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

Dear Mark: Night Eating Syndrome

There’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. I’ve had this problem for over a year and a half, regularly waking up and needing more food (sometimes mountains of it!) before I can go back to sleep. Reading this post I was intrigued to find skipping breakfast (I’ve been following the Leangains IF plan) is part of the problem. I read up on the Leptin Reset (certainly sounds like me) and I can report that I have been sleeping MUCH better from the day I got up and ate a massive meaty breakfast (large chicken breast to get that 50g of protein, plus, eggs, bacon and plenty of fat). Definitely worth a try if you have this problem!

    archaeologyboy wrote on October 9th, 2013
  2. I am a night eater. Does not matter what I eat during the day.
    I’ll eat anything at night. I start at around 1230 and 1 I wake up every hour on the hour up till 4 or five.
    Then I am able to sleep.
    This happens every night for over 10 years.
    I don’t really like chocolate but if there is any in the house I eat all of it.
    The other night I ate a whole thing of oreos.
    If we have brats and there are left overs I can eat 6-7 at night.
    I have done large meals for supper. Snack high in protein later, glass of milk and ect.
    I eat alot during the day. I eat healthy. The only time I don’t is at night.
    I wanted to say thank you for the article.
    I am going to try your ideas to see if it helps.

    FYI when you eat all night it is hard to eat breakfast.

    Jami wrote on October 10th, 2013
  3. wow the craziest part about this is when i read are u sitting in a dark room at 12:00 am. this really helped thanks for writing this article. i was beginning to think i had sleep apnea

    kenshin himura wrote on November 5th, 2013
  4. Hi, in light fot he article i do skip breakfast. i sleep eatevery night unless i have a good bit of alchol in me. now I’m going to suggest something a bit different. At night i sometimes get up wanting peanut butter. I don’t eat breakfast or lunch but it isn’thunger pains that wake me. I wake sometimes almost unconscious eating whatever i can find sometimes things with sugar and sometimes with high carbs. but im not hungry. my stomach is not hungry its my mouth its dry and water won’t quinch my thirst. When you eat foods or are hungry your mouth produces more saliva you’ll find this when you are hungry or when you smell something you want. this is just a craving. true hunger will start with stomach pain and gurgling. pleasepay close atgtention to what your stomach is really saying. I keep water by my bedbut it doesn’t fix the thirst. Instead I have tried keeping an orange already pealed by bed side rthere is something about it that helps When I’m eating it moistens my mouth and it has the sugar i crave. perhaps my body needs sugar and thia is the best non fat food i canthink of. My stomach is not hungry..mymouth just needs something more.

    jennifer wrote on December 9th, 2013
  5. I had Night Eating Syndrome for 35 years. I could take any kind of sleeping pill and would still wake up (2-5 times/night) with the compulsion to eat. Finally I went to a sleep doctor who put me on setraline (Zoloft). Within 4 days I was sleeping through the night. Even if I woke up, there was no compulsion to get out of bed and head to the fridge. Within 6 months I had dropped 50 pounds, just by sleeping through the night.

    Heather wrote on January 8th, 2014
  6. “Are you reading this at 12am?” Ha! Try 3:30 am !! It’s just one of those nights :/ but the seasonal disorder cross over really flipped a switch, for me! I NEED a light therapy lamp, I think. Luckily, now, when I do have the night eats, I eat primally. Unfortunatley, way more than I should of the stuff ( 85%+ chocoolate, almond butter, strawberries w/ heavy cream) but better none the less. I just forgive myself and ith helps me get better, every day.

    AnaBanana wrote on January 12th, 2014
  7. I suffer from hypothyroidism. This sleep/night eating and insomnia began about 5 years ago. It is not every night but when it does happen (about twice a month), I wake up four or five nights in a row. It’s always cookies or granola bars. I’ll eat until I am full. Sometimes it’s two or three cookies and other times it’s half a bag.

    I eat mostly regular healthy meals and snacks.

    I also suffer from insomnia about a week before my menstrual cycle.

