The treatment of night eating syndrome, a disorder characterized by evening hyperphagia, morning anorexia, and insomnia, continues to gain attention with its inclusion in the DSM-V. Known treatments for NES include pharmacological, phototherapy, weight loss and dietary, and psychological interventions, which, together with the syndrome’s clinical characteristics, support a treatment guiding biobehavioral model. The biobehavioral model proposes that a genetic predisposition, coupled with stress, enhances midbrain serotonin transporter (SERT) binding, which results in lower post-synaptic serotonin, dysregulating circadian rhythms and decreasing satiety. Selective serotonin reuptake inhibitors should therefore decrease SERT binding, increase postsynaptic serotonin, and restore circadian function and satiety regulation. Psychological interventions may be used to decrease stress as well as address insomnia and circadian rhythm disruptions. Dietary and behavioral interventions may produce beneficial changes in satiety as well as dysregulated eating. Avenues for future treatment outcome studies, including alternative pharmacological and combination therapies, are discussed.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
Stunkard AJ, Grace WJ, Wolff HG. The night-eating syndrome: a pattern of food intake among certain obese patients. Am J Med. 1955;19(1):78–86.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington DC: American Psychiatric Publishing; 2013.
Goncalves MD, Moore RH, Stunkard AJ, Allison KC. The treatment of night eating: the patient’s perspective. Eur Eat Disord Rev. 2009;17(3):184–90.
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. 2010;43(3):241–7. Provides the proposed diagnostic criteria for NES.
American Academy of Sleep Medicine. International classification of sleep disorders, revised: diagnostic and coding manual. 2nd ed. Westchester IL: American Academy of Sleep Medicine; 2005.
Vander Wal JS. Night eating syndrome: a critical review of the literature. Clin Psychol Rev. 2012;32(1):49–59. Provides a comprehensive overview of NES, including diagnosis, clinical features, assessment, comorbidity, neuroendocrine findings, clinical implications, and treatment.
Lundgren JD, Allison KC, Stunkard AJ. Familial aggregation in the night eating syndrome. Int J Eat Disord. 2006;39(6):516–8.
Root TL, Thornton LM, Lindroos AK, Stunkard AJ, Lichtenstein P, Pedersen NL, et al. Shared and unique genetic and environmental influences on binge eating and night eating: a Swedish twin study. Eat Behav. 2010;11(2):92–8.
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(7):657–63.
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(11):6214–7.
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(11):1789–96.
Goel N, Stunkard AJ, Rogers NL, Van Dongen HPA, Allison KC, O’Reardon JP, et al. Circadian rhythm profiles in women with night eating syndrome. J Biol Rhythms. 2009;24(1):85–94.
Rogers NL, Dinges DF, Allison KC, Maislin G, Martino N, O’Reardon JP, et al. Assessment of sleep in women with night eating syndrome. Sleep. 2006;29(6):814–9.
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(8):970–8.
Geliebter A, Gluck ME, Yahav E. Cortisol following a stress test and dexamethason suppression test (DST) in relation to psychopathology in the night eating syndrome. Appetite. 2002;39:77.
Lundgren JD, Allison KC, O’Reardon JP, Stunkard AJ. A descriptive study of non-obese persons with night eating syndrome and a weight-matched comparison group. Eat Behav. 2008;3:343–51.
Vander Wal JS, Gang CH, Griffing GT, Gadde KM. Escitalopram for treatment of night eating syndrome: a 12-week, randomized, placebo-controlled trial. J Clin Psychopharmacol. 2012;32(3):341–5.
Rand CSW, Kuldau JM. Eating patterns in normal weight individuals: bulimia, restrained eating, and the night eating syndrome. Int J Eat Disord. 1986;5(1):75–84.
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(1):65–9.
Striegel-Moore RH, Dohm F-A, Hook JM, Schreiber GB, Crawford PB, Daniels SR. Night eating syndrome in young adult women: prevalence and correlates. Int J Eat Disord. 2005;37(3):200–6.
