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Sleep and Eating Disorders

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Insomnia is related to an increased risk of eating disorders, while eating disorders are related to more disrupted sleep. Insomnia is also linked to poorer treatment outcomes for eating disorders. However, over the last decade, studies examining sleep and eating disorders have relied on surveys, with no objective measures of sleep for anorexia nervosa or bulimia nervosa, and only actigraphy data for binge eating disorder. Sleep disturbance is better defined for night eating syndrome, where sleep efficiency is reduced and melatonin release is delayed. Studies that include objectively measured sleep and metabolic parameters combined with psychiatric comorbidity data would help identify under what circumstances eating disorders and sleep disturbance produce an additive effect for symptom severity and for whom poor sleep would increase risk for an eating disorder. Cognitive behavior therapy for insomnia may be a helpful addition to treatment of those with both eating disorder and insomnia.
Sleep and Eating Disorders
Kelly C. Allison
&Andrea Spaeth
&Christina M. Hopkins
Published online: 23 August 2016
#Springer Science+Business Media New York 2016
Abstract Insomnia is related to an increased risk of eating
disorders, while eating disorders are related to more disrupted
sleep. Insomnia is also linked to poorer treatment outcomes
for eating disorders. However, over the last decade, studies
examining sleep and eating disorders have relied on surveys,
with no objective measures of sleep for anorexia nervosa or
bulimia nervosa, and only actigraphy data for binge eating
disorder. Sleep disturbance is better defined for night eating
syndrome, where sleep efficiency is reduced and melatonin
release is delayed. Studies that include objectively measured
sleep and metabolic parameters combined with psychiatric
comorbidity data would help identify under what circum-
stances eating disorders and sleep disturbance produce an
additive effect for symptom severity and for whom poor sleep
would increase risk for an eating disorder. Cognitive behavior
therapy for insomnia may be a helpful addition to treatment of
those with both eating disorder and insomnia.
Keywords Eating disorders .Anorexia nervosa .Bulimia
nervosa .Night eating syndrome .Binge eating disorder .
Human survival depends on both eating and sleeping behav-
iors. Dysregulation of these behaviors leads to distress and
negative health and psychological outcomes. Research on
the relationship between sleep and eating has historically
focused on studies of the effect of starvation and re-feeding
on sleep, the connection among markers of sleep disturbance,
eating disorders, and mood disorders and, more recently, the
characterization of two forms of disordered eating and
sleeping: the night eating syndrome (NES) and sleep-related
eating disorder (SRED). The aim of this paper is to review the
clinical features of anorexia nervosa (AN), bulimia nervosa
(BN), binge eating disorder (BED), and NES and to discuss
the literature examining the relationship between sleep distur-
bances and these forms of disordered eating. Although the
goal was to examine the recent literature, we extended the
focus to encompass the last decade given the limited number
of studies on this topic.
Anorexia Nervosa
AN is characterized as an inability to maintain a healthy body
weight, manifested by (1) a body weight that is less than what
would be expected based on height and age, (2) an intense fear
of gaining weight or becoming fat, (3) disturbance in the way
in which one experiences body weight and shape, (4) undue
influence of body weight and shape on self-worth, and (5)
denial of the seriousness of ones low body weight or
This article is part of the Topical Collection on Sleep Disorders
*Kelly C. Allison
Andrea Spaeth
Christina M. Hopkins
Department of Psychiatry, Perelman School of Medicine at the
University of Pennsylvania, Philadelphia, PA 19104, USA
Center for Weight and Eating Disorders, Department of Psychiatry,
Perelman School of Medicine, 3535 Market St., 3rd Floor,
Philadelphia, PA 19104, USA
Center for Sleep and Circadian Neurobiology, Perelman School of
Medicine, 504 Richards Medical Research Laboratories, 3700
Hamilton Walk, Philadelphia, PA 19104, USA
Curr Psychiatry Rep (2016) 18: 92
DOI 10.1007/s11920-016-0728-8
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... Eating disorders often foster sleep disturbances [1]. Conversely, sleep disorders may interfere with eating behaviors. ...