    I totally believe in the cortisol level theory. I was reading about this in a Facebook group for people who suffer from Hashimoto’s/Hypothyroidism. Some people took their medication at night, contrary to what the doctor says to take it first thing in the morning on an empty stomach. The people who took their medication at night did not wake up at all or very rarely.

    I will switch my taking medication at night and see if that works. If not, I’ll try other suggestions here. I’ve seen taking magnesium/zinc/calcium as a good thing for hypothyroidism as well in other sites.

    Thank you for posting this article.

    Kimberley wrote on January 22nd, 2014
    • Hi Hypothyroidism, I also have this wonderful disorder. I did want to let you know that I do not suffer the same problem however. I take my medicine in the morning also. Do not have problems with sleep at all. I also do yoga which may help. Something to consider. I personally have never heard of any of my family members that also have this having sleep issues. Could be something else that is causing it all together. Just wanted you to know this so you will investigate other potential issues.

      I hope you find the solution to your sleep problem. I would look more deeply into the premenstral issue because if it always happens prior to your starting there may be a correlation. It could be anyway. Lots of luck!!

      June wrote on January 22nd, 2014
  8. I’m 27 and have struggled with NES (binge eating right before bed or getting up in the middle of the night) since 19. Lots of different therapies, treatment programs, spirituality (including 12-step, and I mean really working the program), meds, self-help, despair and hopelessness to the point of going to the ER, job loss, etc. I’m 6’3″ and have managed to avoid Diabetes and keep my weight relatively normal (180-215 lbs) through fasting, exercising, and taking other extreme measures (e.g. going camping without food) despite binging on 3,000-10,000+ calories most nights. The craving to binge seems to have nothing to do with hunger anymore, especially since I still binge regardless of countless behavioral modifications like those suggested here.

    At this point, the only thing that helps is having a loved one (girlfriend, brother, etc.) in the room with me at nighttime. This actually eliminates the urges, but I’ve been very careful not to “use” people like that (I’m sick of this problem, the resulting despair, and feeling physically ill every day ruining relationships). In other words, I know what to do behaviorally (I probably am as qualified as any nutritionist or therapist at this point) but no amount of action on my part seems to help; I inevitably drive to the store, buy junk food, and binge unless I have someone that loves me by my side through the night, which doesn’t help me ride out cravings so much as gets rid of them altogether and allows me to go to bed and sleep peacefully through the night.

    So I dunno. I try to take responsibility for my behavior, avoid self-pity, I don’t drink or do drugs since I know that just makes binging even more inevitable, and I try to keep my hopelessness and fear to myself at this point and not bring other people down (because unless they are with me in the evening, they can’t really do anything to help anyway). I’m willing to try some of your suggestions out (again), but don’t know where to start. It is my hope that someone that has been in my shoes and recovered from this terrible NES problem can guide me.

    Tom wrote on January 24th, 2014
  9. So, during the day and during the night, (if my parents aren’t near the kitchen) I’ll want to eat whatever sounds good. At night, I literally can’t sleep because say I have some type of snack in the fridge. I will not stop thinking about it and eventually I’ll go upstairs to the kitchen and have a snack. I don’t eat breakfast due to my school starting at 6:30 after I probably just went to bed at 3:00am, and I don’t have lunch because I have severe anxiety in the school lunch room.
    Do I have night eating syndrome or could it be something else entirely?

    Carri wrote on February 13th, 2014
  10. 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
  11. 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
  12. 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
  13. 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
  14. 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
  15. 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
    • Mamu,

      These are great questions to check in with myself about, thank you! Longer post of my recent recovery experience coming…

      Tom wrote on January 7th, 2015
  16. 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
  17. Wow, great to see this getting a lot of replied. I’ve had this problem for years and tried just about everything mentioned here. My current theory is that for me it relates to COMT Val/Val which hypermetabolises some neurotransmitters leading to depletion. I’m beginning L-Tryptophan to increase serotonin and lactic acid. No results to report yet…

    Person wrote on January 6th, 2015
  18. I’ve read thru this whole thread and it was very informative..but there’s one wierd symptom I’m having along with the late night hunger that I suspect it related.. Heart flutters..not quite palpitations or racing..just a flutter and its uncomfortable .. Its so tied into the hunger sensation I believe its related.. Anyone experienced this? It pretty much goes away when I eat but I’m stubborn cuz I don’t wanna bother getting up and eating at midnight I’d rather figure out why it’s happening. I don’t eat strict paleo but I can’t figure out why this happens some night and not others.

    dee wrote on January 20th, 2015
    • YES!

