“The new DSM-V classification (Editor’s note: fifth edition of the Diagnostic and Statistical Manual of Mental Disorders) has individualized thenocturnal binge (night eating syndrome) as a variant of typical binge eating, as is also prandial (meal) binge”, introduces Prof. Pierre Déchelotte, Head of the Rouen University Hospital Nutrition Department. These different forms of hyperphagia are part of compulsive eating disorders (ED) and are distinct from bulimia because there is no recourse to compensatory behaviors (vomiting, taking laxatives, etc.).
Definition: what is nocturnal binge?
Nocturnal hyperphagia is manifested by an irrepressible desire to eat during the night. These compulsions or nocturnal snacks often go hand in hand with poor sleep: the person is awake or wakes up and consumes food compulsively. “Sometimes, even, there is an automatic consumption and it is only in the morning when waking up that the person sees what they have eaten when they find the packaging”, describes Professor Déchelotte. There is then a state of modified consciousness. The specialist interviewed specifies that the intensity of the nocturnal hyperphagia compulsions is generally less than in thetypical binge eating disorder (binge eating disorder in English) and that there is no watertight border between the forms of hyperphagia: patients can present several types of hyperphagia at the same time or alternate typical bulimic hyperphagia, nocturnal or prandial hyperphagia.
Nocturnal hyperphagia: what are the causes?
Nocturnal binge, like all compulsive eating disorders, is highly intertwined with anxious and depressive comorbidities. “With nocturnal binge eating, insomnia is usually part of the picture. depressive fund and anxious increases the difficulty of going back to sleep with obsessive thoughts about the need to eat”, says Professor Déchelotte. People with nocturnal hyperphagia often have other addictions (cyber-addiction, compulsive shopping, etc.) or OCD. “We also see in people aged 20 to 30 an excessive co-consumption of food and screens. This behavior has developed a lot recently, in particular thanks to confinement with the withdrawal into oneself that this has generated”, informs us Professor Déchelotte.
What are the risk factors for nocturnal binge?
People who suffer from nocturnal binge gain weight quickly because of their food compulsions at night. “Furthermore, because of the satiation induced by excessive food intake at night, people with nocturnal binge are not hungry during the day, which maintains the disorder by promoting nighttime eating”, emphasizes Prof. Pierre Déchelotte. This compulsive eating disorder also results in difficulty getting up in the morning and drowsiness during the day.
Nocturnal hyperphagia: what consequences?
People who suffer from nocturnal binge gain weight quickly because of their food compulsions at night. “Furthermore, because of the satiation induced by excessive food intake at night, people with nocturnal binge are not hungry during the day, which maintains the disorder by promoting nighttime eating”, emphasizes Prof. Pierre Déchelotte. This compulsive eating disorder also results in difficulty getting up in the morning and drowsiness during the day.
How is nocturnal binge diagnosed?
The doctor informs us that “this disorder is under-diagnosed because people who suffer from it often find it difficult to talk about it, because they feel guilt, shame”. It is estimated that in France 12 to 13% of adults have an eating disorder; compulsive disorders account for more than half of all EDs, and nocturnal binge eating is estimated to account for 20% of compulsive EDs, and therefore ultimately affects approximately 1% of adults. Diagnosis is made according to DSM-V criteria. The two main diagnostic criteria are the consumption of at least 25% of the daily food intake after the evening meal and/or the presence of nocturnal awakenings accompanied by food compulsions. “Always look for comorbidities such as anxiety-depression, OCD, cyber-addiction and of course sleep disorders“, says Professor Déchelotte.
Nocturnal hyperphagia: what management and treatment?
Treatment for nocturnal binge is similar to that for typical binge eating. It is based on restructuring the sleep/wake rhythm, restructuring food during the day, taking anti-depressants (selective serotonin reuptake inhibitors or SSRIs such as fluoxetine or sertraline) and of course psychotherapy, especially behavioral “As soon as possible, the practice of an Adapted Physical Activity (APA) is of course also recommended” says Professor Déchelotte “because it is beneficial for the reduction of excess corpulence but also on the psychological level”.
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⋙ Binge eating disorder: causes, symptoms, test, treatment
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⋙ Bulimia and bulimic binge: how to detect the first signs of these eating disorders?