Binge eating disorder is currently the most common eating disorder in the United States. It affects approximately 2.8 million people. Binge eating disorder is characterized by frequent binges of excessive overeating, followed by feelings of guilt, shame, or regret. It can have both physical and emotional health consequences.

Night eating syndrome (NES) has some similarities to binge eating disorder. There are distinct differences between these two conditions, however, which dictates that different treatment approaches be taken, depending on the exact diagnosis. Because of this, getting an accurate diagnosis is important.

Symptoms

People with binge eating disorder eat excessive amounts of food in one sitting on a fairly regular basis. Overeating is then followed by feelings of shame or regret.

People with NES, on the other hand, will often consume most of their calories at night. They often skip meals in the morning and eat progressively more during the day. People with NES typically consume 25 to 50 percent or more of their daily calories after their evening meal.

Individuals will often wake up, sometimes multiple times during the night, to eat and then fall back asleep. NES sufferers are well aware that they do this, which differentiates NES from sleep-related eating disorder (SRED). People with SRED have no recollection the next morning of their late-night eating escapades. It’s common for people with NES to feel like they cannot fall back asleep without eating something. Most people with NES don’t always eat to excess at night or feel out of control as in binge eating disorder, but there are exceptions.

If you find yourself overeating after a bad day at work or grabbing a snack at night if you can’t get back to sleep after waking, there’s likely little need for concern. You should seek help if:

  • You have at least one binge eating episode a week for at least three months straight. This could be a sign of binge eating disorder.
  • You experience night waking and eating behaviors at least three times per week for three months. This could be a sign of NES.
  • Your quality of life, including job and social relationships, is affected by your eating habits. You may have an eating disorder.

On average, people with night eating disorder wake up more than three times per night and more than half of these episodes are associated with food, says Dr. Ralph E. Carson, R.D., Ph.D., executive director of FitRX Treatment Center. Dr. Carson has developed several eating disorder programs and treated eating disorders in various capacities over the past 35 years.

“Most of their calories are consumed after 6 p.m. and often more than a third of their calories are consumed between midnight and 4 a.m.,” Dr. Carson says.

Treatments

The important thing to remember about all eating disorders is that they are not a choice. They are serious, life-threatening illnesses that require appropriate and consistent treatment.
Rebecca Bitzer, M.S., R.D., L.D.

Binge eating disorder was listed as a formal diagnosis in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) in 2013. NES is still lumped in under “Other Specified Feeding or Eating Disorder” in the DSM. NES is less well-known than binge eating disorder, and therefore this diagnosis can easily be missed. It is often easier to receive treatment for binge eating disorder. There has also been more research devoted to studying it to date. Some researchers, though, are trying to change that.

Symptoms for these two disorders can overlap, so seeking help from a knowledgeable provider experienced with treating these conditions is crucial.

Treatment for Binge Eating Disorder

No one knows exactly what causes binge eating disorder. Psychological treatments, such as cognitive behavioral therapy (CBT), have shown promising results, though. CBT explores the relationship between thoughts, feelings, and behaviors, and works to help people modify self-destructive behaviors.

Other treatments include:

  • psychotherapy: interpersonal psychotherapy, dialectical behavior therapy (a type of CBT that focuses on regulating emotions to curb harmful behavior patterns)
  • medication: lisdexamfetamine dimesylate (Vyvanse), topiramate (Topamax), certain antidepressant medications
  • behavioral weight loss programs
  • group therapy, and eating disorder support groups

Because binge eating disorder is a highly complicated condition, usually with multiple contributing factors, a variety of treatment options are often used.

It’s important to note that while binge eating disorder is characterized by overeating, obesity does not cause binge eating disorder, nor does it mean that you have binge eating disorder. While weight loss may factor into a treatment plan, it is not a curative treatment on its own.

Weight loss as a prescribed treatment can actually do more harm than good in some cases. It can even damage a person’s recovery process, says Rebecca Bitzer, M.S., R.D., L.D., a certified eating disorder registered dietitian and coauthor of the workbook, “Taste the Sweet REBELLION: REBEL Against Dieting.”

A 2006 study, however, found that weight loss programs do not worsen symptoms of binge eating disorder and may be beneficial, especially for people who are obese. That is why it is always important to work with your doctor to come up with the best treatment plan for you. What works for one person may not work for another.

Treatment for Night Eating Syndrome

Although night eating syndrome is an eating disorder, treatment methods differ from those used to treat binge eating disorder. Researchers still do not know what causes night eating syndrome. Research into treatments is still in its infancy.

Night eating disorder may be precipitated by poor eating habits. According to Dr. Carson, some treatments focus on changing diet and sleep patterns, practicing relaxation techniques, and exercising. Some studies have also shown a potential benefit with the use of SSRI medications such as sertraline (Zoloft).

When to Seek Help

If any of the symptoms above for binge eating disorder or night eating syndrome sound all too familiar to you, especially if they’re affecting your quality of life or negatively impacting your job and relationships, it’s time to seek help. A trusted healthcare professional, whether a physician, nutritionist, psychiatrist, or other eating disorder expert, will be able to give you an unbiased opinion without moral judgment. If you are unsure where to seek help, start by speaking with your primary care physician or calling your insurance company. They should be able to refer you to a specialist.

It’s not your fault if you have an eating disorder. And you don’t have to suffer alone. Reach out today if you or someone you know might be experiencing one of these eating disorders. Treatment is available and recovery may be just around the corner.