Ating with a significantly increased intake in the evening and/or

Ating with a significantly increased intake in the evening and/or night time, as manifested by one or both of the following: at least 25 of food intake is consumed after the evening meal or at least two episodes of nocturnal eating per week. An important recent addition to core criteria includes the presence of significant distress and/or impairment in functioning. Stunkard’s team recommend further investigation on the pathogenesis of NES, in particular its relationship with traumatic life events, psychiatric comorbidity, the age of onset of NES and course of NES over time. The relationship between NES and other ED also requires further clarification as night-eaters exhibit some features of other ED; previous guidance to separate NES from other ED may have hindered earlier characterisation of NES. Evidence from European and American studies suggests NES features strongly in AG-490 biological activity populations with severe obesity. The complex interplay between depression, impaired sleep and obesity-related comorbidity in severely obese individuals makes understanding NES in this context even more difficult. This review examines evidence to date on the characterisation of NES and concludes by examining the applicability of current NES criteria to individuals with severe obesity. Nutrition and Diabetes (2012) 2, e44; doi:10.1038/nutd.2012.16; published online 10 LOR-253 side effects September 2012 Keywords: obesity; night eating; sleep; circadian rhythmINTRODUCTION The obesity epidemic continues to impact heavily on the health economy, and the need for successful and enduring obesity treatments is essential. Recent years have seen sustained attempts to understand the contribution of disordered eating patterns to the development of obesity. Considerable progress has been made in understanding night eating syndrome (NES), a cluster of behaviours first identified in 1955 by Stunkard,1 a psychiatrist specialising in eating disorders (ED). This narrative review describes the evolution of NES from initial identification to current conceptualisation. Methods of identification, prevalence in varying populations, behavioural and clinical characteristics, and treatment options are discussed. Evolving evidence of the relationship between NES and other ED, sleep-related ED, sleep, depression and anxiety is also considered. The paper concludes by examining the relationship of NES with obesity and the applicability of current NES criteria to a severely obese population.grounds of sample size as even single case reports may be important indicators of future understanding of NES. Reviews, commentaries, reports from professional and non peer-reviewed publications and case reports of other syndromes where discussion of NE was incidental were excluded, yielding 84 studies for potential inclusion, of which 73 have been included in this review.METHODS The Medline, Scopus, PsychInfo and CINAHL databases were searched for all studies published between 1955 and January 2012. One-hundred and ninty-one papers were found using the search terms of NES, night-eating (NE), late night eating, NE behaviour and nocturnal eating. Results were filtered to return studies of human subjects published in English. Only original research was considered for inclusion. The conceptualisation of NES is still evolving, thus papers were not excluded on theEVOLUTION OF DIAGNOSTIC CRITERIA NES is now considered a dysfunction of circadian rhythm with a disassociation between eating and sleeping, characterised by a phase onset delay.Ating with a significantly increased intake in the evening and/or night time, as manifested by one or both of the following: at least 25 of food intake is consumed after the evening meal or at least two episodes of nocturnal eating per week. An important recent addition to core criteria includes the presence of significant distress and/or impairment in functioning. Stunkard’s team recommend further investigation on the pathogenesis of NES, in particular its relationship with traumatic life events, psychiatric comorbidity, the age of onset of NES and course of NES over time. The relationship between NES and other ED also requires further clarification as night-eaters exhibit some features of other ED; previous guidance to separate NES from other ED may have hindered earlier characterisation of NES. Evidence from European and American studies suggests NES features strongly in populations with severe obesity. The complex interplay between depression, impaired sleep and obesity-related comorbidity in severely obese individuals makes understanding NES in this context even more difficult. This review examines evidence to date on the characterisation of NES and concludes by examining the applicability of current NES criteria to individuals with severe obesity. Nutrition and Diabetes (2012) 2, e44; doi:10.1038/nutd.2012.16; published online 10 September 2012 Keywords: obesity; night eating; sleep; circadian rhythmINTRODUCTION The obesity epidemic continues to impact heavily on the health economy, and the need for successful and enduring obesity treatments is essential. Recent years have seen sustained attempts to understand the contribution of disordered eating patterns to the development of obesity. Considerable progress has been made in understanding night eating syndrome (NES), a cluster of behaviours first identified in 1955 by Stunkard,1 a psychiatrist specialising in eating disorders (ED). This narrative review describes the evolution of NES from initial identification to current conceptualisation. Methods of identification, prevalence in varying populations, behavioural and clinical characteristics, and treatment options are discussed. Evolving evidence of the relationship between NES and other ED, sleep-related ED, sleep, depression and anxiety is also considered. The paper concludes by examining the relationship of NES with obesity and the applicability of current NES criteria to a severely obese population.grounds of sample size as even single case reports may be important indicators of future understanding of NES. Reviews, commentaries, reports from professional and non peer-reviewed publications and case reports of other syndromes where discussion of NE was incidental were excluded, yielding 84 studies for potential inclusion, of which 73 have been included in this review.METHODS The Medline, Scopus, PsychInfo and CINAHL databases were searched for all studies published between 1955 and January 2012. One-hundred and ninty-one papers were found using the search terms of NES, night-eating (NE), late night eating, NE behaviour and nocturnal eating. Results were filtered to return studies of human subjects published in English. Only original research was considered for inclusion. The conceptualisation of NES is still evolving, thus papers were not excluded on theEVOLUTION OF DIAGNOSTIC CRITERIA NES is now considered a dysfunction of circadian rhythm with a disassociation between eating and sleeping, characterised by a phase onset delay.