Nighttime eating syndrome (NES)

It turns out, it is a subtype of eating disorder, and is in the DSM

307.59 (F50.89) Other Specified Feeding or Eating Disorder (OSFED)
Examples: Atypical Anorexia Nervosa
Bulimia Nervosa (low frequency or limited duration)
Binge-Eating Disorder (low frequency or limited duration)
Purging Disorder
Night Eating Syndrome

I only read about this term yesterday, but I have had the disorder for years. Yesterday I also read that it is rarely talked about, but is more common than Anorexia or Bulimia, and especially among older people, obese people, and people with sleep apnea (I am obese but after a significant weight loss, am fit, am 54, and have sleep apnea which is well controlled).

"Night eating syndrome is an eating disorder that happens alongside a sleep disorder (insomnia)." from https://my.clevelandclinic.org/healt...g-syndrome-nes

I have it, but I do not have all the symptoms listed on the Cleveland Clinic's webpage about it.

I wake up in the middle of the night, on most nights, sometimes more than once, from hunger. In the past I had hunger pangs. Now I have hunger, but not pangs. Pangs used to spike anxiety in me. Now I am calmer. But I still cannot go back to sleep until I eat, until I feel full. I have tried and it did not work.

I used to drink dairy in order to quickly remove the painful hunger pangs. Then my RD recommended eating, not drinking, my calories, because solid food gives a longer period of satiety. I switched to eating, which may have helped shift the hunger from painful to merely unpleasant.

My first go-to dish is a serving of plain Greek yogurt with berries and nuts. If that does not do the trick, I would eat apple slices with crunchy peanut butter. If that is still not enough, I would drink a high-protein shake.

Sometimes all of it is enough. Other times, I am hungry again two hours later.

Very occasionally I do not wake up hungry in the middle of the night. The day after I typically feel my best. And I do not need naps after it.

On most days, I need naps. I have both insomnia and hypersomnia. I wonder how much nighttime eating contributes to hypersomnia during the day and excessive daytime sleepiness.

I will see a sleep medicine dr who specializes in hypersomnia in September.

I do not have cravings, either for carbs or for anything. Mentally, I do not want to eat. I eat to quell hunger and not for pleasure.

During the day, I sometimes have sudden and painful hunger and at other times, I can go long periods without food. When hunger is painful, I eat to quell it and not to experience pleasure. There are days when I get no pleasure from eating and instead eat to avoid painful physical feelings.

I have tried Naltrexone and Topamax for it, but they have not helped.

The description of NES mentions feeling depressed, especially in the evening. I do not feel depressed and I do not experience intra-day mood fluctuations.

I have read that Zoloft helps against NES, but, for one, my psychiatrist is not excited about prescribing an SSRI to a bipolar patient, and, for another, the premise behind the helpfulness of Zoloft in NES is in its success in treating depression, but I do not have depression.

Has anyone heard of NES or known people who have it?

It is embarrassing to admit to having this affliction to other people, and NES makes it difficult to travel. Say, last I traveled, I stayed in a hotel. I put single-portion yogurt cups and nuts in my luggage (there was a mini fridge in my room) and ordered protein shakes to be delivered from Amazon directly to the hotel. I managed. Protein shakes do not need to be refrigerated. But I was there alone, so it was purely my problem, whereas next time I plan to travel, I will be staying with distant relatives, in a small apartment. I cannot yet picture how I would manage. Getting up in the middle of the night to eat, risking waking up my hosts?.. Not something to look forward to.

I am probably repeating myself, but my psychiatrist, who prescribed my topamax, later suggested tagamet for my stomach pains, which i told him i was eating food to ease when not really hungry. I wasnt distinguishing between hunger pangs - ie actually needing to eat? - and a painful stomach. My nephew, who is a stick, says he likes that empty feeling. I think i dont experience it often enough. I wonder if i should try a ginger chew, as i dont like to take a tagamet unless i am really suffering indigestion.

I know, you mentioned that when I first complained of this. I do not experience it as painful stomach. I experience it as painfully empty stomach. I am now on Mounjaro 15 mg, a step-up from 12.5 mg on which I had been until recently, and I occasionally get stomach cramps as my GI tract adjusts to the higher dose (an expected side effect which should go away). These cramps and the empty feeling are completely different. Both are hard to describe in words, but the sensations are different. And when I feel that cramping, eating is the last thing from my mind.

So - you are saying youre hungry?

The keto people seem to eat a lot of beef jerky on youtube (i dont really come in contact with real people). That could be eaten fairly quietly. I would suggest protein. I just found that the protein drink many bariatric patients use comes in powder as well as liquid, and it is 30 gm of protein per serving and very low carb, altho it may be fake sugar.

