It’s normal for teenagers to sometimes eat late at night or have a snack before bedtime. But if a young person is eating a lot of food in the evening or at night, it might be a cause for concern.
Repeated nighttime binge eating – or eating a lot of food at night – is a type of disordered eating behaviour that can harm a young person’s physical and mental health. It’s also a symptom of different eating disorders, including binge-eating disorder and night eating syndrome.
Importantly, eating problems can be very serious even if they don’t meet the criteria for an eating disorder. Young people who engage in persistent nighttime binge eating require support, regardless of their diagnosis. If you’re worried that a child or adolescent may be binge eating at night, it’s important to speak with a mental health professional.
Binge Eating Behaviour, Night Eating Syndrome, and Binge Eating Disorder
Binge eating behaviour is a type of disordered eating, characterised by eating a lot of food in a short amount of time while experiencing a sense of loss of control over eating. It can be a symptom of various eating disorders, including night eating syndrome, binge eating disorder, bulimia nervosa, and anorexia nervosa.
If a young person is eating a lot at night or waking up at night to eat, it might be a sign that they’re living with one of these disorders. It might also mean that a young person is at risk of developing – or in the early stages of – an eating disorder.
What Is Night Eating Syndrome?
Night eating syndrome (NES) is a type of eating disorder. It’s less well known than some other types of eating disorders and is sometimes overlooked as ‘normal’ teenage behaviour. Young people with NES eat a lot of food at night or after their evening meal, or wake up during the night to eat.
While many young people snack or eat late at night, people with NES eat a significant proportion of their daily energy intake after dinner. They may have a strong urge to eat after dinner and before going to bed, or feel like they can’t fall asleep without eating.
In the Diagnostic and Statistical Manual of Mental Disorders, night eating syndrome falls under the category of “other specified feeding or eating disorder” (OFSED). The criteria for a diagnosis of NES include:
- Engaging in recurrent episodes of night eating, such as eating after waking up from sleep or eating a lot of food after a meal
- Having an awareness that they are eating and remembering it afterwards
- Experiencing significant distress and difficulties in everyday life because of night eating
Night eating syndrome usually develops during adolescence, although it is often not diagnosed until adulthood. It’s associated with several other mental health conditions, including anxiety and depression.
Binge Eating Disorder and Bulimia Nervosa
Nighttime binge eating can also be a symptom of binge eating disorder. Binge eating disorder is characterised by episodes of out-of-control eating while consuming a lot of food in a short time. Young people with binge eating disorder experience distress after or related to binge eating episodes, such as feelings of guilt, shame, or sadness.
When nighttime binge eating episodes occur alongside ‘purges’ (behaviours like vomiting, excessive exercise, or diet restriction that drastically reduce energy intake to the body), it may be a symptom of bulimia nervosa.
What Are the Differences Between Night Eating Syndrome and Binge Eating Disorder?
There are a few key differences between night eating syndrome and binge eating disorder.
- night eating syndrome doesn’t require that someone experiences a sense of loss of control when they are eating a lot of food
- binge eating episodes in binge eating disorder can happen at any time of day, although they are more likely later in the day
One study compared the eating patterns, disordered eating, and depressive symptoms in people with night eating syndrome and binge eating disorder. They found that people with binge eating disorder reported more over-eating episodes, shape and weight concerns, and lack of control than those with NES. People with both binge eating disorder and night eating syndrome had more depressive symptoms than those without either disorder.
Nighttime Binge Eating and Young People’s Mental Health
Night eating syndrome is associated with several mental health disorders, including anxiety, depression, sleep disorders, and other eating disorders. Having a mental health condition like anxiety and depression may make it more likely for a young person to develop night eating syndrome, but night eating syndrome may also make the development of these disorders more likely.
For example, a 2018 study among college students found that students with higher night eating scores experienced greater psychological distress. Another study among young adults found that symptoms of depression were linked to night-eating. They also found a possible link between earlier depression and later night-eating.
While it’s not always clear whether mental health symptoms cause or result from nighttime binge eating, the association itself is important. Night eating may be a sign of other mental health problems that also require care and support, whether it’s an eating disorder, anxiety, or depression.
What Causes Nighttime Binge Eating?
While it’s still not clear exactly what causes nighttime binge eating, researchers have some ideas. Both genetic and environmental factors may play a role.
