Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Night eating syndrome and nocturnal snacking: association with obesity, binge eating and psychological distress

International Journal of Obesity volume 31, pages 1722–1730 (2007)Cite this article

Abstract

Objective:

Night eating syndrome (NES) is characterized by a time-delayed pattern of eating relative to sleep, where most food is consumed in the evening and night. This study aimed to investigate the clinical significance of NES and nocturnal snacking by exploring the relationship between NES and (1) obesity, (2) binge eating disorder (BED) and (3) psychological distress.

Subjects:

One hundred and eighty bariatric surgery candidates, 93 members of a non-surgical weight loss support group and 158 general community respondents (81 males/350 females, mean age: 45.8±13.3 years, mean body mass index (BMI): 34.8±10.8 and BMI range: 17.7–66.7).

Methods:

NES diagnosis required within the previous 3 months: (1) no appetite for breakfast, (2) consumption of ⩾50% of daily energy after 1900 hours and (3) sleep difficulties ⩾3 nights/week. Nocturnal snacking (awakening to eat) was recorded. Validated questionnaires assessed BED, symptoms of depression, appearance dissatisfaction (AD) and mental health-related quality of life (MHQoL). NES and binge eating (BE) (⩾1 episode/week) were confirmed by interview.

Results:

NES criteria were met by 11.1% of the total cohort. Across all groups, BE (P=0.001), BMI (P=0.003) and male gender (P=0.013) explained 10% of NES variance. Individuals with co-morbid NES and BE reported similarly elevated psychological distress as other binge eaters. NES alone was not associated with psychological distress. Those with NES who consumed nocturnal snacks reported poorer MHQoL (P=0.007) and greater depressive symptoms (P=0.039) and hunger (P=0.013) than others with NES. Low MHQoL (P=0.007) and male gender (P=0.022) explained 27% of the variance in the nocturnal snacking group.

Discussion:

In this study, NES was positively associated with BMI, BE and male gender. Elevated psychological distress was only apparent in those who consumed nocturnal snacks. Further characterization and understanding of the clinical significance of NES and nocturnal snacking is required.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Stunkard AJ, Grace WJ, Wolff HG . The night-eating syndrome: a pattern of food intake among certain obese patients. Am J Med 1955; 19: 78–86.

    Article  CAS  Google Scholar 

  2. O'Reardon JP, Peshek A, Allison KC . Night eating syndrome: diagnosis, epidemiology and management. CNS Drugs 2005; 19: 997–1008.

    Article  CAS  Google Scholar 

  3. Ceru-Bjork C, Andersson I, Rossner S . Night eating and nocturnal eating-two different or similar syndromes among obese patients? Int J Obes Relat Metab Disord 2001; 25: 365–372.

    Article  CAS  Google Scholar 

  4. Kuldau JM, Rand C . The night eating syndrome and bulimia in the morbidly obese. Int J Eat Disord 1986; 5: 143–148.

    Article  Google Scholar 

  5. Rand CS, Macgregor AM, Stunkard AJ . The night eating syndrome in the general population and among postoperative obesity surgery patients. Int J Eat Disord 1997; 22: 65–69.

    Article  CAS  Google Scholar 

  6. Adami GF, Campostano A, Marinari GM, Ravera G, Scopinaro N . Night eating in obesity: a descriptive study. Nutrition 2002; 18: 587–589.

    Article  Google Scholar 

  7. Gluck ME, Geliebter A, Satov T . Night eating syndrome is associated with depression, low self-esteem, reduced daytime hunger, and less weight loss in obese outpatients. Obes Res 2001; 9: 264–267.

    Article  CAS  Google Scholar 

  8. Napolitano MA, Head S, Babyak MA, Blumenthal JA . Binge eating disorder and night eating syndrome: psychological and behavioral characteristics. Int J Eat Disord 2001; 30: 193–203.

    Article  CAS  Google Scholar 

  9. Powers PS, Perez A, Boyd F, Rosemurgy A . Eating pathology before and after bariatric surgery: a prospective study. Int J Eat Disord 1999; 25: 293–300.

    Article  CAS  Google Scholar 

  10. Stunkard A, Berkowitz R, Wadden T, Tanrikut C, Reiss E, Young L . Binge eating disorder and the night-eating syndrome. Int J Obes Relat Metab Disord 1996; 20: 1–6.

    CAS  Google Scholar 

  11. Birketvedt GS, Florholmen J, Sundsfjord J, Osterud B, Dinges D, Bilker W et al. Behavioral and neuroendocrine characteristics of the night-eating syndrome. JAMA 1999; 282: 657–663.

