meditation are great ways to reduce stress, balance brain chemistry and hormone production, and stop the nighttime cravings. If you are under stress, not only do you have all the effects of elevated and dysregulated cortisol to deal with, but you also disrupt your circadian rhythms. Reducing stress means to remove stressors from your life. Whether that’s saying “no”, asking for help, or making changes to the structure of your life, whatever you can do to reduce stress will make a difference. Coffee also increases the body’s stress response to psychological stressors, so it is best to save coffee consumption for the earlier hours of the day. Other ways to manage stress might include going for a walk at lunch, taking a bath, or just making time for a good laugh or a hobby in your life.
Ask for help: This is perhaps the most difficult but also the most crucial step. Seek help from a trained professional as they will be able to help you through the next steps in forming a healthy relationship with food.
Conclusion
NES is not always recognized by health professionals, as it is still relatively new to healthcare providers within all disciplines and therefore often overlooked. Those who suffer from NES are not simply indulging in a bad habit. Sufferers have a real clinical illness, therefore acknowledging that eating disorders come in all shapes and forms is that much more important. If you suspect you or someone you know has NES, it is crucial to remove the shame, allow yourself or your loved one to feel supported and seek help.
References
Allison KC, Stunkard AJ, Thier SL. Overcoming Night Eating Syndrome: A Step-By-Step Guide to Breaking the Cycle. Oakland, Calif.: New Harbinger Publications; 2004.
Allison KC, Stunkard AJ. Self-help for night eating syndrome. In: Latner JD, Wilson GT, eds.Self-Help Approaches for Obesity and Eating Disorders: Research and Practice. New York: Guilford Press; 2007: 310-324.
Berner LA and Allison KC. Behavioral management of night eating disorders. Psychol Res Behav Manag. 2013; 6: 1–8. Published online 2013 Mar 28. doi: 10.2147/PRBM.S31929
Birketvedt, G., Florholmen, J., Sundsfjord, J., Østerud, B., Dinges, D., Bilker, W., & Stunkard, A.J. (1999). Behavioral and neuroendocrine characteristics of the night-eating syndrome. Journal of the American Medical Association, 282, 657-663.
Goel N, Stunkard AJ, Rogers NL, et al. Circadian rhythm profiles in women with night eating syndrome. J Biol Rhythms. 2009;24(1):85-94.
O’Reardon JP, Ringel BL, Dinges DF, et al. Circadian eating and sleeping patterns in the night eating syndrome. Obes Res. 2004;12:1789–1796.