... Diagnostic criteria for SRED were updated in 2014 by the American Academy of Sleep Medicine [4]. SRED is characterized by dysfunctional eating behaviors that occur after an arousal during the main sleep period, associated with at least one of the following signs: consumption of peculiar forms or combinations of food or inedible or toxic substances, sleep-related injurious or potentially injurious behaviors performed while in pursuit of food or while cooking food, and/or adverse health consequences from recurrent nocturnal eating (such as weight gain) [1]. There is a partial or complete loss of conscious awareness during the eating episode, with subsequent impaired recall. ...
... Besides, nonbenzodiazepines act on selective benzodiazepine receptor sites in the GABA A -receptor complex [31]. This specificity, while reducing the global neurologic ADR risk, could also increase the duration of slow-wave sleep [31], therefore fostering SRED [1]. In addition, zolpidem has been found to increase the risk of other NREM parasomnias (potentially leading to various CSBs), suggesting a shared pathophysiology [3]. ...
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Sleep-related eating disorder (SRED) is a parasomnia with recurrent, involuntary, amnestic eating episodes during sleep. There is growing evidence of the association between SRED and medications. Therefore, we aimed to rank drugs showing the strongest association. VigiBase® (WHO pharmacovigilance database) was queried for all reports of “Sleep-related eating disorder”. Disproportionality analysis relied on the Reporting Odds Ratio, with its 95% Confidence Interval (CI), and the Information Component. Our VigiBase® query yielded 676 cases of drug-associated SRED. Reports mostly involved zolpidem (243, 35.9%), sodium oxybate (185, 27.4%), and quetiapine (97, 14.3%). Significant disproportionality was found for 35 medications, including zolpidem (387.6; 95%CI 331.2–453.7), sodium oxybate (204.2; 95%CI 172.4–241.8), suvorexant (67.3; 95%CI 38.0–119.2), quetiapine (53.3; 95%CI 43.0–66.1), and several psychostimulants and serotonin-norepinephrine reuptake inhibitors (SNRIs). Patients treated with nonbenzodiazepines or SNRIs were significantly older (mean age: 49.0 vs. 37.5; p < 0.001) and their SRED were more likely to be serious (62.6% vs. 51.4%; p = 0.014) than patients treated with sodium oxybate or psychostimulants. Psychotropic drugs are involved in almost all reports. In patients with SRED, an iatrogenic trigger should be searched for.
... For this reason, it is accepted that sleep plays a role in the balance and restoration of normal brain functions [9]. Sleep disturbance can lead to eating disorders and NES by reducing sleep efficiency [10]. Eating disorders and NES also affect quality of life. ...
... It was correlated with the response to the question "What do you prefer when you want to consume something at night?" (and the statement "I don't consume anything at night"). NES is one of the most frequently observed eating behavior disorders in recent years [10]. It can be thought the fact that university students continuing their education online from home due to pandemic affects their health behaviors such as day/night confusion, sleep, physical activity and nutrition, and can be a reason behind the prevalence of NES being high in our study. ...
... Based on the results obtained from the studies in the literature, it can be deduced that quality of life of individuals may decrease due to sleep quality deterioration. In literature, poor sleep quality was thought to be associated with worse life quality as it can cause serious physiological and psychological problems, and poor academic performance in the context of educational success [5,10,21]. ...
Sleeping disorders can impair sleeping efficiency and lead to eating disorders and night eating syndrome. Eating disorders and night eating syndrome can be considered as factors that reduce the quality of life. The aim of the study was to investigate the effects of eating and sleeping disorders, and night eating syndrome, on quality of life. Material and methods. The sample of the descriptive, cross-sectional research was comprised of 846 students, who were studying at Uskudar University in the 2020/2021 academic year, accepted to participate in the study and provided complete information. Data was collected with a diagnostic form, a SCOFF Eating Disorders Scale form, a Night Eating Questionnaire (NEQ) form, a Pittsburgh Sleep Quality Index (PSQI) form, and a World Health Organization Quality of Life Short Form (WHOQOL-BREF-TR) together, all were created in Google Forms and applied online. Research data was evaluated with IBM SPSS v® software. Results. A total of 846 university students, consisting of 712 (84.2%) females and 134 (15.8%) males participated in the study. The mean age of the participants was 21.4±3.1 years, and the mean body mass index was 22.5±8.0 kg/m2. Eating disorders risk was found as 38.4%, night eating syndrome risk as 67.7% and all participants had poor sleep quality. WHOQOL-BREF-TR scale's total and all sub-dimension mean scores were found to be lower in students with a risk of eating disorders and night eating syndrome, compared to students without it (p<0.001). A statistically significant negative correlation was found between the PSQI total score and WHOQOL-BREF-TR scale's total and all sub-dimension scores of the participants (p<0.001). Conclusion. Students with a risk of night eating syndrome have interrupted sleep due to desire to eat at night, which is another factor that reduces sleep quality. For healthy generations, sleep and nutrition habits should be carefully examined and appropriate treatment methods should be applied by determining the faulty attitudes of individuals in nutrition, eating and sleeping disorders.
