Night eating syndrome in obesity

  • G. Marchesini
  • S. Calugi
  • R. Marzocchi
  • R. Dalle Grave
Part of the Human Health Handbooks book series (HHH, volume 3)


Night eating syndrome is an eating disorder characterized by a delay in the circadian timing of food intake, which is remarkably reduced during the first part of the day and greatly increased after dinner, frequently with awakenings characterized by nocturnal food ingestion and morning anorexia. In the absence of standard diagnostic criteria, its prevalence is difficult to estimate. According to the most agreed criteria, the disorder affects approximately 1.5 % of the general population, it is more common among obese persons and the prevalence increases with increasing adiposity. Longitudinal studies with adequate follow-up are needed to determine whether night eating contributes to weight gain and the development of obesity. The research should also aim to assess the interaction of genetic and environmental processes in the pathogenesis and in the maintenance of the disorder. There is no satisfactory treatment of night eating. Limited information is available on drug treatment (sertraline, topiramate). Lifestyle modifications aimed at weight loss are standard treatment whenever night eating is associated with obesity and have demonstrated a favorable effect, but more research is needed also in this area to optimize the protocols.


diet food intake behavior therapy night eating 



Binge eating disorder


Body mass index


Cognitive-behavioral treatment


Night eating syndrome


Night eating questionnaire


Night eating syndrome history and inventory


Sleep-related eating disorder


  1. Adami, G.F., Meneghelli, A. and Scopinaro, N., 1999. Night eating and binge eating disorder in obese patients. International Journal of Eating Disordorders 25, 335–338.CrossRefGoogle Scholar
  2. Allison, K.C., Ahima, R.S., O’Reardon, J.P., Dinges, D.F., Sharma, V., Cummings, D.E., Heo, M., Martino, N.S. and Stunkard, A.J., 2005a. Neuroendocrine profiles associated with energy intake, sleep, and stress in the night eating syndrome. Journal of Clinical Endocrinology and Metabolism 90, 6214–6217.PubMedCrossRefGoogle Scholar
  3. Allison, K.C., Crow, S.J., Reeves, R.R., West, D.S., Foreyt, J.P., Dilillo, V.G., Wadden, T.A., Jeffery, R.W., Van Dorsten, B. and Stunkard, A.J., 2007. Binge eating disorder and night eating syndrome in adults with type 2 diabetes. Obesity (Silver Spring) 15, 1287–1293.CrossRefGoogle Scholar
  4. Allison, K.C., Engel, S.G., Crosby, R.D., de Zwaan, M., O’Reardon, J.P., Wonderlich, S.A., Mitchell, J.E., Smith West, D., Wadden, T.A. and Stunkard, A.J., 2008a. Evaluation of diagnostic criteria for night eating syndrome using item response theory analysis. Eating Behavaviors 9, 398–407.CrossRefGoogle Scholar
  5. Allison, K.C., Grilo, C.M., Masheb, R.M. and Stunkard, A.J., 2005b. Binge eating disorder and night eating syndrome: a comparative study of disordered eating. Journal of Consulting and Clinical Psychology 73, 1107–1115.PubMedCrossRefGoogle Scholar
  6. Allison, K.C., Lundgren, J.D., Moore, R.H., O’Reardon, J.P. and Stunkard, A.J., 2010a. Cognitive behavior therapy for night eating syndrome: a pilot study. American Journal of Psychotherapy 64, 91–106.PubMedGoogle Scholar
  7. Allison, K.C., Lundgren, J.D., O’Reardon, J.P., Geliebter, A., Gluck, M.E., Vinai, P., Mitchell, J.E., Schenck, C.H., Howell, M.J., Crow, S.J., Engel, S., Latzer, Y., Tzischinsky, O., Mahowald, M.W. and Stunkard, A.J., 2010b. Proposed diagnostic criteria for night eating syndrome. International Journal of Eating Disorders 43, 241–247.PubMedGoogle Scholar