I have rarely observed regular mealtimes. When i was a teen, my mother convinced me that the way to lose weight was to hold off eating as long as possible. Some part of me still sees that as a virtue, no matter how much i try to regulate it. I am working my way thru the day establishing a workable pattern for me, starting with protein coffee upon arising, monitoring my blood sugar along the way. It is tedious.

That sounds rough. When my insomnia gets bad, I have kinda used the extra hours to engage in bulimic activities, but that's more out of boredom and stress (and that triggering a different ED) rather than legitimate hunger though.


Would that be something that focusing on treating the sleep disorder part would help more or is it a "no matter how ridiculously exhausted or sedated my body and mind are, I wake up needing to eat" deal?

What intrigues me is that this is a question of how to deal with "legitimate" hunger. My penultimate t used to tell that i was an emotional eater. I was SOOOO out of touch and in denial! Now i see that he was right. So it is a whole new experience for me, a whole new paradigm.

I have bought beef jerky. Will try it. I have never tasted it. I can see how it this works, it will be far more convenient for travel.

Muddy Boots, you could be a Dr if not for the mental health troubles that derail your efforts - I have messaged two Drs about NES today, one psychiatrist who specializes in ED (I do not know him) and my own weight loss PA. Both said this should be dealt with at the sleep clinic, as a sleep disorder and not an eating disorder.

Unfortunately i just had a birthday, but for a while there, i was 72 and Muddy was 27. Its like we were antipodal. Our ages will always add up to the same number, being a multiple of 9 years apart. My dad was 36 when i was born, same thing. She is brilliant.

That sounds rough. I can only relate to daytime eating in that regard. I have to eat every few hours as I tend to get very hungry if I go long periods without food (snacking between meals). But when I wake with insomnia, I am never hungry. The onlly time I eat well, drink in the night is if I wake up with restless leg syndrome. I often find for me that drinking a glass of milk helps quite quickly (within 10-15 min I'm back asleep).

I have never heard of NES before, but it sounds tough. Have you seen a GI about it?

I do often wake up thirsty, but that is no big deal; I keep a cup of water on my nightstand for that purpose; it's not like I'm consuming extra calories.

Yeah I eat in my sleep sometimes. I ate 3 boy scout chocolate bars in a row the other night. I try not to keep food near me at night.

Its gotten a lot better. I used to eat bowls of Spaghetti and bowls of plain peanut butter in my slep.

I saw a GI NP in Dec and she ordered an endoscopy. I will have it in June. She thought that maybe H pylori is causing painful hunger that wakes me up

If you eat IN your sleep, that is a different sleep disorder. Not an eating disorder. But people who have that disorder typically do not recall having eaten. How do you know what you ate in your sleep?

I remember parts of it but not everything. Like I might not remember getting out of bed and walking to the kitchen. I remember kinda fixing things but not really eating. Details of things are just in and out. Yeah not the same thing. Sorry

Then it is a sleep disorder. That is what it is. Sleep eating. I will find out what the exact term is.

Happy belated birthday, inaluna!!

https://my.clevelandclinic.org/healt...ting-disorders

this is exactly what you have. people have little or no memory afterwards. you have little memory.

So I met with a telehealth therapist who treats eating disorders, for free, through my EAP program that provides three free sessions per issue. The therapist admitted to having no experience with NES, but wanted to still try treating it. I am dubious, but I will give it some time and let her try. I have also signed up for RD services for $20 an hour, also via telehealth, weekly. Maybe if somebody helps me with the menu planning in real time, it will help.
Finally, I have purchased Glucose Goddess' supplement to lower glucose spikes. Not that my spikes are very pronounced, but hey, if she can make them even lower, it might help. She lists reduced hunger as one of the positive effects of the supplement. I will give it a try.

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Saw this and thought of you!

Lovely! I am in good company.

I am cautiously optimistic. Eating steaks for dinner seems to be helping. It either reduces nighttime hunger or, and I am afraid to jinx it, last night eliminated it altogether. I slept through the night, almost. I woke up once from a nightmare and went back to sleep. Oura registered high sleep efficiency above 90% and a lot of deep sleep, 20% of total sleep. So although I was in bed for only 6 hours, I was fine in the morning and had a good day.

I wonder if this is repeatable.

I wonder if it’s the amount or type of protein in it that satisfies your hunger better than anything else you’ve been eating.

Alan Roberts, the angry albeit very fit man on youtube, eats just steaks and eggs. He lost 100 lbs and kept it off. Hasnt binged in 4 years. Eats maybe a small amt of carbs at dinner.

Eggs are cool because they contain all 9 types of proteins we need yet cannot synthesize ourselves.

Last night I did not eat a steak and I was up to eat a snack at 4:15 am and have not been able to go back to sleep. So far it doesn't disprove the steak is good hypothesis.

Does red meat have different types of protein than fish?

Different nutrients. Like, beef has iron, fish has omega-3s. Maybe you are still low on iron?