... One meta-analysis including 76 studies revealed that the prevalence of sleep disturbance among Chinese university students was 25.7% (4). Sleep disturbance among students is found to be negatively associated with both mental and physical health, such as academic failure, depression, and poor quality of life (5-7), but also adverse health behaviors, such as Internet addiction, sedentary, and binge-eating behavior (8)(9)(10). Individuals with sleep disturbance are characterized by being insufficiently physically active, having poor social relationships and economic status, and reporting greater academic stress (11)(12)(13)(14). ...
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Purpose University freshmen are particularly vulnerable as they are undergoing the transition from high school to university with a range of changes. Sleep problems among this group in the Qinghai–Tibet Plateau of China were barely studied. This study aimed to explore sleep disturbance, and its association with quality of life (QoL) and demographic and clinical characteristics among university freshmen in Qinghai–Tibet Plateau, China. Methods A multistage stratified cluster random sampling method was performed to recruit student participants with a structured questionnaire to collect sociodemographic and clinical characteristics, and lifestyle behaviors. Sleep disturbance including three aspects of sleep disturbance (i.e., difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA)) was assessed using standardized measurement. Multiple logistic regression models were applied to analyze the data. Results Among included 2,769 freshmen, the prevalence of sleep disturbance was 14.8% (95% CI: 14.2–15.5%), and corresponding prevalence of DIS, DMS, and EMA was 8.2% (95% CI: 7.7–8.7%), 8.3% (95% CI: 7.8–8.8%), and 4.2% (95% CI: 3.8–4.6%), respectively. Freshmen with sleeping disturbance had significantly lower QoL in physical [ F (1, 2769) = 60.23, p < 0.001], psychological [ F (1, 2769) = 46.18, p < 0.001], social [ F (1, 2769) = 23.04, p < 0.001], and environment [ F (1, 2769) = 6.07, p = 0.01] domains. Multiple logistic regression analyses revealed that having breakfast five times a week or less (less than three times, OR = 1.79, 95% CI: 1.34–2.40; 3–5 times, OR = 1.40, 95% CI: 1.09–1.79), self-perceived severe Internet dependence (OR = 1.71, 95% CI: 1.11–2.65), self-perceived poor health status (OR = 3.44, 95% CI: 2.06–5.74), high academic stress (OR = 1.42, 95% CI: 1.13–1.78), poor relationship with classmates (OR = 3.44, 95% CI: 1.53–7.71), and severe ADHD symptoms (OR = 1.08, 95% CI: 1.05–1.12) were positively associated with sleeping disturbance. Conclusion Sleep disturbance was common among freshmen and is associated with poorer QoL. Prevention and intervention strategies should be developed and implemented, especially among the vulnerable university freshman groups.
... found that the levels of abnormal eating attitudes were more correlated with anxiety than depression; however, the opposite was found in (12). In addition, our study found that a higher level of insomnia was associated with higher levels of abnormal eating attitudes, consistent with previous findings (39). The potential mechanisms underlying bidirectional associations between them were described in (40). ...
