A descriptive study of non-obese persons with night eating syndrome and a weight-matched comparison group

Abstract

The purpose of this study was to characterize the Night Eating Syndrome (NES) and its correlates among non-obese persons with NES, and to compare them to non-obese healthy controls. Nineteen non-obese persons with NES were compared to 22 non-obese controls on seven-day, 24-hour prospective food and sleep diaries, the Eating Disorder Examination and the Structured Clinical Interview for DSM-IV Diagnoses interviews, and measures of disordered eating attitudes and behavior, mood, sleep, stress, and quality of life. Compared to controls, persons with NES reported significantly different circadian distribution of food intake, greater depressed mood, sleep disturbance, disordered eating and body image concerns, perceived stress, decreased quality of life, and more frequent Axis I comorbidity, specifically anxiety, mood, and substance use disorders. These findings are the first to describe the clinical significance of night eating syndrome among non-obese individuals in comparison to a non-obese control group, and they suggest that NES has negative health implications beyond that associated with obesity. Keywordsnight eating syndrome; eating disorders; sleep; mood; stress; clinical significance IntroductionNight Eating Syndrome (NES) is concived as a delay in the circadian pattern of food intake (Stunkard, Grace, & Wolf, 1955). The original definition of NES, based on clinical observation of obese persons, operationalized the syndrome as evening hyperphagia (the consumption of ≥ 25% of total daily food intake after dinner), morning anorexia, and depressed mood that worsens in the evening (Stunkard, Grace, & Wolf, 1955). Since this definition was proposed, over 50 publications on the characterization and prevalence of NES have been presented. Naturally, as the circadian eating patterns of additional populations have been studied, the operational definition of NES has evolved (Birketvedt et al., 1999;O'Reardon et al., 2004). Currently, NES is operationalized as engaging in evening hyperphagia (consumption of ≥ 25% of total daily calories after completion of the evening meal) and/or nocturnal awakenings accompanied by ingestions of food (≥ 3 episodes/week) (Allison, Grilo, Masheb, & Stunkard, Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. (Stunkard, Grace, and Wolf, 1955). Current research supports the association between NES and excess weight for some people. For example, we found (Lundgren et al., 2006) found that obese psychiatric outpatients were five times more likely than non-obese psychiatric outpatients to meet criteria for NES. Also, Andersen and colleagues (2004...

Night eating syndrome and emotional states in university students

“…The association between NES and depressive symptoms, determined by the Beck Depression Inventory (BDI), was verified in several papers 29,31,32 , including one study with university students 33 . Importantly, not all studies found statistical significance for this relationship 34 , although there is more evidence supporting that subjects with NES present higher levels of depression.…”

“…More recently, the association of the syndrome with psychological stress was evaluated, mainly evaluated using the Perceived Stress Scale (PSS) 29,31 . This relationship was also confirmed in research carried out among university students 36 .…”

Night eating, binge eating and related features in patients with obstructive sleep apnea syndrome

“…In these studies, which were all conducted by sleep researchers, the level of consciousness and recall varied widely with 9-100% of the samples reporting full consciousness and recall suggesting a significant variability in level of alertness during eating episodes and supporting the assumption of an arbitrary distinction between NES and SRED. Also in patients with NES greater sleep disturbances (Lundgren, Allison, O'Reardon, & Stunkard, 2008) including lower sleep quality, reduced sleep duration and increased number of awakenings were reported (Rogers et al, 2006); however, none of the 15 women with NES studied by showed evidence of OSAS during polysomnography (PSG). In contrast, in a recent study we found a relatively high number of participants reporting parasomnias, including 9.8% with OSAS, in a sample of 106 self-identified night eaters (de Zwaan, Roerig, Crosby, Karaz, & Mitchell, 2006).…”

Transtornos alimentares e padrão circadiano alimentar: uma revisão

“…Estimativas de prevalência sugerem que a SCN é mais comum entre indivíduos obesos, porém nem todos os indiví-duos com SCN apresentam excesso de peso 20,29,30 . Lundgren et al 30 , em estudo descritivo com comedores noturnos não obesos e grupo controle, evidenciaram que comedores noturnos não obesos também têm implicações negativas na saúde, sendo associado com comportamentos alimentares, humor, estresse e distúrbios do sono.…”

“…Lundgren et al 30 , em estudo descritivo com comedores noturnos não obesos e grupo controle, evidenciaram que comedores noturnos não obesos também têm implicações negativas na saúde, sendo associado com comportamentos alimentares, humor, estresse e distúrbios do sono. Não há diferenças entre comedores noturnos obesos e não obesos para apetite matutino, hiperfagia vespertina, difi culdades para dormir e humor.…”