  8. Allison, K.C., Lundgren, J.D., O’Reardon, J.P., Martino, N.S., Sarwer, D.B., Wadden, T.A., Crosby, R.D., Engel, S.G. and Stunkard, A.J., 2008b. The Night Eating Questionnaire (NEQ): psychometric properties of a measure of severity of the Night Eating Syndrome. Eating Behaviors 9, 62–72.PubMedCrossRefGoogle Scholar
  9. Allison, K.C., Stunkard, A.J. and Thier, S.L., 2004. Overcoming the night eating syndrome: a step-by-step guide to breaking the cycle. New Harbinger, Oakland, CA, USA, 192 pp.Google Scholar
  10. Allison, K.C., Wadden, T.A., Sarwer, D.B., Fabricatore, A.N., Crerand, C.E., Gibbons, L.M., Stack, R.M., Stunkard, A.J. and Williams, N.N., 2006. Night eating syndrome and binge eating disorder among persons seeking bariatric surgery: prevalence and related features. Surgery for Obesity Related Diseases 2, 153–158.CrossRefGoogle Scholar
  11. Birketvedt, G.S., Florholmen, J., Sundsfjord, J., Osterud, B., Dinges, D., Bilker, W. and Stunkard, A., 1999. Behavioral and neuroendocrine characteristics of the night-eating syndrome. Journal of American Medical Association 282, 657–663.CrossRefGoogle Scholar
  12. Birketvedt, G.S., Sundsfjord, J. and Florholmen, J.R., 2002. Hypothalamic-pituitary-adrenal axis in the night eating syndrome. American Journal of Physiology- Endocrinology and Metabolism 282, E366-369.PubMedGoogle Scholar
  13. Boseck, J.J., Engel, S.G., Allison, K.C., Crosby, R.D., Mitchell, J.E. and De Zwaan, M., 2007. The application of ecological momentary assessment to the study of night eating. International Journal of Eating Disordders 40, 271–276.CrossRefGoogle Scholar
  14. Calugi, S., Dalle Grave, R. and Marchesini, G., 2009. Night eating syndrome in class II-III obesity: metabolic and psychopathological features. International Journal of Obesity (Lond) 33, 899–904.CrossRefGoogle Scholar
  15. Ceru-Bjork, C., Andersson, I. and Rossner, S., 2001. Night eating and nocturnal eating-two different or similar syndromes among obese patients? International Journal of Obesity Related Metabolic Disorders 25, 365–372.CrossRefGoogle Scholar
  16. Colles, S.L., Dixon, J.B. and O’Brien, P.E., 2007. Night eating syndrome and nocturnal snacking: association with obesity, binge eating and psychological distress. International Journal of Obesity (Lond) 31, 1722–1730.CrossRefGoogle Scholar
  17. Colles, S.L., Dixon, J.B. and O’Brien, P.E., 2008. Grazing and loss of control related to eating: two high-risk factors following bariatric surgery. Obesity (Silver Spring) 16, 615–622.CrossRefGoogle Scholar
  18. Dalle Grave, R., Calugi, S., Ruocco, A. and Marchesini, G., 2011. Night eating syndrome and weight loss outcome in obese patients. International Journal of Eating Disorders 44, 150–156.PubMedGoogle Scholar
  19. De Zwaan, M., Burgard, M.A., Schenck, C.H. and Mitchell, J.E., 2003. Night time eating: a review of the literature. European Eating Disorders Review 11, 7–24.CrossRefGoogle Scholar
  20. De Zwaan, M., Roerig, D.B., Crosby, R.D., Karaz, S. and Mitchell, J.E., 2006. Nighttime eating: a descriptive study. International Journal of Eating Disorders 39, 224–232.PubMedCrossRefGoogle Scholar
  21. Epel, E.S., McEwen, B., Seeman, T., Matthews, K., Castellazzo, G., Brownell, K.D., Bell, J. and Ickovics, J.R., 2000. Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychomatic Medicine 62, 623–632.Google Scholar
  22. Gluck, M.E., Geliebter, A. and Satov, T., 2001. Night eating syndrome is associated with depression, low self-esteem, reduced daytime hunger, and less weight loss in obese outpatients. Obesity Research 9, 264–267.PubMedCrossRefGoogle Scholar