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Background This study investigated the associations between behavioral health risk factors (anxiety, depression, stress, insomnia, drinking, smoking) and abnormal eating attitudes among Chinese vocational high school students (CVHSS). Potential moderating relationships were also explored with relevant socio-demographic factors of the student's age, sex, rural or urban community, household income, family type and educational level of the father and mother. Methods A total of 7,984 students from three vocational high schools in Hunan, China completed a questionnaire about their socio-demographic characteristics, alcohol use, smoking, and symptoms of depression, anxiety, stress (21-item version of the Depression Anxiety Stress Scale), insomnia (8-item Athens Insomnia Scale), and abnormal eating attitudes (19-item Chinese version of Eating Attitudes Test). Results The prevalence rates for behavioral health problems among these students ranged widely depending on the risk factor: 42.5% insomnia, 41.3% anxiety, 26.2% depression, 14.4% stress, 13.7% drinking, and 8.3% smoking. Additionally, 61.7% of students were at-risk for at least one of these six behavioral health disorders. Abnormal eating attitudes were associated with depression ( r = 0.422), anxiety ( r = 0.490), stress ( r = 0.490), and insomnia ( r = 0.375), with all of these relationships being significant ( p < 0.01) and large size statistical effects. However, other analyzes found that none of the socio-demographic background factors had meaningful associations with the behavioral health risk factors (0 of 28 tests) and very few background factors were associated with the abnormal eating attitude measures (only 3 of 35 tests). Females had higher levels than males on dieting and bulimia but not on the other two eating attitude components. Conclusions This study determined that behavioral health risk factors (sleep problems and anxiety in particular) were common among high school students in China and that mental health and sleep disorder risks also tended to co-occur in some students with abnormal eating attitudes. Therefore, prevention and early identification programs for behavioral risk factors are needed for this population. It is important to pay more attention to students with abnormal eating attitude-related symptoms, who may have also underlying mental health problems and need further evaluation.
... With respect to opportunities, it is significant to note that frequent awakenings and reduced sleep efficiency are characteristic of one particular eating disorder, anorexia nervosa (Allison et al., 2016;Christensen & Short, 2021;Nobili et al., 1999). From an adaptive perspective, it makes sense that an organism in a state of caloric and nutritional deprivation would be better served by staying awake and monitoring their environment for potential food sources. ...
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Sleep is a behavioral state whose quantity and quality represent a trade-off between the costs and benefits this state provides versus the costs and benefits of wakefulness. Like many species, we humans are particularly vulnerable during sleep because of our reduced ability to monitor the external environment for nighttime predators and other environmental dangers. A number of variations in sleep characteristics may have evolved over the course of human history to reduce this vulnerability, at both the individual and group level. The goals of this interdisciplinary review paper are (1) to explore a number of biological/instinctual features of sleep that may have adaptive utility in terms of enhancing the detection of external threats, and (2) to consider relatively recent cultural developments that improve vigilance and reduce vulnerability during sleep and the nighttime. This paper will also discuss possible benefits of the proposed adaptations beyond vigilance, as well as the potential costs associated with each of these proposed adaptations. Finally, testable hypotheses will be presented to evaluate the validity of these proposed adaptations.
... Eating disorder behaviors are associated with indicators of circadian disruption, including blunted rest-activity circadian rhythms and poorer sleep efficiency (e.g., Allison et al., 2016;Roveda et al., 2018). ...
Caloric consumption occurs in rhythms, typically during daytime, waking hours, marked by peaks at mealtimes. These rhythms are disrupted in individuals with eating disorders; mealtime peaks are blunted and delayed relative to sleep/waketimes. Individuals with eating disorders also tend to experience an overall phase delay in appetite; they lack hunger earlier in the day and experience atypically high hunger later in the day, the latter of which may culminate in binge‐eating episodes. This disruptive appetitive behavior—early in the day restrictive eating and later in the day binge eating—may be partially accounted for by circadian disruptions, which play a role in coordinating appetitive rhythms. Moreover, restrictive eating and binge eating themselves may further disrupt circadian synchronization, as meal timing serves as one of many external signals to the central circadian pacemaker. Here, we introduce the biobehavioral circadian model of restrictive eating and binge eating, which posits a central role for circadian disruption in the development and maintenance of restrictive eating and binge eating, highlighting modifiable pathways unacknowledged in existing explanatory models. Evidence supporting this model would implicate the need for biobehavioral circadian regulation interventions to augment existing eating disorder treatments for individuals experiencing circadian rhythm disruption. Existing treatments for eating disorders that involve binge eating and restrictive eating mandate a regular pattern of eating; this is largely responsible for early behavioral change. This intervention may work partly by regulating circadian rhythm and diurnal appetitive disruptions. Supplementing existing treatments with additional elements specifically designed to regulate circadian rhythm and diurnal appetitive rhythms may increase the effectiveness of treatments, which presently do not benefit all who receive them.