Colles SL, Dixon JB, O’Brien PE. Night eating syndrome and nocturnal snacking: association with obesity, binge eating and psychological distress. Int J Obes. 2007;31(11):1722–30.
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. 2007;15(5):1287–93.
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(1):156–8.
Calugi S, Dalle Grave R, Marchesini G. Night eating syndrome in class II–III obesity: metabolic and psychopathological features. Int J Obes. 2009;33(8):899–904.
Adami GF, Meneghelli A, Scopinaro N. Night eating and binge eating disorder in obese patients. Int J Eat Disord. 1999;25(3):335–8.
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(1):62–72.
Powers PS, Perez A, Boyd F, Rosemurgy A. Eating pathology before and after bariatric surgery: a prospective study. Int J Eat Disord. 1999;25(3):293–300.
Kuldau JM, Rand CSW. The night eating syndrome and bulimia in the morbidly obese. Int J Eat Disord. 1986;5(1):143–8.
Rand CS, Kuldau JM. Morbid obesity: a comparison between a general population and obesity surgery patients. Int J Obes Relat Metab Disord. 1993;17(11):657–61.
Gallant AR, Lundgren J, Drapeau V. The night-eating syndrome and obesity. Obes Rev. 2012;13(6):528–36.
Spaggiari MC, Granella F, Parrino L, Marchesi C, Melli I, Terzano MG. Nocturnal eating syndrome in adults. Sleep. 1994;17(4):339–44.
Winkelman JW. Treatment of nocturnal eating syndrome and sleep-related eating disorder with topiramate. Sleep Med. 2003;4(3):243–6.
Miyaoka T, Yasukawa R, Tsubouchi K, Miura S, Shimizu Y, Sukegawa T, et al. Successful treatment of nocturnal eating/drinking syndrome with selective serotonin reuptake inhibitors. Int Clin Psychopharmacol. 2003;18(3):175–7.
Cooper-Kazaz R. Treatment of night eating syndrome with topiramate: dawn of a new day. J Clin Psychopharmacol. 2012;32(1):143–5.
O’Reardon JP, Stunkard AJ, Allison KC. Clinical trial of sertraline in the treatment of night eating syndrome. Int J Eat Disord. 2004;35(1):16–26.
Stunkard AJ, Allison KC, Lundgren JD, Martino NS, Heo M, Etemad B, et al. A paradigm for facilitating pharmacotherapy at a distance: sertraline treatment of the night eating syndrome. J Clin Psychiatry. 2006;67(10):1568–72.
Allison KC, Studt SK, Berkowitz RI, Hesson LA, Moore RH, Dubroff JG, et al. An open-label efficacy trial of escitalopram for night eating syndrome. Eat Behav. 2013;14(2):199–203.
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(5):893–8.
Lundren JD, Allison KC, Vinai P, Gluck ME. Assessment instruments for night eating syndrome. In: Lundgren JD, Allison KC, Stunkard AJ, editors. Night eating syndrome: research, assessment, and treament. New York: The Guilford Press; 2012. p. 197–220.
Krysta K, Krzystanek M, Janas-Kozik M, Krupka-Matuszczyk I. Bright light therapy in the treatment of childhood and adolescence depression, antepartum depression, and eating disorders. J Neural Transm. 2012;119(10, Sp. Iss. SI):1167–72.
Stunkard AJ, Allison KC, Lundgren JD, O’Reardon JP. A biobehavioural model of the night eating syndrome. Obes Rev. 2009;10 Suppl 2:69–77.
Friedman S, Even C, Dardennes R, Guelfi JD. Light therapy, obesity, and night-eating syndrome. Am J Psychiatry. 2002;159(5):875–6.
Friedman S, Even C, Dardennes R, Guelfi JD. Light therapy, nonseasonal depression, and night eating syndrome. Can J Psychiatr Rev Can Psychiatr. 2004;49(11):790.
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(4):264–7.
Aronoff NJ, Geliebter A, Hashim SA, Zammit GK. The relationship between daytime and nighttime food intake in an obese night-eater. Obes Res. 1994;2(2):145–51.
