Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
7 May

Dear Mark: Night Eating Syndrome

nighteating2There’s nothing quite so powerful as the urge to eat. Being living organisms that require sustenance and nutrition, we find it difficult to resist. It’s not like smoking, or sex, or drugs, which you can technically avoid and still live, because they aren’t really required for an individual’s survival. No, food is an absolute necessity. So what happens when that basic human requirement for life – the need to eat something – conflicts with another important factor in health – the need to sleep? Today’s edition of Dear Mark deals with exactly that: night-eating syndrome, a real and extremely frustrating eating disorder in which the afflicted awaken during the night, compelled to eat everything and anything. As you’ll see from the following question, when you wake up at 3 AM with a raw, preternatural hunger gnawing at your very core, you’re probably not going to throw together a nice spinach, kale, and watercress salad in lemon vinaigrette and poach a few pastured eggs. You’re going to grab what’s available and what’s easy and what satisfies that carnal urge:

I have no problem eating healthy foods during the day. For some reason, I get up in the middle of the night feeling hungry, and eating whatever junk food (donuts, pastries) my family has in the kitchen. I’ve tried eating more during the day, but I give in to the craving 9 times out of 10. I’ve searched the blog, also tried eating more during the day, but this is the only thing I haven’t found an article on. Not sure if it’s a physical or mental issue. This is the only part of going Primal I’ve struggled with. Any suggestions on how to stop doing this? Thanks for reading.

Alexander

I did some digging around, and while experts have a pretty good handle on what’s going on – hormonally – with night-eating syndrome (PDF), they’re still trying to figure out the etiology, the cause of it all. From what we can tell, someone with night-eating syndrome has lower melatonin at night, which weakens their REM sleep. They have lower leptin, which is an appetite suppressant. Their ghrelin (an appetite stimulant) is phased forward by five hours, meaning they get hungry ahead of “when they should.” They have higher thyroid stimulating hormone (which is also seen in hypothyroid, as the thyroid is trying to “stimulate” more hormone production because it’s lacking). In response to a corticotropin-releasing hormone test, they release less cortisol, which suggests a depleted (overworked, overstressed) hypothalamic-pituitary-adrenal axis (HPA). They snack more throughout the day and tend to skip breakfast. Rather than eat solid meals, they graze. All signs seem to suggest that both troughs and spikes of their hormonal cycles are muted; since the body needs acute spikes and drops for proper functioning and signaling, this could pose a problem.

So while we don’t have the absolute cause pinned down, it seems like the HPA, or the stress response system, are involved. I do have some general advice. Some of these may not apply to you, but take a look and see if anything looks familiar.

Don’t fast and don’t skip meals. I know, I know. You just got done reading that long series where I touted the benefits of fasting, and here I go telling you not to do it. What gives? Not only do habitual night-eaters tend to avoid breakfast (which could just be a correlation), they’re also hormonally dysregulated, especially in regards to the adrenals. If you’re trying to fix an adrenal issue, you do not want to be skipping meals and playing around with fasting. Fasting is incredibly useful for the intact and the healthy, but it can do a number on people with messed up HPAs. Since nocturnal binge-eaters have a dysfunctional HPA (almost as a rule), that’s probably you.

Eat breakfast, and make it big. I suggest some sort of animal and a serving of fruit.

Eat meals, not snacks. Do three or four solid meals each day, instead of grazing.

Watch your fructose intake, particularly processed refined fructose, which can disrupt leptin.

If you’re training too much or too hard, either cut back or support it with adequate nutrition and recovery time. That means doing CrossFit once or twice a week instead of four or five times (or not at all). That means turning half of your long runs into long walks (or all of them). That means getting plenty of sleep, and if you have a bad night where you get just a few hours, don’t work out the next day (you’ll survive). If you can’t (won’t) cut back on the training, then you have to make sure you’re eating enough calories and enough carbohydrates. I don’t like the idea of filling up on carbs (and I train in such a way that doesn’t require a ton of them for that exact reason), but if you need ‘em, you need ‘em.

Turn off the electronics after dark, and use candles. Might I suggest playing board or card games with friends or a significant other, instead of video games or watching TV? There’s nothing like a game of Jenga by candlelight. If you’re going to use electronics or keep the lights on, get some blue-light blocking goggles. Blue light’s suppression of melatonin may not be causative in night-eating syndrome, but it certainly isn’t helping.

Consider light therapy, especially if you’re indoors during the day. We need exposure to bright light upon waking and during the day (just as we don’t need it at night), but indoor lighting simply doesn’t cut it. If sunlight isn’t an option, look into getting a lightbox. Seasonal Affective Disorder (SAD) and night-eating have a lot of crossover, and there have even been case studies showing that patients who suffer from both enjoy amelioration of their symptoms after employing light therapy.

Practice stress reduction or avoidance. Whether that’s avoiding chronic stress (desirable, but not always realistic), improving your reaction to stress, or developing coping mechanisms. Evidence points to a night eater having an over-stressed HPA, and more stress will only worsen the problem. Chris Kresser just wrapped up a 30-day “Best Your Stress” challenge, but you can still follow along and reap the benefits. Read through my previous suggestions for reducing stress as a starter, and consider meditation, too. One study found that a twenty minute muscle relaxation exercise performed daily was able to increase morning appetite and reduce late night eating.

Last, but not least, be honest as you appraise your lifestyle. Are you going to bed early enough? Are you reading this post at 12 AM in a dark room? Are you eating enough food (and the right kind) to fuel your performance? Are you training a bit too much, a bit too often, and should you perhaps tone it down and take some days off? Are you walking as much as you should? Are you reducing stress as much as you can?