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The acute phase of the COVID-19 pandemic was associated with significant increases in the prevalence and severity of eating disorders (EDs). Studies also highlighted changes to sleep quality and duration in many individuals throughout this period. Although these two phenomena have been examined separately, here we highlight the need to investigate the potential link between these outcomes. Sleep dysregulation and EDs have previously been hypothesized to interact via a positive feedback loop, wherein poor sleep exacerbates ED symptomatology which, in turn, further worsens sleep. Thus, we speculate that the aggravation of sleep disturbances and EDs during COVID-19 lockdowns may have been somewhat interdependent. We further hypothesize that the worsening of depression and anxiety symptomology during the acute phase of the pandemic may have served as an additional mediating variable. Altogether, in our view, these observations highlight a need for future work to examine the possible causal relationship between sleep and ED pathology, which may ultimately lead to improved clinical management of disordered eating.
Acute and chronic sleep deprivation have detrimental effect on physical and mental health and may affect eating behavior. Empirical findings demonstrated that sleep deprivation increases food intake and alters eating behavior through different potential pathways. These underlying mechanisms may be biological, cognitive, neural, emotional, and behavioral. Furthermore, cross-sectional evidence documented an association between sleep deprivation and disordered eating and binge eating. Similarly, some studies linked poor sleep due other comorbidities with binge eating. Additional novel experimental studies also support the link between sleep deprivation and binge eating. Despite these summarized findings, still little evidence is available to establish firm conclusions about the directionality of this link, and the need to further research is predominant.
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Binge-eating disorder (BED), characterized by recurrent episodes of binge eating without compensatory behaviors, has been studied in association with mood, anxiety, and metabolic disorders, including obesity. In addition, BED has been linked to sleep problems; however, the literature fails to explore the link between BED and the circadian system, which governs biological rhythms synchronizing our physiology to the environment. We have analyzed the BED bibliography with regards to circadian markers, sleep disorders, and chronotypes, and found that this is generally overlooked in the field. In this sense, this perspective article advocates for a chronobiological approach, such as chrono-nutrition, to BED study and characterization.
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Objective: To investigate the relationship between eating disorders, body mass index (BMI), sleep disorders, and daytime functioning. Design: Survey. Setting: The Netherlands. Participants: N=574 Dutch young adults (18-35 years old). Measurements: Participants completed a survey on eating and sleep habits including the Eating Disorder Screen for Primary care (ESP) and SLEEP-50 questionnaire subscales for sleep apnea, insomnia, circadian rhythm disorder (CRD), and daytime functioning. SLEEP-50 outcomes of participants who screened negative (≤2) and positive (>2) on the ESP were compared. In addition, SLEEP-50 scores of groups of participants with different ESP scores (0-4) and different BMI groups (ie, underweight, healthy weight, overweight, and obese) were compared using nonparametric statistics. Results: Almost 12% (n=67) of participants screened positive for having an eating disorder. Relative to participants without eating disorders, participants who screened positive for eating disorders reported significantly higher scores on sleep apnea (3.7 versus 2.9, P=0.012), insomnia (7.7 versus 5.5, P<0.0001), CRD (2.9 versus 2.3, P=0.011), and impairment of daytime functioning (8.8 versus 5.8, P=0.0001). ESP scores were associated with insomnia (r=0.117, P=0.005), sleep apnea (r=0.118, P=0.004), sleep quality (r=-0.104, P=0.012), and daytime functioning (r=0.225, P<0.0001), but not with CRD (r=0.066, P=0.112). BMI correlated significantly with ESP scores (r=0.172, P<0.0001) and scores on sleep apnea (r=0.171, P<0.0001). When controlling for BMI, the partial correlation between ESP and sleep apnea remained significant (r=0.10, P=0.015). Conclusion: Participants who score positive for eating disorders scored significantly higher on sleep disorder scales, and reported significantly more impairment of daytime functioning.