  23. Goel, N., Stunkard, A.J., Rogers, N.L., Van Dongen, H.P., Allison, K.C., O’Reardon, J.P., Ahima, R.S., Cummings, D.E., Heo, M. and Dinges, D.F., 2009. Circadian rhythm profiles in women with night eating syndrome. Journal of Biological Rhythms 24, 85–94.PubMedCrossRefGoogle Scholar
  24. Greeno, C.G., Wing, R.R. and Marcus, M.D., 1995. Nocturnal eating in binge eating disorder and matched-weight controls. International Journal of Eating Disorders 18, 343–349.PubMedCrossRefGoogle Scholar
  25. Grilo, C.M. and Masheb, R.M., 2004. Night-time eating in men and women with binge eating disorder. Behavavior Research and Therapy 42, 397–407.CrossRefGoogle Scholar
  26. Haimov, I., Lavie, P., Laudon, M., Herer, P., Vigder, C. and Zisapel, N., 1995. Melatonin replacement therapy of elderly insomniacs. Sleep 18, 598–603.PubMedGoogle Scholar
  27. Howell, M.J., Schenck, C.H. and Crow, S.J., 2009. A review of nighttime eating disorders. Sleep Medicine Reviews 13, 23–34.PubMedCrossRefGoogle Scholar
  28. Hsu, L.K., Betancourt, S. and Sullivan, S.P., 1996. Eating disturbances before and after vertical banded gastroplasty: a pilot study. International Journal of Eating Disorders 19, 23–34.PubMedCrossRefGoogle Scholar
  29. Lamerz, A., Kuepper-Nybelen, J., Bruning, N., Wehle, C., Trost-Brinkhues, G., Brenner, H., Hebebrand, J. and Herpertz-Dahlmann, B., 2005. Prevalence of obesity, binge eating, and night eating in a cross-sectional field survey of 6-year-old children and their parents in a German urban population. Journal of Child Psychology and Psychiatry 46, 385–393.PubMedCrossRefGoogle Scholar
  30. Lundgren, J.D., Allison, K.C., Crow, S., O’Reardon, J.P., Berg, K.C., Galbraith, J., Martino, N.S. and Stunkard, A.J., 2006a. Prevalence of the night eating syndrome in a psychiatric population. American Journal of Psychiatry 163, 156–158.PubMedCrossRefGoogle Scholar
  31. Lundgren, J.D., Allison, K.C. and Stunkard, A.J., 2006b. Familial aggregation in the night eating syndrome. International Journal of Eating Disorders 39, 516–518.PubMedCrossRefGoogle Scholar
  32. Marshall, H.M., Allison, K.C., O’Reardon, J.P., Birketvedt, G. and Stunkard, A.J., 2004. Night eating syndrome among nonobese persons. International Journal of Eating Disorders 35, 217–222.PubMedCrossRefGoogle Scholar
  33. Morin, C.M., 2006. Combined therapeutics for insomnia: should our first approach be behavioral or pharmacological? Sleep Medicine 7 Suppl 1, S15-19.PubMedCrossRefGoogle Scholar
  34. Morse, S.A., Ciechanowski, P.S., Katon, W.J. and Hirsch, I.B., 2006. 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 29, 1800–1804.PubMedCrossRefGoogle Scholar
  35. O’Reardon, J.P., Allison, K.C., Martino, N.S., Lundgren, J.D., Heo, M. and Stunkard, A.J., 2006. A randomized, placebo-controlled trial of sertraline in the treatment of night eating syndrome. American Journal of Psychiatry 163, 893–898.PubMedCrossRefGoogle Scholar
  36. O’Reardon, J.P., Ringel, B.L., Dinges, D.F., Allison, K.C., Rogers, N.L., Martino, N.S. and Stunkard, A.J., 2004a. Circadian eating and sleeping patterns in the night eating syndrome. Obesity Research 12, 1789–1796.PubMedCrossRefGoogle Scholar
  37. O’Reardon, J.P., Stunkard, A.J. and Allison, K.C., 2004b. Clinical trial of sertraline in the treatment of night eating syndrome. International Journal of Eating Disorders 35, 16–26.PubMedCrossRefGoogle Scholar
  38. Rand, C.S., Macgregor, A.M. and Stunkard, A.J., 1997. The night eating syndrome in the general population and among postoperative obesity surgery patients. International Journal of Eating Disorders 22, 65–69.PubMedCrossRefGoogle Scholar
