Shining the Light on Night Eating  
Thursday, May 7, 2015
LifeTime WeightLoss in Lifestyle, Nutrition, Paul Kriegler, nighttime eating, weight loss help

How many of us find ourselves gravitating toward the kitchen each evening?

Do we know what we’re seeking out? How often do we forage for something to fill us - or maybe just distract us?

While the majority of our days are often busy and regimented, the openness of our evening hours can be a trap for temptation. Our willpower seemed enough in the light of day, but something else edges out that control after dinner.

While many of us feel this pull and indulge in after dinner eating, when does it become a problem for our weight loss - or even basic health? When does night eating move from bothersome inclination to clinical problem? 

While most of us may reach for something to eat in the evening hours, a nighttime snack doesn’t have to upend our weight loss process. In fact, a small but healthy and filling snack after dinner can help curb cravings and keep us on track.

That said, for some people nighttime eating takes on a much more harmful dimension. A snack turns into a second, which turns into many every night. What is a measured temptation for others operates as a recurring, compulsive cycle for them. The fact is, many people battle full-blown Night Eating Syndrome without ever being evaluated or officially diagnosed. 

The Medical Picture

Night Eating Syndrome is an officially classified medical disorder. It falls under the “Other Specified Feeding or Eating Disorder” category of the American Psychiatric Association’s DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).

It’s defined as an established pattern of wakefully consuming 25% or more of one’s total caloric intake after the evening meal and meeting three of the following criteria: urges to eat in the evening/at night, difficulty sleeping, belief that one must eat in order to fall back to sleep, lack of morning hunger, and/or depressed mood.

Unfortunately, these are vague characteristics that actually share many of the same clinical and mood symptoms as other psychological challenges. Interestingly, one study has examined the parallels between Night Eating Syndrome and Seasonal Affective Disorder and observed key differences in regulatory hormones and circadian patterns: 

Differences in hunger control hormones leptin and ghrelin - 

Balance and rhythm of these key hunger and satisfaction hormones were misaligned in those with NES compared to the control subjects in the study. The levels of the appetite suppressing hormone leptin (which normally tells your brain you’ve had enough to eat) were lower in the subjects who’d been diagnosed with NES. Likewise, the hunger-activating hormone ghrelin peaked about 5 hours earlier than “normal” in the NES subjects.  

Literally, those affected with Night Eating Syndrome had hormonal signals not only telling them to eat in the middle of the night but also that what they ate wasn’t good enough to satisfy hunger. Even if they only had veggies in their fridge, they’d still be prone to over-eating. Let’s just say willpower in this hormonal set-up would face a lot of physiological push-back.

Differences in the “sleepy time” hormone melatonin - 

Compared to control subjects, those with night-eating patterns have a delayed melatonin surge, which may contribute to lighter - or at very least - altered sleep rhythms, despite having near-identical sleep onset times as the control subjects. Imagine you’re simply wired to sleep more lightly than your counterparts. This means it may be easier for someone with NES patterns to be roused in the first place by external factors as well as internal sensations (e.g. hunger).

Differences in energizing resilience hormone cortisol - 

When researchers assessed participants for their ability to produce the energizing hormone known as cortisol (by administering a drug that stimulates its production in the adrenal glands), the night-eaters had weaker cortisol production. Their batteries were more worn out, perhaps from the chronic battle against inadequate sleep driven by or accompanying the altered melatonin rhythms.

You see, when we get inadequate or disrupted sleep, cortisol can help us make up for some of the gaps in our “normal” physiologic energy control. If our backup “battery power” is relied on for days or weeks in a row without sufficient “recharge,” we may complain of low energy, sluggishness, or even cravings for the quickest sources of energy we can ingest - simple carbohydrates and/or caffeine!

While there are a few more metabolic differences that have been observed - including altered TSH (thyroid stimulating hormone), glucose, and insulin patterns - these may not be as causative of the eating behaviors according to researchers.

Much of the research on these bothersome patterns attempts to decipher which comes first: the chicken or the egg. In this case, do circadian rhythm, feedback mechanisms, and brain chemistry change and then cause a shift in behavior patterns? Or is it poor behavior patterns that lead to the observed changes in “normal” rhythms?

The answer to this conundrum will ultimately decide if the most effective treatment strategies should center on behavioral therapies or drug therapies. One note: patients with Night Eating Syndrome often respond positively to treatment with SSRI’s, a popular class of anti-depressant drugs. Nonetheless, our own behavior patterns are one part of the equation (whether they came first or not). When we look at how to adapt those, we can interrupt the entire cycle of dysfunction. 

The Lifestyle Picture

These types of behavior and physiological patterns rarely (if ever) happen in isolation from other challenges in our overall lifestyle balance.

Addressing destructive patterns generally requires a multifaceted, whole health approach. If you have night eating issues (whether they’re of a serious clinical nature or not), the good news is there is much you can do to help reset your own rhythms.  

What can you do if you suffer from these patterns?

Strive for routine sleep hygiene. 

Become as specific as you can about your nighttime routine.

Stressful disorganization, late night exposure to artificial light or late snacking on foods that create blood sugar roller-coasters can all disrupt your valuable time for rest.

I ask my clients to let themselves go to sleep at the first sign of feeling tired around sundown. This means fighting the urge to “get more done” or finish the episode you can DVR anyway. If you want, have a small snack that will support steady blood sugars throughout the night - one consisting of fat, protein, and fibrous carbohydrates (like veggies or berries).

One of my favorites is chocolate whey protein powder (DaVinci or Life Time are my favorites) mixed in a bowl with about a tablespoon of almond or cashew butter and a just enough liquid to make a pudding consistency. (For liquid, I use heavy cream, coconut milk or almond milk.) If you like brownie batter, you won’t be disappointed.

Practice nourishment regularity and quality. 

Expect to get hungry a few times throughout the day, and plan your main meals as dedicated times for nourishment.

Life is busy, but nourishment shouldn’t be put off in the midst of the daily mayhem. When we try to white-knuckle it through the day by putting off eating good, healthy food at relaxed mealtimes, it’s bound to catch up with us later in the evening when we suddenly feel the weight of the day’s deprivation.

As a result, we may set in motion the spiral toward regular nighttime eating. Eating three well-balanced, Healthy Way of Eating inspired meals tends to stave off nighttime bingeing better than free-for-all grazing all day long. A good strategy for establishing mindful mealtime hygiene means only eating when seated at a table without distraction, pausing between bites (whenever possible!), and enjoying the company of those around you at every opportunity. 

Actively manage stressors. 

We all encounter circumstances that throw us out of homeostasis every day, but we have some choice as to how far off balance we truly get.

Effective stress management includes healthy self-care practices and stay positive strategies. If we constantly perceive our environment as something that drags us down, our brain will eventually seek a quick and repeatable reward like that surge of dopamine and serotonin we get when we consume sugar.

Likewise, the more we put ourselves last and deny our need for rest, rejuvenation and enjoyment in our lives, the more we may look to food as a mood boost or distraction. Life balance can help insulate us from unhealthy choices and the patterns that stem from them.

Thanks for reading today. Do you have additional questions about night eating or feel the above characteristics may describe your situation? Talk with one of our dietitians today.

In health, Paul Kriegler - Corporate Registered Dietitian

This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.

Article originally appeared on LifeTime WeightLoss (http://www.lifetime-weightloss.com/).
See website for complete article licensing information.