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Cited by 433Eating Disorders and BehaviorsRegulation of Appetite and ObesitySleep and related disorders

Behavioral and neuroendocrine characteristics of the night-eating syndrome

Birketvedt, Grethe Støa·1999·JAMA
DOI 10.1001/jama.282.7.657
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Abstract

CONTEXT: Investigators first described the night-eating syndrome (NES), which consists of morning anorexia, evening hyperphagia, and insomnia, in 1955, but, to our knowledge, this syndrome has never been subjected to careful clinical study. OBJECTIVE: To characterize NES on the basis of behavioral characteristics and neuroendocrine data. DESIGN AND SETTING: A behavioral observational study was conducted between January 1996 and June 1997 in a weight and eating disorders program at the University of Pennsylvania. A neuroendocrine study was conducted from May through August 1997 at the Clinical Research Center of the University Hospital, Tromso, Norway. SUBJECTS: The behavioral study included 10 obese subjects who met criteria for NES and 10 matched control subjects. The neuroendocrine study included 12 night eaters and 21 control subjects. Behavioral study subjects were observed for 1 week on an outpatient basis, and neuroendocrine study subjects were observed during a 24-hour period in the hospital. MAIN OUTCOME MEASURES: The behavioral study measured timing of energy intake, mood level, and sleep disturbances. The neuroendocrine study measured circadian levels of plasma melatonin, leptin, and cortisol. RESULTS: In the behavioral study, compared with control subjects, night eaters had more eating episodes in the 24 hours (mean [SD], 9.3 [0.6] vs 4.2 [0.2]; P<.001) and consumed significantly more of their daily energy intake at night than did control subjects (56% vs 15%; P<.001). They averaged 3.6 (0.9) awakenings per night compared with 0.3 (0.3) by controls (P<.001). In night eaters, 52% of these awakenings were associated with food intake, with a mean intake per ingestion of 1134 (1197) kJ. None of the controls ate during their awakenings. In the neuroendocrine study, compared with control subjects, night eaters had attenuation of the nocturnal rise in plasma melatonin and leptin levels (P<.001 for both) and higher circadian levels of plasma cortisol (P = .001). CONCLUSION: A coherent pattern of behavioral and neuroendocrine characteristics was found in subjects with NES.

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  • The core criteria of night eating syndrome (evening hyperphagia, associated with nighttime awakening and ingestion) are associated with definite behavioral and hormonal phase delays.

    “The core criteria of evening hyperphagia, associated with nighttime awakening and ingestion are associated with definite behavioral and hormonal phase delays (Allison et al., 2005; Birketvedt et al., 1999; O'Reardon et al., 2004).”

    From Biological rhythms, higher brain function, and behavior: Gaps, opportunities, and challenges (2009) · cites this paper as Birketvedt et al., 1999

  • NES is also present in normal-weight/non-obese individuals.

    “and, it is interesting to note that NES is also present in normal-weight/non-obese individuals [12,30,31,37,38].”

    From The Health Impact of Nighttime Eating: Old and New Perspectives (2015) · cites this paper as [30]

  • Compared to those who do not eat late at night, individuals with NES consume a larger portion of their total calories at night (≥50% after dinner) and have higher overall daily and evening caloric intake in some but not all cases.

    “Compared to those who do not eat late at night, individuals with NES consume a larger portion of their total calories at night (≥50% after dinner) and have higher overall daily and evening caloric intake in some [30,31], but not all cases [32,33,34].”

    From The Health Impact of Nighttime Eating: Old and New Perspectives (2015) · cites this paper as [30]

  • Both shift workers and individuals with NES report higher levels of subjective sleep disturbances (short sleep, reduced sleep quality, difficulty falling asleep) compared to their respective counterparts.

    “Indeed, both shift workers [41] and individuals with NES [30] report higher levels of subjective sleep disturbances (short sleep, reduced sleep quality, difficulty falling asleep) compared to their respective counterparts.”

    From The Health Impact of Nighttime Eating: Old and New Perspectives (2015) · cites this paper as [30]

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Authors
Birketvedt, G. S.
Affiliations
UiT The Arctic University of Norway (NO)
Corresponding author
Birketvedt, Grethe Støa
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
1999-08-18
Volume
282
Issue
7
Pages
657
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.282.7.657
OpenAlex
W2043287433
Cited by
433
References
40
Citations by year
2026: 6 · 2025: 8 · 2024: 12 · 2023: 18 · 2022: 13 · 2021: 14 · 2020: 10 · 2019: 14 · 2018: 13 · 2017: 9 · 2016: 21 · 2015: 16 · 2014: 14 · 2013: 22 · 2012: 26
FWCI
19.05
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
night eating syndrome, dietary habits, neuroendocrine regulation, melatonin, leptin, cortisol, circadian rhythm, sleep disorders, insomnia, hyperphagia, obesity, mood
MeSH terms
Adult, Anorexia, Feeding and Eating Disorders, Circadian Rhythm, Feeding Behavior, Female, Humans, Hydrocortisone, Hyperphagia, Sleep Initiation and Maintenance Disorders, Male, Melatonin, Neurosecretory Systems, Obesity, Proteins, Regression Analysis, Syndrome, Poisson Distribution, Statistics, Nonparametric, Leptin

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