  39. Root, T.L., Thornton, L.M., Lindroos, A.K., Stunkard, A.J., Lichtenstein, P., Pedersen, N.L., Rasmussen, F. and Bulik, C.M., 2010. Shared and unique genetic and environmental influences on binge eating and night eating: a Swedish twin study. Eating Behaviors 11, 92–98.PubMedCrossRefGoogle Scholar
  40. Sassaroli, S., Ruggiero, G.M., Vinai, P., Cardetti, S., Carpegna, G., Ferrato, N., Vallauri, P., Masante, D., Scarone, S., Bertelli, S., Bidone, R., Busetto, L. and Sampietro, S., 2009. Daily and nightly anxiety among patients affected by night eating syndrome and binge eating disorder. Eating Disorders 17, 140–145.PubMedCrossRefGoogle Scholar
  41. Spaggiari, M.C., Granella, F., Parrino, L., Marchesi, C., Melli, I. and Terzano, M.G., 1994. Nocturnal eating syndrome in adults. Sleep 17, 339–344.PubMedGoogle Scholar
  42. Striegel-Moore, R.H., Franko, D.L. and Garcia, J., 2009. The validity and clinical utility of night eating syndrome. International Journal of Eating Disorders 42, 720–738.PubMedCrossRefGoogle Scholar
  43. Striegel-Moore, R.H., Franko, D.L., May, A., Ach, E., Thompson, D. and Hook, J.M., 2006. Should night eating syndrome be included in the DSM? International Journal of Eating Disorders 39, 544–549.PubMedCrossRefGoogle Scholar
  44. Stunkard, A., Berkowitz, R., Wadden, T., Tanrikut, C., Reiss, E. and Young, L., 1996. Binge eating disorder and the night-eating syndrome. International Journal of Obesity Related Metababolic Disorders 20, 1–6.Google Scholar
  45. Stunkard, A.J., 1976. The Pain of Obesity. Bull Publishing Co, Palo Alto, CA, USA, 236 pp.Google Scholar
  46. Stunkard, A.J., Allison, K.C., Lundgren, J.D., Martino, N.S., Heo, M., Etemad, B. and O’Reardon, J.P., 2006. A paradigm for facilitating pharmacotherapy at a distance: sertraline treatment of the night eating syndrome. Journal of Clinical Psychiatry 67, 1568–1572.PubMedCrossRefGoogle Scholar
  47. Stunkard, A.J., Grace, W.J. and Wolff, H.G., 1955. The night-eating syndrome; a pattern of food intake among certain obese patients. American Journal of Medicine 19, 78–86.PubMedCrossRefGoogle Scholar
  48. Tholin, S., Lindroos, A., Tynelius, P., Akerstedt, T., Stunkard, A.J., Bulik, C.M. and Rasmussen, F., 2009. Prevalence of night eating in obese and nonobese twins. Obesity (Silver Spring) 17, 1050–1055.CrossRefGoogle Scholar
  49. Tzischinsky, O. and Latzer, Y., 2004. Nocturnal eating: Prevalence, features and night sleep among Binge Eating Disorder and Bulimia Nervosa patients in Israel. European Eating Disorders Review 12, 101–109.CrossRefGoogle Scholar
  50. Vinai, P., Allison, K.C., Cardetti, S., Carpegna, G., Ferrato, N., Masante, D., Vallauri, P., Ruggiero, G.M. and Sassaroli, S., 2008. Psychopathology and treatment of night eating syndrome: a review. Eating and Weight Disorders 13, 54–63.PubMedGoogle Scholar
  51. Winkelman, J.W., 2003. Treatment of nocturnal eating syndrome and sleep-related eating disorder with topiramate. Sleep Medicine 4, 243–246.PubMedCrossRefGoogle Scholar
  52. Zhdanova, I.V., Wurtman, R.J., Morabito, C., Piotrovska, V.R. and Lynch, H.J., 1996. Effects of low oral doses of melatonin, given 2–4 hours before habitual bedtime, on sleep in normal young humans. Sleep 19, 423–431.PubMedGoogle Scholar

Copyright information

© Wageningen Academic Publishers 2013

Authors and Affiliations

  • G. Marchesini
    • 1
  • S. Calugi
    • 2
  • R. Marzocchi
    • 1
  • R. Dalle Grave
    • 2
  1. 1.Unit of Metabolic Diseases and Clinical Dietetics‘Alma Mater Studiorum’ UniversityBolognaItaly
  2. 2.Department of Eating and Weight DisordersVilla Garda HospitalGardaItaly

Personalised recommendations