    Article  CAS  Google Scholar 

  12. Allison KC, Ahima RS, O'Reardon JP, Dinges DF, Sharma V, Cummings DE et al. Neuroendocrine profiles associated with energy intake, sleep, and stress in the night eating syndrome. J Clin Endocrinol Metab 2005; 90: 6214–6217.

    Article  CAS  Google Scholar 

  13. Allison KC, Grilo CM, Masheb RM, Stunkard AJ . Binge eating disorder and night eating syndrome: a comparative study of disordered eating. J Consult Clin Psychol 2005; 73: 1107–1115.

    Article  Google Scholar 

  14. O'Reardon JP, Ringel BL, Dinges DF, Allison KC, Rogers NL, Martino NS et al. Circadian eating and sleeping patterns in the night eating syndrome. Obes Res 2004; 12: 1789–1796.

    Article  Google Scholar 

  15. O'Reardon JP, Stunkard AJ, Allison KC . Clinical trial of sertraline in the treatment of night eating syndrome. Int J Eat Disord 2004; 35: 16–26.

    Article  Google Scholar 

  16. Schenck CH, Mahowald MW . Review of nocturnal sleep-related eating disorders. Int J Eat Disord 1994; 15: 343–356.

    Article  CAS  Google Scholar 

  17. Rand C, Kuldau JM . Eating patterns in normal weight individuals: bulimia, restrained eating, and the night eating syndrome. Int J Eat Disord 1986; 5: 75–84.

    Article  Google Scholar 

  18. Striegel-Moore RH, Dohm FA, Hook JM, Schreiber GB, Crawford PB, Daniels SR . Night eating syndrome in young adult women: prevalence and correlates. Int J Eat Disord 2005; 37: 200–206.

    Article  Google Scholar 

  19. de Zwaan M, Burgard M, Schenck CH, Mitchell JE . Night time eating: a review of the literature. Eur Eat Disorders Rev 2003; 11: 7–24.

    Article  Google Scholar 

  20. Aronoff NJ, Geliebter A, Zammit G . Gender and body mass index as related to the night-eating syndrome in obese outpatients. J Am Diet Assoc 2001; 101: 102–104.

    Article  CAS  Google Scholar 

  21. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed. Washington, DC, 1994.

  22. Adami GF, Meneghelli A, Scopinaro N . Night eating and binge eating disorder in obese patients. Int J Eat Disord 1999; 25: 335–338.

    Article  CAS  Google Scholar 

  23. Greeno CG, Wing RR, Marcus MD . Nocturnal eating in binge eating disorder and matched-weight controls. Int J Eat Disord 1995; 18: 343–349.

    Article  CAS  Google Scholar 

  24. Grilo CM, Masheb RM . Night-time eating in men and women with binge eating disorder. Behav Res Ther 2004; 42: 397–407.

    Article  Google Scholar 

  25. Tanofsky-Kraff M, Yanovski SZ . Eating disorder or disordered eating? Non-normative eating patterns in obese individuals. Obes Res 2004; 12: 1361–1366.

    Article  Google Scholar 

  26. Colles SL, Dixon JB . Night eating syndrome: impact on bariatric surgery. Obes Surg 2006; 16: 811–820.

    Article  Google Scholar 

  27. Lennernas M, Hambraeus L, Akerstedt T . Shift related dietary intake in day and shift workers. Appetite 1995; 25: 253–265.

    Article  CAS  Google Scholar 

  28. Spitzer RL, Devlin M, Walsh BT, Hasin D, Wing R, Marcus MD et al. Binge eating disorder: a multisite field trial of the diagnostic criteria. Int J Eat Disord 1992; 11: 191–203.

    Article  Google Scholar 

  29. Spitzer RL, Yanovski S, Wadden T, Wing R, Marcus MD, Stunkard A et al. Binge eating disorder: its further validation in a multisite study. Int J Eat Disord 1993; 13: 137–153.

    Article  CAS  Google Scholar 

  30. Stunkard AJ, Messick S . The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res 1985; 29: 71–83.

    Article  CAS  Google Scholar 

  31. Beck AT, Steer RA . Manual for the Beck Depression Inventory. Psychological Corporation: San Antonio, TX, 1993.

    Google Scholar 

  32. Richter P, Werner J, Heerlein A, Kraus A, Sauer H . On the validity of the Beck Depression Inventory. A review. Psychopathology 1998; 31: 160–168.

