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Night eating syndrome in class II–III obesity: metabolic and psychopathological features

Abstract

Objective:

To investigate the relationship of metabolic disorders and psychological features with the night eating syndrome (NES) in individuals with moderate-to-severe obesity.

Design:

Cross-sectional observation.

Subjects:

A total of 266 consecutive participants with class II–III obesity, entering an inpatient weight loss program.

Measurements:

Participants who reported consuming either a large amount of their caloric intake after the evening meal (roughly self-assessed as 25% of daily calories) or the presence of nocturnal feeding at the Night Eating Questionnaire (NEQ) (N=49) were interviewed by the Night Eating Syndrome History and Inventory (NESHI). Assessment also included the clinical/biochemical parameters of the metabolic syndrome and several questionnaires of psychopathology. NES was diagnosed by NESHI criteria (evening hyperphagia (25% of daily food intake after the evening meal) and/or waking at night to eat at least three times a week) in the last 3 months.

Results:

Twenty-seven participants (10.1%) met NESHI criteria. Differences were not observed between participants with and without NES as to age, body mass index (BMI), prevalence of metabolic syndrome, Binge Eating Scale and Body Shape Questionnaire. NES participants had significantly higher scores of Beck Depression Inventory (BDI) and Impact of Weight on Quality of Life (IWQOL). Among NES cases, the BDI score was indicative of moderate depression in 18.5% of cases and of severe depression in 44.4%. Logistic regression analysis, adjusted for confounders, identified the BDI score as the only variable significantly associated with the diagnosis of NES.

Conclusion:

Diagnosing NES does not help identify obese individuals with specific medical complications, but indicates more severe psychological distress and depression.

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References

  1. Geliebter A . Night-eating syndrome in obesity. Nutrition 2001; 17: 483–484.

    Article  CAS  Google Scholar 

  2. Stunkard A, Allison K, Lundgren J . Issues for DSM-V: night eating syndrome. Am J Psychiatry 2008; 165: 424.

    Article  Google Scholar 

  3. 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 

  4. 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 

  5. 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 

  6. Allison KC, Wadden TA, Sarwer DB, Fabricatore AN, Crerand CE, Gibbons LM et al. Night eating syndrome and binge eating disorder among persons seeking bariatric surgery: prevalence and related features. Surg Obes Relat Dis 2006; 2: 153–158.

    Article  Google Scholar 

  7. 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 

  8. 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 

  9. 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 

  10. Lundgren JD, Allison KC, Crow S, O'Reardon JP, Berg KC, Galbraith J et al. Prevalence of the night eating syndrome in a psychiatric population. Am J Psychiatry 2006; 163: 156–158.

    Article  Google Scholar 

  11. 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 

  12. Striegel-Moore RH, Franko DL, Thompson D, Affenito S, Kraemer HC . Night eating: prevalence and demographic correlates. Obesity (Silver Spring) 2006; 14: 139–147.

    Article  Google Scholar 

  13. Rand CS, 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 

  14. 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 

  15. Colles SL, Dixon JB, O'Brien PE . Night eating syndrome and nocturnal snacking: association with obesity, binge eating and psychological distress. Int J Obes (Lond) 2007; 31: 1722–1730.

    Article  CAS  Google Scholar 

  16. Morse SA, Ciechanowski PS, Katon WJ, Hirsch IB . Isn't this just bedtime snacking? The potential adverse effects of night-eating symptoms on treatment adherence and outcomes in patients with diabetes. Diabetes Care 2006; 29: 1800–1804.

    Article  Google Scholar 

  17. Allison KC, Crow SJ, Reeves RR, West DS, Foreyt JP, Dilillo VG et al. Binge eating disorder and night eating syndrome in adults with type 2 diabetes. Obesity (Silver Spring) 2007; 15: 1287–1293.

    Article  Google Scholar 

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

    Article  Google Scholar 

  19. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735–2752.

    Article  Google Scholar 

  20. Allison KC, Lundgren JD, O'Reardon JP, Martino NS, Sarwer DB, Wadden TA et al. The Night Eating Questionnaire (NEQ): psychometric properties of a measure of severity of the Night Eating Syndrome. Eat Behav 2008; 9: 62–72.

    Article  Google Scholar 

  21. Allison KC, Lundgren JD, O'Reardon JP, Geliebter A, Gluck ME, Vinai P et al. Proposed diagnostic criteria for night eating syndrome. Int J Eat Disord 2009, doi:10.1002/eat.20693 [E-pub ahead of print].

  22. Gormally J, Block S, Daston S, Rardin D . The assessment of binge eating severity among obese persons. Addict Behav 1982; 7: 47–55.

    Article  CAS  Google Scholar 

  23. Cooper PJ, Taylor MJ, Cooper Z, Fairburn CG . The development and validation of the body shape questionnaire. Int J Eat Disord 1987; 6: 485–494.

    Article  Google Scholar 

  24. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J . An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561–571.

    Article  CAS  Google Scholar 

  25. Kolotkin RL, Head S, Hamilton M, Tse CK . Assessing impact of weight on quality of life. Obes Res 1995; 3: 49–56.

    Article  CAS  Google Scholar 

  26. Rothschild M, Peterson HR, Pfeifer MA . Depression in obese men. Int J Obes 1989; 13: 479–485.

    CAS  PubMed  Google Scholar 

  27. Adami GE, Meneghelli A, Scopinaro N . Night eating syndrome in individuals with Mediterranean eating-style. Eat Weight Disord 1997; 2: 203–206.

    Article  CAS  Google Scholar 

  28. Striegel-Moore RH, Franko DL, May A, Ach E, Thompson D, Hook JM . Should night eating syndrome be included in the DSM? Int J Eat Disord 2006; 39: 544–549.

    Article  Google Scholar 

  29. Stunkard AJ, Allison KC, Geliebter A, Lundgren JD, Gluck ME, O'Reardon JP . Development of criteria for a diagnosis: lesson from the night eating syndrome. Compr Psychiatry 2009, doi:10.1016/j.comppsych.2008.09.013.

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

  31. Dalle Grave R, Calugi S, Molinari E, Petroni ML, Bondi M, Compare A et al. Weight loss expectations in obese patients and treatment attrition: an observational multicenter study. Obes Res 2005; 13: 1961–1969.

    Article  Google Scholar 

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

    Article  Google Scholar 

  33. O'Reardon JP, Allison KC, Martino NS, Lundgren JD, Heo M, Stunkard AJ . A randomized, placebo-controlled trial of sertraline in the treatment of night eating syndrome. Am J Psychiatry 2006; 163: 893–898.

    Article  Google Scholar 

  34. Allison KC, Martino NS, Stunkard A . CBT treatment for night eating syndrome: a pilot study. Obes Res 2005; 13: A83.

    Google Scholar 

  35. 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 

Download references

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Correspondence to G Marchesini.

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Calugi, S., Dalle Grave, R. & Marchesini, G. Night eating syndrome in class II–III obesity: metabolic and psychopathological features. Int J Obes 33, 899–904 (2009). https://doi.org/10.1038/ijo.2009.105

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