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...