Understanding night eating syndrome and how to manage it

For people with night eating syndrome (NES), eating late in the evening means more than just enjoying a bedtime snack. It’s not unusual for someone with NES to consume a quarter of their daily calorie intake after dinner and then wake up several times during the night to eat again.

People with NES feel compelled to eat or feel full in order to sleep. This contributes to the idea that they may be remedying their insomnia with their late-night excessive food consumption. That being said, their urge to overeat can also lead to feelings of guilt, shame, and poor sleep quality. 

NES is more common in people who have other eating disorders, including anorexia nervosa and binge eating disorder (BED). It’s also more common in people with anxiety, depression, and substance use disorders. Approximately 9% of Americans will have an eating disorder in their lifetime, while an estimated 1.5% will be diagnosed with NES.

Symptoms of night eating syndrome

Eating disorders aren’t always easy to recognize. Since NES involves both overeating late at night and insomnia, some people may believe they just have a sleep disorder.

NES isn’t the same as sleep-related eating disorder (SRED), which causes people to sleepwalk, eat while they’re asleep, and have little memory of eating the next day. With NES, people eat large amounts before bed and are aware that they wake up during the night to eat, believing food will soothe their insomnia and help them fall back to sleep.

Although NES and binge eating disorder share similar symptoms, they’re distinct eating disorders. People who binge eat use food to numb their emotions and eat any time of day, while those with NES tend to consume large amounts of food before bedtime and wake up during the night to eat.

A mental health professional may make a diagnosis of NSE if you experience the following symptoms for at least three months: 

• Consuming at least 25% of your daily calories in the evening after dinner
• Nocturnal snacking (waking to eat in the middle of the night)
• Sleep difficulties at least three times a week
• Depression
• No appetite for breakfast and eating little throughout the day
• Believing you can’t fall asleep or fall back to sleep without eating
• Eating late at night even when you aren’t physically hungry 

Untreated NES can make it difficult to maintain a healthy weight. It can also increase your risk of diabetes, high cholesterol, and high blood pressure. Other health problems associated with NES include a higher body mass index (BMI), increased levels of pain, and lower quality of life.  

What causes NES?

Although the root cause of NES isn’t fully understood, some studies indicate that having depression, anxiety, impulsivity, or childhood trauma, can increase your risk of developing NES. Other research that explores possible causes for NES shows that chronic stress and high levels of cortisol (the stress hormone) can lead people to eat more food late at night. 

People with NES have been found to have a delayed circadian pattern of food intake that results in increased hunger at night. NES is also more common in people with diabetes and obesity.

In some cases, NES has been shown to run in families, leading researchers to believe that genes may play a role in who develops the condition.

Managing and treating night eating syndrome

Overcoming NES involves addressing both the physical and psychological factors that contribute to the condition. A therapist can help develop a treatment plan that might include some of the following self-care strategies.

• Mind-body exercises: There is some evidence that progressive muscle relaxation (PMR) may benefit NES. Using PMR, you alternately tense (squeeze) and relax (release) your muscles, starting with a specific body area, like your toes, and working your way up to the top of your head. Practicing PMR for 10-20 minutes before bedtime can help with insomnia, anxiety, depression and stress by calming the mind and inducing sleep. 

• Journaling: Many people who experience NES notice a drop in their mood in the evening. Journaling during this time can help you better understand your thoughts and feelings, giving you further insight into what may be beneath the surface.  

• Light therapy: Some studies have shown that 30-minute sessions of l0,000-lux white light therapy are effective in treating symptoms of NES. When light boxes are recommended by a therapist and used on a regular basis, they can help people with NES fall asleep faster and stay asleep throughout the night. 

To treat NES, a therapist might also recommend medications, cognitive behavioral therapy (CBT), nutritional counseling, and lifestyle changes. CBT, also known as talk therapy, helps change negative thought patterns and behaviors related to NES. 

Nutritional counseling can help people with NES build a more mindful relationship with food, plan out small healthy meals to eat throughout the day, and learn ways to break the cycle of eating late at night.

In some cases, a mental health professional may prescribe medications to address underlying anxiety or depression. There are also medications that can help regulate your sleep cycle. It’s best to talk to your provider about whether medication might be a good option for you.

Find care with Rula

Night eating syndrome can have a profound impact on both your physical and emotional health. Recovering from NES is possible with access to the right resources and support, beginning with a qualified mental health professional.

At Rula, we can connect you with a therapist who accepts your insurance so that you can begin receiving the support you need. In as little as three minutes, you can find a therapist who understands your symptoms and offers the specialized treatment you deserve. With our convenient online appointments, you can connect with a therapist as soon as tomorrow at a time and place that works for you.

Find a therapist with Rula