While the reigning uncertainty with regards to the cause of this situation is frustrating, you can use this opportunity to try a bunch of different tactics. I hope it helps.

Readers, now it’s your turn. Have you dealt with this problem before? What worked and what didn’t? If you have any more advice, please leave it in the comment section.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. If I have coffee during the daytime, even if it’s just one cup in the morning I wake at night hungry. And I can’t go back to sleep unless I get up and eat something. Oddly enough, tea does not cause the same problem, although I’m sure it still stresses my adrenals.

    Maria wrote on April 14th, 2014
  2. it is currently 12:02 AM im starving even though i ate a huge salad with shame on me blue cheese dressing. i only ate half of it cause i was feeling nauseated after gulping down a mouthful of blue cheese.

    Wish i could eat right now but i already have a gut guess i will have to ignore my stomach

    Gracy wrote on June 30th, 2014
  3. I’ve been doing the nes for nearly 4 years now. The past two years since being in a doctoral pt program it’s gotten progressively worse. All of these solutions sound reasonable and I’ve even done the Whole30 which helped with overall cravings and digestion for two months but ive gone back to the old way of eating. .. light veggies and meats thru out the day and waking up 3 times EVERY single night without fail and binging on housemates food. I feel out of control and wake up feeling sick every morning andb itb takes me a full day of working with patients in the clinic to recover. Its not as bad when I live alone because I don’t keep food around and therefore end up eating carrots and other veggies at midnight which keeps me from gaining wt but I’m on a clinical rotation and sharing a home with other med students. Its embarassing, I need a long term solution or to be locked in my room!! I have a great day even if I only wake up once to eat but its three times:( I try journaling, meditation, putting chairs in front of my door etc but nothing works except being in a living envt where there is no food available because inevitably I wake up to eat wherever I am. I’ve even thought about moving out simply to avoid all the food. This is silly. I’ve been here one month and put on five lbs, as everyone knows its a self esteem killer when you have this fantastic daytime persona, intelligence, common sense andwillpower only to be followed up with this routinely self destructive out of control night time eating. Help please:/

    rach wrote on July 5th, 2014
  4. Just wanted to say this article was LIFE CHANGING. Some of these things I had been figuring out slowly on my own, but when I found this article it all came together…paradigm shift! I’m doing the light therapy, candles at night, eat bfast by nine (I never used to eat before two), not skipping lunch (I used to regularly skip meals), and try not to eat after seven…I even set an alarm clock for seven pm. My emotional night eating is all but gone and I’ve been able to stick to my low carb goals. Thank you!

    Jessica wrote on July 19th, 2014
  5. I’m posting to update that through trial and error I have isolated the cause of my night-waking night-eating – it seems to be caused by ignoring hunger and going without food (in any way). If I skip a meal I function fine during the day (even workouts are no problem) but doing so inevitably upsets my sleep. But so long as I eat a big (meaty) breakfast, a decent lunch and a decent dinner (all PB) and also am sure to have a snack (again PB) if i feel hungry (sometimes around midmorning, and also when i get home from work, and before a workout) , and also eat as soon as possible after a workout then I basically sleep well.

    At the beginning I was really having to stuff myself during the day, I think i was having an issue where my hunger hormones were out of sync so I’d still feel hungry even though I was actually full. But as I have persevered I am noticing that it’s getting much easier to eat to satisfaction. (I am also losing weight, probably both because I am eating less and because I am sleeping better) . I think the problem probably started with my experiments in IF (prompted by mark’s “are you fat adapted?” post) – i think I tried too hard and messed up my sleep/hunger hormones. Perhaps in time I will get to the stage where I feel I can experiment with IF again, but for now the rule is : if hungry, eat! (as mark says, eat WHEN – when hunger ensues naturally). I’d recommend anyone else who has problems with night waking/eating to try eating a lot more during the day, starting from when they get up, and if necessary eat til you are really full. This can be hard to do psychologically if you are feeling overweight, but remember if it’s PB you’ll probably be fine and any weight you gain will soon come off once your sleep stabilises. My experience is that this does take time – it’s taken two months and I still wake occasionally in the night, but the overall trend is clearly upward. good luck with it – I can vouch that this is an extremely frustrating problem to have to deal with.

    archaeologyboy wrote on July 20th, 2014
  6. funny you just summarised exactly what i am doing wrong in your last paragraph

    Last, but not least, be honest as you appraise your lifestyle. Are you going to bed early enough? Are you reading this post at 12 AM in a dark room? Are you eating enough food (and the right kind) to fuel your performance? Are you training a bit too much, a bit too often, and should you perhaps tone it down and take some days off? Are you walking as much as you should? Are you reducing stress as much as you can?

    thank you for the help!!!

    Mamu wrote on September 4th, 2014
  7. wondering if anyone else has this problem just before bedtime? I don’t seem to be hungry in the middle of the night, instead what happens is i have absolutely no appetite until midday and as the day progresses i find out my hunger will kick in late evening.

    As a former bulimic (YES! YOU CAN KICK IT!! ) the thought of force feeding myself when i’m not hungry is horrible. I did do it when i was on the paleo and then autoimmune diet but it brought back the feeling of wanting co purge. so i stopped.. unfortunately these diets were too severe for me and i ended up very ill with the first allergies i’ve had in my life to any form of coconut and also eggs.

    like most people on here, i find i eat very healthy and i have been slowly bringing my thyroid and adrenal glands back to a healthy state. For me it’s more of a psychological desire to eat than hunger.

    This is why i am posting:
    I am wondering if anybody else gets this? It’s like I am subconsciously feeling the need to have an overly full stomach before going to bed.

    really appreciate your feedback and any support and thank you!

    Sarina wrote on September 6th, 2014

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