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NES: A Factor in poor weight loss outcomes
 NES (Night Eating Syndrome) is a
syndrome with distinct psychopathology and increased food intake (over 50%)
later in the day, both of which may contribute to poorer
weight loss outcome. NES
is prevalent in about 6% of people who seek
treatment for
obesity.
In contrast to
binge eating disorder, which is characterized by short intense bursts of
eating, NES sufferers generally eat continuously through out the evening and
night.
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Three hormones
play a significant role in causing this eating disorder. Firstly, Dr. Birketvedt
and her colleagues at the University of Tromso in
 Norway found that levels of
melatonin � the hormone that helps us fall asleep and stay asleep at night �
were significantly reduced in NES sufferers. Similarly, leptin � the hormone
that suppresses appetite� didn�t rise to normal levels in night-eaters,
suggesting that their hunger pangs may be extreme enough to disturb sleep.
Finally, cortisol� what�s often called the �stress hormone�, that kicks in when
we�re
feeling tense � was elevated at night in the group with NES, perhaps further
enticing them to wake up and head to the kitchen.
NES has a
hereditary component which is not yet been fully understood.
A
disordered stress response, characterized by a reduced
pituitary -
adrenal
stress reaction, may
be a cause of NES. The anterior pituitary gland secretes a number of hormones
which control hormone secretion by other glands in the body such as the thyroid,
adrenal glands, and ovaries as well as secretes the hormones growth hormone and prolactin. The posterior pituitary gland consists of nervous tissue and stores
and releases the hormones oxytocin and vasopressin (ADH).
Several hormones important in the body's reactions to stress are made in the
adrenal glands.
Do You Have
Night-eating Syndrome?
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You eat 50
percent or more of your daily food intake after dinner
-
You have no
appetite for breakfast
-
You have
trouble falling and/or staying asleep
-
When you wake
up during the night you often eat
-
The foods you
eat at night are mostly
carbohydrates
-
If you have
any combination of these signs, consult your doctor.
Signs and
symptoms
-
 The person has
little or no appetite for breakfast. Delays first meal for several hours after
waking up. Is not hungry or is
upset about how much was eaten the night before.
-
Eats more food
after dinner than during that meal.
-
Eats more than
half of daily food intake after dinner but before breakfast. May leave the bed
to snack at night.
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This pattern
has persisted for at least two months.
-
Person feels
tense, anxious, upset, or guilty while eating.
-
NES is thought
to be stress related and is often accompanied by
depression. Especial ly at
night the person may be moody,
tense, anxious, nervous, agitated, etc.
-
Has trouble
falling asleep or staying asleep. Wakes frequently and then often eats.
-
Foods ingested
are often carbohydrates: sugary and starch.
-
Behavior is
not like binge eating which is done in relatively short episodes. Night-eating
syndrome involves continual eating
throughout evening hours.
Treatment
With much still
unknown about NES, treatment is tricky. So far, little research has been
conducted to address whether supplements of melatonin and/or leptin would
work to help night-eaters get their hormones back on track. Somewhat more
work
has been done to look at the benefits of selective serotonin reuptake inhibitors
(SSRIs), a type of antidepressant. The JAMA study theorised that because
night-eaters overwhelmingly seek out high-carbohydrate snacks, which calm and
satisfy the body, they may in effect be trying to elevate serotonin levels which
help to encourage sleep. If that holds true, then SSRIs might work even more
efficiently to achieve that benefit. Along the same lines,
NES sufferers can follow a special diet, including foods high in tryptophan
(such as turkey and peanut butter), an
amino acid which also helps to induce
sleep. It may also help some night-eaters to find ways to
reduce stress and to
plan social events in their evenings, thereby circumventing the opportunity to
eat, at least in the early part of the night.
 Night eating may
be the result of a medical condition or hypoglycemia, both of which can be
treated. If not, the habit of eating in the middle of the night can be broken
with behavior modification and/or stress reduction. Eating frequent small meals
during the day beginning in the morning, reducing carbohydrate intake, and
increasing protein intake before bedtime are diet patterns that may help.
Protein metabolizes slowly and will stabilize blood sugar levels during sleep.
Contrary to protein, sugary snacks raise the blood sugar quickly, then cause it
to plunge. So, avoid sweet foods before bedtime.
Changing your
eating pattern is the first step of weight loss.
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