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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.

 

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?

  • 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.

  • 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. Especially 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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