Heritability
There’s very little research about the heritability of night eating syndrome – how the syndrome may be passed from parents to children. However, some small sample studies suggest that mothers’ and children’s night eating may be linked.
Even so, it’s not clear whether this association is caused by shared genetics or patterns of behaviour within families.
Chronic Stress, Psychological Symptoms, and Emotional Eating
Research among college students has found associations between night eating and emotional eating – increased eating as a response to negative emotions. This means that young people who use eating as a coping mechanism may be more likely than others to engage in nighttime eating.
It also means that young people experiencing different kinds of emotional distress – such as anxiety, depression, and stress – may be more likely to eat at night and develop night eating syndrome.
Other research has reported a longitudinal effect between depression and night eating. That is, experiencing depression is linked to developing night eating later on in life. One study found that depressive symptoms in adolescence are linked to night eating in young adulthood.
Sleeping Patterns, Circadian Rhythms, and Sleep Disorders
It’s well established that sleep disorders and sleeping patterns are linked to nighttime eating. A 2020 study found that people who prefer to do things in the evenings and go to bed later (who may have delayed circadian rhythms) are more likely to eat at night.
Research also suggests that night eating could affect sleeping patterns and contribute to sleep disorders. A 2018 study concluded that night eating symptoms directly increased insomnia severity and shifted sleeping and waking patterns towards the evening. Another study found that students with moderate and full night eating syndrome had worse sleep quality than those without night eating syndrome.
Researchers have also uncovered links between sleep disorders and binge eating disorder and behaviours. In one study, people who experienced overall sleep disturbance were more likely to have binge eating disorder (or engage in binge eating behaviours) one year later. Sleeping less than 9 hours a night was also linked to later binge eating behaviours.
Treating Nighttime Binge Eating
Nighttime binge eating, nighttime eating syndrome, and binge eating disorder seriously affect a young person’s well-being. However, with the right support, young people can recover from eating problems and eating disorders – and the earlier they seek help, the better.
Treating Nighttime Eating Syndrome in Adolescents and Young Adults
Research into nighttime eating syndrome is still limited and often based on small sample size studies. However, studies have identified several different treatment approaches that may effectively treat nighttime eating syndrome in young people. These include:
- Psychotherapy, such as cognitive behavioural therapy (CBT)
- Medications that regulate serotonin levels, such as SSRIs
- Bright light therapy
Psychotherapeutic approaches like CBT teach young people coping skills to avoid eating at night and manage their emotions in healthy ways. They also help young people regulate eating and sleeping routines and monitor their own behaviours.
Medications like SSRIs aim to regulate serotonin levels. Serotonin is a hormone (brain chemical) that affects many functions, including mood, appetite, and sleep. Unbalanced serotonin levels may play a role in maintaining night eating disorder, contributing to delayed circadian rhythms and disrupted appetite and fullness signals.
Therapies such as bright light therapy aim to influence circadian rhythms, moving a young person’s ‘body clock’ to an earlier time. This can help young people to sleep earlier and reduce their appetite at night.
Treating Binge Eating Disorder in Young People
Treatment for binge eating disorder in young people usually centres around psychotherapy. This might include:
- cognitive behavioural therapy
- interpersonal therapy
- dialectical behavioural therapy
Cognitive behavioural therapy focuses on regulating eating patterns and identifying and changing unhelpful or harmful eating-related thoughts that underpin binge eating symptoms. Interpersonal therapy supports young people to develop the skills to resolve interpersonal difficulties that maintain binge eating. Dialectical behavioural therapy focuses on the emotion-related triggers of binge eating, helping young people to accept, manage, and cope with emotions in healthy ways.
Most young people get better from binge eating with effective support. However, they may need to try different treatment options before they find the one that works for them. Many young people benefit from a combination of different treatment modalities, for example, dialectical behavioural therapy alongside interpersonal therapy.
The Wave Clinic: Specialist Treatment for Eating Disorders
The Wave Clinic offers specialist treatment spaces for young people with eating disorders and other mental health conditions. Our programs combine a diverse selection of treatment modalities, designed and delivered with exceptional expertise. Our approach is trauma-focused and family-centred, emphasising the influence of past experiences and present social systems on young people’s thoughts, feelings, and behaviours.
If you’re interested in finding out more about our programs, get in touch today.
