Night eating syndrome is an eating disorder characterized by delayed pattern of food intake primarily occurring during the later hours of the evening. Patients consume at least 25% of daily food after dinner or participate in a nocturnal eating episode at least twice a week. NES has been dated back to the “mid-1950s with reported cases having little know documentation other than institutional commitment.”Stunkard. These earlier cases were simply considered recurrent episodes with insomnia related side effects. It was not until the late 1990s when cross-study comparisons and time lapse observations were considered. Although recent studies have been conducted only 1.1-1.5% of the population has been reported to suffer from this condition. In relation to our lecture, NES plays a significant role as either an underlying or inherited condition interfering with recovery. Patients struggling with physical or mental disorders tend to develop co-disorders that inhibit the patient from recovering fully even with the aid of a certified counselor or physician. Substance abuse and bariatric complications are also common traits among individuals who suffer from NES due to their extreme nature.
I chose to write about NES because the sever lack of research behind it. This condition is considered one of the most preventable diseases and can commonly be associated with midnight snacking. Individuals who suffer from this disorder have little to know resources to utilize and are commonly bunched with anorexics. Personally, the relation between night eating and heart rhythm abnormalities struck me at my core. My family is at risk for sever heart conditions and cardiac arrythmia which eventually lead to my grandfather’s heart attacks and passing. After speaking with my father, he mentioned to me that he too struggled with night eating and had to develop tactics to combat it. This realization helped me understand that this condition can happen to anyone regardless of having a previous eating disorder. NES should be on the forefront of research instead of simply being added to the DSM as underlying criteria. In conclusion, NES will be a topic of interest for me and I will continue to be mindful when evaluating patients or cases that present signs of night eating.
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During our class discussion several topics were discussed regarding NES. Curtain triggers such as depression, anxiety, sadness, and boredom can cause sever acceleration of the condition. Although knowledge about NES and depressive mood is substantial, the relationship between NES and anxiety is relatively understudied. According to the “affect regulation model of eating disorders disruption of mood and stressful life events may trigger a coping response of overeating.” SEVINCER. Sadness and boredom are also directly associated with the development and nurturing of this disorder. As the patient continues to participate in night eating the likeliness of them developing a secondary disorder increases dramatically. During lecture, Caitlyn emphasized the importance of understanding the root of the disorder. The patient may be suffering from concerns relating to weight, negative self-image, or even frequent failed attempts at dieting. All these characteristics are leading signs that put the patient at heightened risk for developing NES. The last slide in the lecture PowerPoint covers several important concepts that are key to understanding the condition. NES is not a sleep disorder. While NES can affect sleeping patterns and cause irregularities in serotonin production, it mainly occurs after bedtime. A study published in the journal of the American Medical Association found that by “6 p.m., people with night eating syndrome consumed more than a third of their daily calories, while a control group had consumed almost three-quarters. Between 8pm and 6am the night eaters consumed 56% of daily calories, while controls consumed only 15%.” COX
In conclusion, the topics covered in class were directly related to several outside findings I researched. There seems to be a commonality between existing eating disorders and the development of NES. Not only is it becoming more research, but physicians and counselors are searching for NES signs before their final diagnosis.
What to Know About NES
Night eating syndrome is found in higher rates among obese adults than in the general population but specifically in individuals recovering from bariatric surgery’s. Common health complications include obesity, high blood pressure, diabetes, cardiac complications, acid reflux and the development of additional eating disorders such as anorexia and bulimia. Much like many eating disorders it takes time to observe these affects but the key is to recognize specific behaviors. Night eaters graze on food throughout the evening and often wake up several times to grab something to eat. This process happens usually after bed time and can be hard to spot given the household sleeping pattern. Some other common signs include hiding food, rapid eating during meals, and acquiring “filling foods.” Filling foods are generally bulky items that help the patient feel a sense of relief without eating to extreme. These are just a few of the common signs and implications NES can wage on a patient’s body. Anorexia can become a significant factor when combating NES whether it was present before or after the diagnosis. “Approximately 40% of individuals with bulimia in inpatient treatment centers convey signs of NES while roughly 50% of individuals within outpatient treatment report signs.” GERSON
In comparison to a “Swiss sample of young adults aged 18-26 years old who demonstrated a 10% overlap between NES and BN.” GERSON Between both studies NES was utilized as means to fall back asleep or cope with the patient’s condition. In conclusion, NES has a severe impact on the development of a patents recovery plan. Recognizing signs and symptoms can help family members, doctors, and even patients recognize if they suffer from NES and seek immediate treatment.
Treatment of NES has been conducted and research in many ways but still developing. Several methods such as mental health evaluation, cognitive behavioral therapy, serotonin regulatory medication, and calming meditation/restful thinking have been proven useful for patients. Health evaluations are generally considered the first step when addressing an eating disorder. Without this process patients and professional care takers would not be on the same page. Health evaluations provide specific insight into the patient’s current health and psychological background. Once these aspects have been evaluated professionals can build a structured recovery plan that the patient can adhere and grow with. Cognitive behavioral therapy has been shown to be “highly effective in the treatment of insomnia and served as a theoretical framework for the development of CBT for NES. Components of CBT-I, such as improving sleep hygiene and standardizing bedtime and morning awakening times, 32 were added as important elements to CBT for NES.” Marschollek This idea of restful thinking and reflection not only relaxes the patient but allows them to participate in full embodied sleep and thought. Serotonin regulatory medication therapy is one of the most common forms of treatment in the current field.
By medicating, patients can develop healthy sleeping patterns that not only lessen available eating time but benefit their overall health. As sleeping patterns develop patients will become less restless at bedtime and overpower the compulsivity to eat. Secondly, with the use of medication patients will remain asleep longer than those without, preventing the common “wake up” phenomenon. Meditation is also a beneficial treatment method for all eating disorders not just NES. Through daily meditation and the aid of their therapist patients can break down the emotional building blocks that cause the disorder. Meditation promotes self-reflection and allows individuals to focus on themselves rather than outside factors. Rhythmic breathing is a common activity incorporated into meditation that slows the patients heart rate. This sense of calm can cause the release of inhibitors that slow the mind and generate natural serotonin. In conclusion, treatment options like the ones listed above are a great start on the path to recovery. New ideas and process are being developed every day and soon more research will surface regarding NES and effective treatment.
Awareness and Prevention
NES awareness cannot happen overnight but should be continuously driven through medical programs. Given that individuals dealing with eating disorders are more likely to develop NES physicians should be looking for signs day one. It is important to understand that NES is not specific to the disorder network. The average American could develop this disease with no genetic or environmental pre-disposition. All eating disorders can be addressed in health classes, therapy clinics, and outreach groups in a meaningful way. When raising awareness certain techniques should be taken into consideration. Scare tactics and the fear of gaining “another eating disorder” should be eliminated from all forms of publication. Individuals struggling with eating disorders should be approached with open arm and care rather than expressing disappointment. There are 5 steps I have learned throughout this course to prevent NES. #1 Identify the cause of NES and avoid using food to cure emotions such as sadness, anger, and frustration. #2, Identify triggers that may induce NES to prevent cycles being formed for nighttime eating. #3, Use a routine to lower the stress and encourage meal by meal eating. #4, Eat regularly throughout the day. By doing this the patient will intake the necessary calories and prevent hunger during the later hours. #5, Seek emotional support when struggling with hardship or depression. In conclusion, the awareness and prevention of NES has come a long way since its inception but has many years of research are still needed to validate a common treatment base.
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