    Article  CAS  Google Scholar 

  33. Smarr KL . Measures of depression and depressive symptoms. Arthritis Rheum 2003; 49: S134–S146.

    Article  Google Scholar 

  34. Cash T . Multidimentional Body-Self Relations Questionnaire 02/94 ed. Old Dominion University: Norfolk, VA, 1994.

    Google Scholar 

  35. Dixon JB, Dixon ME, O'Brien PE . Body image: appearance orientation and evaluation in the severely obese. Changes with weight loss. Obes Surg 2002; 12: 65–71.

    Article  Google Scholar 

  36. Ware J . SF-36 Health Survey: Manual and Interpretation Guide. The Health institute, New England Medical Center: Boston, 1997.

    Google Scholar 

  37. Ware J . SF-36 Physical and Mental Health Summary Scales: A User's Manual. The Health Institute, New England Medical Center: Boston, 1994.

    Google Scholar 

  38. Hsu LK, Betancourt S, Sullivan SP . Eating disturbances before and after vertical banded gastroplasty: a pilot study. Int J Eat Disord 1996; 19: 23–34.

    Article  CAS  Google Scholar 

  39. Hsu LK, Sullivan SP, Benotti PN . Eating disturbances and outcome of gastric bypass surgery: a pilot study. Int J Eat Disord 1997; 21: 385–390.

    Article  CAS  Google Scholar 

  40. Manni R, Ratti MT, Tartara A . Nocturnal eating: prevalence and features in 120 insomniac referrals. Sleep 1997; 20: 734–738.

    Article  CAS  Google Scholar 

  41. Stunkard AJ, Allison KC . Two forms of disordered eating in obesity: binge eating and night eating. Int J Obes Relat Metab Disord 2003; 27: 1–12.

    Article  Google Scholar 

  42. de Zwaan M, Roerig DB, Crosby RD, Karaz S, Mitchell JE . Nighttime eating: a descriptive study. Int J Eat Disord 2006; 39: 224–232.

    Article  Google Scholar 

  43. Birketvedt GS, Sundsfjord J, Florholmen JR . Hypothalamic–pituitary–adrenal axis in the night eating syndrome. Am J Physiol Endocrinol Metab 2002; 282: E366–E369.

    Article  CAS  Google Scholar 

  44. Pawlow LA, O'Neil PM, Malcolm RJ . Night eating syndrome: effects of brief relaxation training on stress, mood, hunger,and eating patterns. Int J Obes Relat Metab Disord 2003; 27: 970–978.

    Article  CAS  Google Scholar 

  45. Rand CS, Kuldau JM . Morbid obesity: a comparison between a general population and obesity surgery patients. Int J Obes Relat Metab Disord 1993; 17: 657–661.

    CAS  PubMed  Google Scholar 

  46. Dahlgren A, Kecklund G, Akerstedt T . Different levels of work-related stress and the effects on sleep, fatigue and cortisol. Scand J Work Environ Health 2005; 31: 277–285.

    Article  CAS  Google Scholar 

  47. Dixon JB, Schachter LM, O'Brien PE . Predicting sleep apnea and excessive day sleepiness in the severely obese: indicators for polysomnography. Chest 2003; 123: 1134–1141.

    Article  Google Scholar 

  48. Rowland ML . Self-reported weight and height. Am J Clin Nutr 1990; 52: 1125–1133.

    Article  CAS  Google Scholar 

  49. Nieto-Garcia FJ, Bush TL, Keyl PM . Body mass definitions of obesity: sensitivity and specificity using self-reported weight and height. Epidemiology 1990; 1: 146–152.

    Article  CAS  Google Scholar 

  50. Wadden TA, Phelan S . Assessment of quality of life in obese individuals. Obes Res 2002; 10 (Suppl 1): 50S–57S.

    Article  Google Scholar 

Download references

Acknowledgements

We thank all of the study participants for their time and involvement, and the staff at the Centre for Obesity Research and Education (CORE) and The Centre for Bariatric Surgery in Windsor, Victoria for their on-going support and assistance.

Author information

Authors and Affiliations

  1. Centre for Obesity Research and Education (CORE), The Alfred Hospital, Monash University, Victoria, Melbourne, Australia

    S L Colles, J B Dixon & P E O'Brien

Authors
  1. S L Colles
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J B Dixon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P E O'Brien
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S L Colles.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Colles, S., Dixon, J. & O'Brien, P. Night eating syndrome and nocturnal snacking: association with obesity, binge eating and psychological distress. Int J Obes 31, 1722–1730 (2007). https://doi.org/10.1038/sj.ijo.0803664

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0803664

Keywords

This article is cited by

Search

Advanced search

Quick links