Shoar S, Naderan M, Shoar N, Dehpour AR, Khorgami Z, Hoseini SS. Sleep-related eating disorder: a case report of a progressed night eating syndrome. Acta Med Iran. 2012;50(7):522–4.
Waller SM, Vander Wal JS, Klurfeld DM, McBurney MI, Cho S, Bijlani S, et al. Evening ready-to-eat cereal consumption contributes to weight management. J Am Coll Nutr. 2004;23(4):316–21.
Vander Wal JS, Waller SM, Klurfeld DM, McBurney MI, Cho S, Kapila M, et al. Effect of a post-dinner snack and partial meal replacement program on weight loss. Int J Food Sci Nutr. 2006;57(1–2):97–106.
Coates TJ. Successive self-management strategies towards coping with night eating. J Behav Ther Exp Psychiatry. 1978;9(2):181–3.
Williamson DA, Lawson OD, Bennett SM, Hinz L. Behavioral treatment of night bingeing and rumination in an adult case of bulimia nervosa. J Behav Ther Exp Psychiatry. 1989;20(1):73–7.
Bernstein DA, Borkovec TD, Hazlett-Stevens H. New directions in progressive relaxation training: a guidebook for helping professionals. Westport: Praeger Publishers/Greenwood Publishing Group; US; 2000.
Carlson CR, Hoyle RH. Efficacy of abbreviated progressive muscle relaxation training: a quantitative review of behavioral medicine research. J Consult Clin Psychol. 1993;61(6):1059–67.
Allison KC, Lundgren JD, Moore RH, O’Reardon JP, Stunkard AJ. Cognitive behavior therapy for night eating syndrome: a pilot study. Am J Psychother. 2010;64(1):91–106. First application of CBT to the treatment of NES.
Allison KC. Cognitive-behavioral therapy and night eating syndrome. In: Lundren JD, Allison KC, Stunkard AJ, editors. Night eating syndrome: research, assessment, and treatment. New York: The Guilford Press; 2012. p. 231–45.
Allison KC. Cognitive-behavioral therapy manual for night eating syndrome. In: Lundgren JD, Allison KC, Stunkard AJ, editors. Night eating syndrome: research, assessment, and treatment. New York: The Guilford Press; 2012. p. 246–65.
Dalle Grave R, Calugi S, Ruocco A, Marchesini G. Night eating syndrome and weight loss outcome in obese patients. Int J Eat Disord. 2011;44(2):150–6.
Trojian TH, Jow V. Night eating syndrome presenting as anorexia in an athlete: case report and review. Curr Sports Med Rep. 2009;8(4):182–5.
Kubitz KA, Landers DM, Petruzzello SJ, Han M. The effects of acute and chronic exercise on sleep. A meta-analytic review. Sports Med. 1996;21(4):277–91.
Youngstedt SD, O’Connor PJ, Dishman RK. The effects of acute exercise on sleep: a quantitative synthesis. Sleep. 1997;20(3):203–14.
Yamanaka YHK, Hashimoto S, Takasu N, Miyazaki T, Honma S. Effects of physical exercise on human circadian rhythms. Sleep Biol Rhythms. 2006;4:199–206.
Allison KC, Stunkard AJ, Thier SL. Overcoming night eating syndrome: a step-by-step guide to breaking the cycle. Oakland: New Harbinger Publications; 2004.
Compliance with Ethics Guidelines
Conflict of Interest
Jillon S. Vander Wal declares that she has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
About this article
Cite this article
Vander Wal, J.S. The Treatment of Night Eating Syndrome: A Review and Theoretical Model. Curr Obes Rep 3, 137–144 (2014). https://doi.org/10.1007/s13679-013-0078-3
- Cognitive behavioral therapy
- Eating disorders
- Bright light therapy
- Night eating syndrome
- Nocturnal ingestions
- Relaxation therapy
- Sleep initiation, Maintenance disorders
- Serotonin uptake inhibitors
- Sleep disorders