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Clinical evidence suggests that eating disorder (ED) patients experience poor sleep even if they rarely complain of it. However, direct empirical evidence supporting this relationship is still sparse. In order to provide direct evidence, poor sleep, severity of the ED symptoms and depression were obtained in 562 ED patients at treatment admission (T0). For 271 patients out of them, data were also available after 6months of standard treatment (T1). Results evidence that at T0 poor sleep predicts severity of ED symptoms through the mediation of depression. Persistence of poor sleep at T1 directly predicts the severity of the ED symptoms both directly and through the mediation of depression. These findings suggest that the treatment of ED may benefit from addressing poor sleep since its presence and persistence increase comorbidity and attrition to the standard treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.
Objective: The study aimed to determine the prevalence of binge eating disorder on university campus, its associations with health risk factors, and its associations with work and classroom productivity and activity impairment, adjusted for health risk factors. Participants: The study was conducted at a public Midwestern university in the United States and involved 1,165 students. Methods: Data were collected online, using pre-established instruments. Descriptive, chi-squared, correlation, and robust multiple regression tests were used. Results: About 7.8% of the participants were assessed as having binge eating disorder. Binge eating disorder was more common among obese students than non-obese students. Associations were found between moderate binge eating disorder and classroom productivity and daily activity impairment; however, sleep duration and physical activity were the strongest predictors. Conclusions: University students are at risk of binge eating disorder. Interventions with this population should include education, screening and clinical consultation when warranted.
Objective: Patients with Attention-Deficit/Hyperactivity Disorder (ADHD) have a high prevalence of obesity. This is the first study to investigate whether circadian rhythm disruption is a mechanism linking ADHD symptoms to obesity. Methods: ADHD symptoms and two manifestations of circadian rhythm disruption: sleep problems and an unstable eating pattern (skipping breakfast and binge eating later in the day) were assessed in participants with obesity (n = 114), controls (n = 154), and adult ADHD patients (n = 202). Results: Participants with obesity had a higher prevalence of ADHD symptoms and short sleep on free days as compared to controls, but a lower prevalence of ADHD symptoms, short sleep on free days, and an unstable eating pattern as compared to ADHD patients. We found that participants with obesity had a similar prevalence rate of an unstable eating pattern when compared to controls. Moreover, mediation analyses showed that both sleep duration and an unstable eating pattern mediated the association between ADHD symptoms and body mass index (BMI). Conclusion: Our study supports the hypothesis that circadian rhythm disruption is a mechanism linking ADHD symptoms to obesity. Further research is needed to determine if treatment of ADHD and circadian rhythm disruption is effective in the prevention and treatment of obesity in patients with obesity and/or ADHD.
The effect of bright light therapy (BLT) on the symptoms of night eating syndrome was evaluated. Fifteen adults completed two weeks of daily 10,000 lux BLT administered in the morning. Significant reductions were found pre-to-post treatment in night eating symptomatology, mood disturbance, and sleep disturbance. This pilot trial provides preliminary support for the efficacy of BLT for the treatment of night eating syndrome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
In a clinical population, we estimated the frequency of mood disorders among 271 patients suffering from Anorexia Nervosa (AN) and Bulimia Nervosa (BN) in comparison to a control group matched for age and gender. The frequency of mood disorders was measured using the Mini International Neuropsychiatric Interview (MINI), DSM-IV version. Mood disorders were more frequent among eating disorder (ED) patients than among controls, with a global prevalence of the order of 80% for each ED group. The majority of the mood disorders comorbid with ED were depressive disorders (MDD and dysthymia). The relative chronology of onset of these disorders was equivocal, because mood disorders in some cases preceded and in others followed the onset of the eating disorders. Our sample was characterized by patients with severe ED and high comorbidities, and thus do not represent the entire population of AN or BN. This also may have resulted in an overestimation of prevalence. Mood disorders appear significantly more frequently in patients seeking care for ED than in controls. These results have implications for the assessment and treatment of ED patients, and for the aetio-pathogenesis of these disorders. Copyright © 2015. Published by Elsevier B.V.
