Emerging Trends in Night Eating Syndrome & Other Eating Disorders

a person meeting with a mental health professional to discuss their night eating syndrome

According to ANRED, an eating disorder informational site, eating disorders are most common among females who are 12-25 years of age. Of course, younger and older females can also be affected, and it is estimated that at least 10 percent of people who experience an eating disorder are male. Eating disorders often operate in silence, which makes gauging the true extent of eating disorders challenging.

When a person seeks help for an eating disorder, a mental health professional will typically refer to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) to make the appropriate diagnosis. The following eating disorders are included in the DSM-5:

  • Bulimia nervosa
  • Binge eating disorder
  • Anorexia nervosa
  • Rumination disorder
  • Pica
  • Avoidant/restrictive food intake disorder (ARFID)
  • Unspecified feeding or eating disorder (UFED)
  • Other specified feeding or eating disorder (OSFED)

OSFED includes atypical anorexia nervosa, a less severe variation on bulimia nervosa and binge eating, purging disorder, and night eating disorder. Each disorder involves different symptoms, but all center around diagnosed individuals having an atypical relationship with their caloric intake or body image. But eating disorders are far too complex to be reduced to one cause or a discrete set of factors.

Anyone can develop an eating disorder, but some individuals may be subject to more risk factors than others. The relevant risk factors relate to physical, genetic, psychological, and social phenomena.

Risk Factors
Research shows that genes can influence the development of an eating disorder. A person who has a first-degree relative, such as parent, with an eating disorder is more likely to develop an eating disorder compared to the general population. A person’s neurobiology can also be a factor. For instance, serotonin may be a neurobiological player in the emergence of an eating disorder. Genetics and the brain are physical components of a person, but intangible thought patterns can also play a significant role. Individuals who experience the following traits may be more at risk for an eating disorder:
  • Anxiety
  • Poor self-esteem
  • Difficulties in personal relationships
  • Impulsive behavior

Societal forces can also contribute to an eating disorder. Although it’s a fallacy and a social construct, in American culture, a person’s appearance is often associated with a person’s worth. According to the National Eating Disorders Association (NEDA), a nonprofit dedicated to eating disorder awareness, 20 million females and 10 million males will experience an eating disorder at some point in their lifetimes.

The foregoing risk factors are broad. Research has helped to narrow down and illuminate some specific risk factors for the development of an eating disorder. As mentioned, age, gender, and family history are significant. Additional factors include:

  • Dieting practices and history: Diets are often outcome-driven. Individuals tend to praise others who are losing weight, which can provide the dieter with a perverse incentive to engage in unhealthy dieting strategies.
  • The experience of trauma: For example, research has found that a sexual assault can lead to an eating disorder.
  • Life changes: Stressful events, such as divorce, moving, job loss, a breakup, or death of a loved one, can trigger an eating disorder.
  • A co-occurring mental health disorder: For example, individuals who experience anxiety, depression, or obsessive-compulsions may also be at risk for eating disorders.
  • Involvement in certain social engagements: Individuals involved in certain artistic groups and sports may experience personal image or performance pressures that can lead to an eating disorder.

A hidden danger of eating disorders is that those who experience them often rationalize them. The challenge here is that, as mentioned, family, friends, and social groups may be initially supportive of the side effects, such as weight loss. However, engaging in disordered eating practices is never a rational response to any personal goal. Similar to drug abuse, a person who engages in disordered eating habits may have a healthy intention at first but, over time, finds the proverbial slope becomes increasingly more slippery. Whatever the specific case may be, it is important to keep in mind that eating disorders are highly treatable.

How Common Is Night Eating Syndrome?

Earlier in the history of the DSM, there were only two recognized eating disorders: anorexia nervosa and bulimia nervosa. Expanded treatment has brought night eating syndrome (NES) into the fold of diagnosable and treatable disordered eating conditions. But what is NES? This eating disorder typically features an individual skipping breakfast, binging at dinnertime, and experiencing insomnia in the nighttime and rising to eat, usually for an extended period of time. This behavior is usually accompanied by intense feelings of guilt, shame, and personal responsibility.

There are different estimates regarding the prevalence of NES. Some researchers estimate that 1-2 percent of the adult population in the US experiences NES. However, one University of Pennsylvania School of Medicine study found that approximately 6 percent of obese persons who seek treatment experience NES. Yet another study found that 27 percent of Americans who are overweight by more than 100 pounds have NES. Although it may be difficult to accurately gauge the prevalence of NES in America, the inclusion of this disorder in DSM-5 helps to ensure that those who present with symptoms of an eating disorder are screened for this disorder.

Individuals who experience eating disorders may seek help in different ways. The individual may confide in a loved one or a trusted professional. The types of professionals who are involved in the treatment process are primary care physicians, psychologists, nurses, dieticians, and social workers. Any one of these professionals, among other qualified persons, can help an individual find a rehab center qualified to treat an eating disorder.

In a rehab center, treatment is typically sensitive to the type of eating disorder at issue but provides the recovering person with a comprehensive care plan to work on the emotions underlying the disordered eating behavior. As Mayo Clinic explains, treatment plans for eating disorders can include therapy, medical monitoring, nutritional education, and medication as necessary. A rehab center can either provide care, or coordinate third-party care, for any health complications associated with the eating disorder.

As therapy is a main pillar of treatment, it is helpful to consider the types of therapy that are used as part of eating disorder recovery plans. The following methods have been shown to be effective in this area:

  • Cognitive Behavioral Therapy (CBT): This method helps recovering persons to identify the thoughts, emotions, and behaviors related to the eating disorder, and uses insights gained to change distorted thought patterns and to develop normalized eating behaviors.
  • Group Cognitive Behavioral Therapy: This approach involves a therapist leading a group while employing the techniques of CBT and also helping the group to benefit from mutual support.
  • Family Therapy: This form of treatment brings family members into the process to help the recovering person while in rehab and also to set a precedent for support after program completion.
  • Rational Emotional Behavioral Therapy: This approach, as discussed in a Psychology Today article, has been shown to be effective in the treatment of anorexia in part because it helps recovering persons to change irrational beliefs (such as about one’s body) into rational beliefs.

Eating disorders can present significant health risks due to how they may be hidden and undiagnosed for some time before treatment is sought. Waiting to get help is never advisable. As the informational site ANADshares, eating disorders are associated with the highest mortality rate among all mental health disorders. Young females who suffer from anorexia nervosa are reportedly 12 times more likely to have a premature death compared to general population females of the same age. Various research studies have concluded that the risk of death for males with eating disorders is higher than for females.

As the American Psychological Association points out, eating disorders are often responsive to treatment. Further, notes ANAD, the earlier treatment occurs, the more likely it is to be effective. A recovery program can help a person to overcome the distorted thinking, low self-esteem, and relationship conflicts that typically underlie eating disorders. Further, nutritional education, cognitive tools (such as those learned in CBT), and a supportive social network can provide an effective bulwark against relapse. Treatment in a structured program is considered to be one of the most advisable responses to an eating disorder. Irrespective of the type of eating disorder at issue, it is important to know that help is available.

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