Though symptoms can significantly impact mental and physical health, treatment for this eating disorder is possible.
Although many people enjoy an occasional midnight snack, if eating too much at night becomes excessive or impacts daily functioning, it could indicate an eating disorder called night eating syndrome (NES).
People with this condition may consume a substantial portion of their daily meals at night or eat to cope with sleep difficulties. Also, they may not feel hungry in the morning and not eat until late afternoon.
But how do you know if you should be concerned about your late evening or nighttime eating patterns?
NES is an eating disorder characterized by a pattern of excessive food consumption at night or after awakening.
People with this condition typically feel a strong urge to eat after dinner until bedtime. They may also have trouble staying asleep and may get up throughout the night to eat.
NES was first
- lack of hunger and not eating in the morning
- consuming 25% of daily food intake after the evening meal
However, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) classifies NES as a subtype under Other Specified Feeding or Eating Disorders (OSFED). Other subtypes of OSFED include:
- atypical anorexia nervosa
- low frequency or limited duration binge eating disorder (BED)
- low frequency or limited duration bulimia nervosa
- purging disorder
Older surveys from the 1990s indicate that NES may affect around 1.5% of the general population and approximately
People with NES may also be at risk for other health conditions, including diabetes and high blood pressure. A 2014 study found that 7% of people with type 2 diabetes also met the diagnostic criteria for NES.
The symptoms of night eating syndrome can be like other eating and sleep disorders. But if you or someone you know experiences the following signs, it may indicate NES:
- a strong desire to eat between dinner and bedtime
- difficulty sleeping while feeling the need to eat to fall asleep again
- anxiety or depression symptoms that worsen in the evening
- consuming more than one-quarter of your daily food intake at night
- not eating breakfast or not feeling hungry until late afternoon
- shame and guilt related to
Diagnosing NES can involve completing the Night Eating Diagnostic Questionnaire (NEDQ) or the Night Eating Diagnostic Scale (NEDS). During the screening, your doctor may also consult the DSM-5 criteria for NES and inquire about your mental health history and physical conditions.
According to the DSM-5, requirements for an NES diagnosis typically include:
- eating excessively after dinner or awakening from sleep
- awareness and memory of nighttime eating
- symptoms that cause significant distress or interfere with daily functioning
For a diagnosis to be made, symptoms cannot be related to:
- underlying conditions
- binge eating disorder (BED)
- effects of certain medications
- changes in your sleep-wake cycle
- cultural or social norms
Depression, anxiety, and mood disorders may also cause excessive food consumption. Also, these mental health conditions often co-occur with NES.
Like many eating disorders, night eating syndrome shares some symptoms with other related conditions.
Binge eating disorder (BED)
NES and BED share similar symptoms of increased food consumption. But people with BED may eat more during the day and experience more hunger than those with NES. Motivations behind eating may differ as well.
Someone living with bulimia may also have difficulty controlling urges to eat large quantities of food. However, people with bulimia may purge or engage in excessive exercise to manage the effects of their food consumption.
Sleep-related eating disorder (SRED)
Although NES and SRED are similar,
Research is limited to the causes of NES. But several factors may play a role in the condition.
Circadian rhythm disorders
Mental health conditions
Depression and anxiety may contribute to the development of NES.
In a 2021 cross-sectional study, study participants who consumed more food in the evening or throughout the night had significantly higher anxiety and depression scores than those without NES.
But it’s important to note that anxiety and depression symptoms may contribute to NES, indicating a bidirectional relationship between these conditions.
Other eating disorders
Substance use disorders (SUD)
Due to the actions of certain substances on brain chemicals, someone with a substance use disorder may experience urges to binge eat at night.
This often occurs most frequently when abstaining from the substance. For example, a person who smokes may increase their food consumption when going through smoking cessation.
If you’re living with NES, you’re not alone. Having NES does not mean you lack willpower or are at fault for the condition.
There are treatment options for NES, and learning to manage symptoms effectively is possible. Talking with a doctor about your symptoms is often the best first step in getting help.
According to one 2019 review, long-term data on the effectiveness of various treatment options is lacking. But this may be due to low awareness about the condition. The stigma associated with eating disorders may also contribute to underreporting symptoms.
Still, treatment is possible and often consists of a multifaceted approach involving medication, such as selective serotonin reuptake inhibitors (SSRIs) and therapies that include:
- cognitive behavioral therapy (CBT)
- progressive muscle relaxation therapy
- bariatric weight loss surgery
A doctor and therapist can work with you to find the best possible treatment plan. It’s common to try multiple strategies before finding the right combination.
Eating at night may be a common habit for many people. But if you tend to consume a substantial portion of your daily food intake after dinner or experience trouble sleeping because of urges to eat throughout the night, it may indicate NES.
Diagnosing NES typically starts with a visit to a doctor for a screening to determine whether your symptoms fit the DSM-5 criteria. There are treatment options for NES, and a doctor and therapist can help you decide on the best treatment plan if you are diagnosed.
Treatment for NES often includes a combination of therapies and medications. You may need to try several strategies before finding what works best for you.
Resources for eating disorders
For more information on NES or for help with navigating this condition, you can contact the National Eating Disorders Association (NEDA) helpline via online chat, or call or text (800)-931-2237. For urgent help, you can text “NEDA” to 741741 to reach their Crisis Text Line.
The National Alliance for Eating Disorders has an interactive database to find options near you.