      Tom wrote on January 20th, 2015
    • I would get a physical checkup with my MD first to rule out any heart issues. I used to get panic attacks that seemed like severe heart palpitations. Even called 911 at one point convinced I was having a heart attack. The eating may be a way of directing your body into a more relaxed state so the adrenalin stops pumping. If you think that may be what’s happening, there are lots of ways to self intervene including meditation and the relaxation response. Cheers!

      christy wrote on February 24th, 2015
  19. I had always been very slim until requiring 30 ECT treatments for intractable depression. Since then I have had overweight issues and NES despite being on 40mg Prozac daily. My depression seems under control, but not my appetite. Any correlation?

    Roseau wrote on February 20th, 2015
  20. Thank you so much for this great article! My issue is habitual night eating. For a years I was having all sorts of GI symptoms that I just couldn’t explain. Stomach cramps and the “runs” whenever I ate. The only way I could manage was to eat almost nothing during the day, just fluids,and wait till I got home in the evening to eat anything substantial. A doctor finally suggested a gluten free diet which worked wonders and I can now eat during the day but the habits have persisted to where I can’t seem to sleep unless there’s something in my stomach. It’s great to be pain free but I find myself resorting to munching just to get a little sleep. I’m hopeful that some of the very sensible techniques suggested here such as not using the ipad, watching old movies on TV, avoiding fructose at night will help. Love the candlelight idea!

    christy wrote on February 24th, 2015
  21. Thanks for this article and everyone’s replies which have been useful. I generally go to bed at 8pm ( I have chronic fatigue syndrome) and wake up starving at 10pm, then zombie-eat about 500 cals of whatever I can find. Obviously this is not helping my weight loss attempts! I think I will try to stay up till 10pm and then eat a controlled calorie ‘supper’ (do Americans say supper?) containing protein and slow carbs. Hopefully then I am out of the hunger danger zone and can sleep the rest of night. If not I will try one of the supplements suggested in these comments, like magnesium.

    Lucy wrote on June 1st, 2016
  22. I’ve struggled with NES for about 10 years and here is a bit of what I’ve learned. NES is a syndrome, meaning that even the folks who identified it (Dr. Stunkard and his protege Dr. Allison at University of Pennsylvania) have not uncovered a cause, but have simply described the characteristics of the illness. (The sheets Dr. Allison has patients use to chart CBT-style chain analyses of NES behavior lists 8–10 different factors that may be involved in the behavior and has the patient rank which were relevant on any given night). Hence, many people on this thread find different things to be helpful, not necessarily because of varying degrees of severity of the illness but also because of potentially different etiologies. For example, infections like Candida and Lyme disease can cause NES (I’ve been treated for both over the last four months and believe this was one of the primary causes for me, given how drastically my triggering has been reduced in frequency and intensity). However, unlike taking Diflucan and avoiding starches and sugar for Candida, other NES sufferers find that increasing carbohydrate consumption is helpful. For some people, the serotonergic system is highly implicated. For others, nutrient deficiencies (like electrolytes) or toxicity (like copper) can be causal. Some people just plain old don’t eat enough during the day and their starving bodies take over. For others, it’s a coping mechanism for dealing with stress or trauma. For many, it may be a combination of causes.
    Not knowing why we suffer is frustrating to say the least, but all we can do is pick ourselves up by the bootstraps and keep and trying different remedies and lifestyle changes, often in concert. I now have concrete experience with several different combination efforts effecting recovery and consider my case totally life-altering in its severity, so please reach out to me if you are struggling and need either guidance or just someone to talk to!

    Tom wrote on June 2nd, 2016

Leave a Reply

If you'd like to add an avatar to all of your comments click here!

© 2016 Mark's Daily Apple

Subscribe to the Newsletter and Get a Free Copy
of Mark Sisson's Fitness eBook and more!