Dr. Macklin Talks Night Eating: Syndrome or Habit?

In my clinical practice I define the times that patients are at most risk of overeating as their "high risk times." Clearly, one of the most common high risk times I see is between dinner and breakfast, otherwise known as "night eating."  
 
There are two common reasons for night eating. The first is a medical condition called night eating syndrome and the second is called habit. Both are leading causes of obesity. Both can be treated.
 
Why We Eat at Night
Night Eating Syndrome is characterized by abnormal eating patterns, along with sleep and mood alterations. People with this syndrome wake up in the morning with no interest in food and take in the majority of their calories in the second half of the day. Their mood becomes worse and symptoms of either anxiety or depression increase as the day goes on. Then comes the evening and watch out, because night eating begins.
 
Night time eating is characterized by relentless snacking on high carbohydrate foods and in its extreme form, individuals wake from sleep to snack - sometimes with little awareness.
 
Recent work done at the University of Pennsylvania and the University of Tromso in Norway, suggest that this pattern seems to be more than just habit. These studies showed that individuals with Night Eating Syndrome (NES), show distinctive changes in hormones related to sleep, hunger and stress. "Normal" people experience a night time rise in Melatonin levels, that support sleep, and a nightime rise in the Leptin, a hormone responsible for down regulating appetite. For individuals with NES, those hormone level rises don’t happen. Awareness of NES as a syndrome is relatively new, and much more research needs to be done.
 
The second likely cause of night eating is simply habit. Some of today’s most exciting medical research warns us against regularly eating foods that are high in both sugar and fat. We have learned that these foods carry a powerful capacity to stimulate the reward system in our brain, the same system driven by drugs of abuse, alcohol, cigarettes, sex, gambling and shopping.  
 
If we eat these foods (chips, chocolate, pizza, ice cream etc.) at night, a night eating habit develops. Reward centre activation means dopamine and endorphins are released in our brain and we feel good, sometimes really good.  So much so that we want to feel good again. The memory systems in our brain remember the potentially thousands of times we ate these food at night.  When night arrives, our memory whispers to the reward centre and says “hey…. we have felt great eating chips or ice cream around now, lets get some! And so, the craving is born and so the night eating pattern gets established.
 
How to Fix the Issue

If any of this sounds familiar to you, you are not alone and here is what you can do. Night Eating Syndrome is a clinical diagnosis, see your family doctor.  Early clinical trails have shown that medications that elevate late day levels of serotonin and/or melatonin can be effective at reducing the mood and diet patterns of night eating syndrome. Whether your night eating is clinical or habitual there is a series of lifestyle strategies that in my experience can provide dramatic improvements in night eating and weight.  
 
First and foremost, take on your night eating from a position of strength. This means that by the time you finish dinner, ensure that you have eaten a sufficient balance of calories and nutrition. Under eating and restricting carbohydrates are sure fire ways of strengthening your night eating patterns and make weight loss more difficult.  
 
Next you should set some rules: The most effective strategy in my clinical practice is a rule I call "dinner and done".  Exciting recent medical evidence suggests that combating evening cravings is easiest if you take night eating literally "off the table". It seems that consideration of night eating works against you.  You are most empowered when you do not even let the conversation begin. You know the conversation - "maybe I should just have one, or maybe I should just eat something healthy". Science tells us that these thoughts recruit a whole lot of grey matter and erode our willpower much like a rolling snowball gains momentum.
 
If you take in unnecessary calories at night, work on it, night time calories add up. I will leave you with one ominous fact. If I changed nothing over the next year in the amount of food I eat and my exercise level but only added a chocolate chip cookie and a glass of milk before I went to sleep each night, I would gain 36 pounds of fat in a year!  Good luck.

This post is a repeat, but look forward to more original content to come in the future.