Objective: Although binge eating disorder (BED) is the most prevalent eating disorder, the impact of untreated BED is underappreciated. This review describes the relationship of BED to physical and mental health, quality of life, and functionality. Data sources: PubMed searches were conducted on March 21, 2014; searches were limited to English-language research articles, meta-analyses, and reviews published between January 1, 2003 and March 21, 2014. Search terms included (binge eating OR binge-eating OR binge eating disorder) AND (cardiovascular OR metabolic OR metabolic syndrome OR gastrointestinal OR health OR rehabilitation OR recovery OR sleep OR pregnancy OR quality of life OR functional impairment OR activities of daily living OR QoL OR SF-12 OR ED-5D OR SF-36 OR psychosocial OR depressive OR anxiety OR self-esteem OR suicidality OR suicide OR productivity OR family). Study selection/data extraction: Of 326 identified publications, 43 were relevant to the topic and reported on the association of BED with psychiatric and medical comorbidities, quality of life, and functional outcomes. Results: Individuals diagnosed with BED have increased rates of mental health comorbidities (eg, depression and anxiety) and more pronounced medical impairments (eg, cardiovascular disorders) compared with individuals without BED. BED is also associated with functional impairment and reduced quality of life. Conclusions: Binge eating disorder is associated with impairments in physical and mental health, which can decrease quality of life and functionality and lead to increased health care utilization and decreased productivity. However, some caution is warranted in interpreting these findings because it remains unclear whether BED is an antecedent condition, a complication associated with a comorbid psychiatric condition, or an unrelated feature that occurs concurrently with these comorbidities and impairments. Much of the research on BED is based on observational or epidemiologic studies. Controlled studies are needed to clearly define the long-term impairments associated with BED.
Night eating syndrome (NES) is a circadian rhythm disorder in which food intake is shifted toward the end of the day, interfering with sleep. According to the biobehavioral model of NES, the disorder is the result of a genetic predisposition that, coupled with stress, leads to enhanced reuptake of serotonin, thereby dysregulating circadian rhythms and decreasing satiety. Using the biobehavioral model as a guide, we developed a brief behavioral intervention using education, relaxation strategies, and exercise to address the core symptoms of NES. In this pilot randomized controlled clinical trial, 44 participants with NES were randomly assigned to an educational group (E; n = 14), E plus progressive muscle relaxation therapy (PMR; n = 15); or PMR plus exercise (PMR Plus, n = 15). Participants received a baseline intervention with 1- and 3-week follow-up sessions. Effectiveness analyses showed that participants in all three groups evidenced significant reductions on measures of NES symptoms (p < .001), depression (p < .05), anxiety (p < .01), and perceived stress (p < .05). However, the only significant between group change was for the percent of food eaten after the evening meal, with the PMR group showing the greatest reduction (-30.54%), followed by the PMR Plus group (- 20.42%) and the E group (-9.5%); only the difference between the PMR and E groups was statistically significant (p = .012). Reductions in NES scores were significantly associated with reductions on measures of depression (r = .47; p < .01) and perceived stress (r = .37; p < .05), but not anxiety (r = .26, p = ns). Results support the role of education and relaxation in the behavioral treatment of NES. Copyright © 2015. Published by Elsevier Ltd.
Objective: nocturnal eating behavior is shared by patients affected by a parasomnia the Sleep related Eating Disorder (SRED) and several eating disorders: mainly , Night Eating Syndrome (NES) and Binge Eating Disorder (BED), but characteristics of these patients have been poorly studied, so this maintains the difficulties in defining the borders between these pathologies. Aim of this study was to evaluate polysomnographic and personality characteristics of nocturnal eaters to further differentiate the syndromes. Methods: for 6 months, consecutive patients complaining of nocturnal eating were asked to participate in the study. Twenty-four patients who were found to eat during the PSG study and gender-matched control subjects were included. All subjects underwent a full night video-PSG study and a psychometric assessment including the Eating Disorder Inventory (EDI-2), the self-rating Bulimic Investigatory Test-Edinburgh (BITE), the temperament and character inventory and the Barratt Impulsivity Scale (BIS). Results: we found a mild reduction in sleep efficiency and duration due to a moderate sleep fragmentation, while the percentages of the single sleep stages were not significantly affected. NES scored higher on many subscales of the EDI-2, on the BITE, symptoms subscale and on BIS attentional impulsivity subscale. Conclusions: Psychological characteristics of NES are typical of patients affected by eating disorders, further sustaining the hypothesis that their nocturnal behavior is due to an eating disorder, moreover specific traits allowing to further differentiate NES from BED have been found.