The Validity and Clinical Utility of Night Eating Syndrome

Department of Psychology, Wesleyan University, 207 High Street, Middletown, Connecticut 06459, USA.
International Journal of Eating Disorders (Impact Factor: 3.13). 12/2009; 42(8):720-38. DOI: 10.1002/eat.20721
Source: PubMed


To review the empirical literature for evidence in support of inclusion of Night Eating Syndrome (NES) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.
Based on a literature search using PubMed, 47 empirical studies of NES were identified.
The literature reflects use of varying definitions; progress has been made toward reliable measurement of night eating symptoms; evidence regarding a differentiation of NES from "normalcy" or from other eating disorders is based largely on samples of convenience; only one controlled treatment study has been published.
There are limited data supporting the clinical utility and validity of NES; several options regarding the inclusion of NES in DSM-V are discussed.

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Available from: Ruth Striegel Weissman, Aug 21, 2015
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    • "However, consistent with this study,Runfola et al. (2014) andMeule et al. (2014b)reported that approximately 2% of their student samples were diagnosed with NES using the NEQ > 25 criterion. The occurrence of NES in the community sample is consistent with that found in other studies (seeAllison et al., 2008;Striegel-Moore, Franko, & Garcia, 2009). The students in the present study were similar in age to those in our previous report but were more likely to have a BMI above the normal range. "
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    ABSTRACT: Night eating syndrome (NES) and “food addiction” (FA) are associated with elevated body mass index (BMI) and disturbed eating behavior. The present study was conducted to examine whether NES is associated with FA, and whether BMI, depression and sleep quality contribute to any relationship between NES and FA. Two groups were studied: a sample of 254 university students and a sample of 244 older adults. All completed the Yale Food Addiction Scale (YFAS), the Night Eating Questionnaire (NEQ), the Zung Self-report Depression Scale, and the Pittsburgh Sleep Quality Index, and BMI was computed from height and weight. In both samples, higher global NEQ scores were significantly correlated with more FA symptoms, elevated depression, and poorer sleep quality, and these correlations were significantly higher in the older adult sample than in the younger student sample. Higher BMI was significantly correlated with NEQ score only in the older adult sample. The hypothesis that the prediction of NEQ by YFAS was moderated by BMI and group membership (moderated moderation) was tested; while the prediction of NEQ by YFAS was not moderated by BMI, elevated YFAS predicted higher NEQ in the adult sample than it did in the student sample. In addition, multiple regression revealed that “continued use of food despite adverse effects” was the sole FA symptom predictive of NES symptoms in students while in older adults food tolerance was the only predictor of NES. Thus, NES appears to be associated with FA, more strongly in an older community sample; higher food tolerance in NES may contribute to a desire to eat late in the evening and/or when awakening at night.
    Full-text · Article · Mar 2016 · Appetite
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    • "The decision to include NES as an exemplar of the DSM-5 Feeding or Eating Disorder Not Elsewhere Classified category is also somewhat surprising, however, given that a recent, comprehensive review of the literature found concluded that there was little evidence to support either the validity or clinical utility of this construct as a potential eating disorder diagnosis [70]. Problems with the existing evidence identified in that review included the lack of agreed upon definitions of and operational criteria for the core features of NES, the reliance on convenience samples of obesity patients in research seeking to elucidate the characteristics and correlates of the behaviors concerned, and, in turn, the lack of any compelling evidence for the delineation of NES from other forms of disordered eating or from normalcy [70]. On the other hand, if specific reference to NES in DSM-5 has the effect of stimulating the additional research needed to address these issues, then the decision to include such reference may be justified. "
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    ABSTRACT: Proposed changes to the classification of bulimic-type eating disorders in the lead up to the publication of DSM-5 are reviewed. Several of the proposed changes, including according formal diagnostic status to binge eating disorder (BED), removing the separation of bulimia nervosa (BN) into purging and non-purging subtypes, and reducing the binge frequency threshold from twice per week to once per week for both BN and (BED), have considerable empirical evidence to support them and will likely have the effect of facilitating clinical practice, improving access to care, improving public and professional awareness and understanding of these disorders and stimulating the additional research needed to address at least some problematic issues. However, the omission of any reference to variants of BN characterized by subjective, but not objective, binge eating episodes, and to the undue influence of weight or shape on self-evaluation or similar cognitive criterion in relation to the diagnosis of BED, is regrettable, given their potential to inform clinical and research practice and given that there is considerable evidence to support specific reference to these distinctions. Other aspects of the proposed criteria, such as retention of behavioral indicators of impaired control associated with binge eating and the presence of marked distress regarding binge eating among the diagnostic for BED, appear anomalous in that there is little or no evidence to support their validity or clinical utility. It is hoped that these issues will be addressed in final phase of the DSM-5 development process.
    Full-text · Article · Aug 2013 · International Journal of Eating Disorders
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    • "The diagnostic criteria for NES have evolved since its first description in 1955.1 Varying operational definitions of diagnostic criteria for NES and inconsistent assessment measures used in NES research studies2,3 have complicated cross-study comparison and slowed advances in understanding NES. Though NES was not formally included in previous versions of the Diagnostic and Statistical Manual of Mental Disorders, for the first time, in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the proposed diagnostic criteria for NES are described under Feeding or Eating Disorders Not Elsewhere Classified. "
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    ABSTRACT: Night eating syndrome (NES) is a form of disordered eating associated with evening hyperphagia (overeating at night) and nocturnal ingestions (waking at night to eat). As with other forms of disordered eating, cognitive and behavioral treatment modalities may be effective in reducing NES symptoms. This review presents evidence for a variety of behavioral treatment approaches, including behavioral therapy, phototherapy, behavioral weight loss treatment, and cognitive-behavioral therapy. A more detailed overview of cognitive-behavioral therapy for NES is provided. All of these studies have been case studies or included small samples, and all but one have been uncontrolled, but the outcomes of many of these approaches are promising. Larger randomized controlled trials are warranted to advance NES treatment literature. With the inclusion of NES in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a "Feeding or Eating Disorder Not Elsewhere Classified," more sophisticated, empirically-supported, behaviorally-based treatment approaches are much needed.
    Full-text · Article · Mar 2013 · Psychology Research and Behavior Management
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