Sindrome da Alimentazione Notturna (NES): cos’è, come riconoscerla e come affrontarla

The Night Eating Syndrome (NES) is an eating disorder characterized by an altered pattern of food intake, with a strong concentration of calories in the evening and nighttime hours. People with NES tend to consume at least 25% of their daily caloric intake after dinner and experience recurrent nighttime awakenings accompanied by the need to eat in order to fall back asleep.

How does it manifest?

Among the most frequent symptoms are:
• intense need to eat between dinner and sleep,
• poor appetite in the morning (morning anorexia),
• onset or maintenance insomnia,
• depressed mood and worsening of mood in the evening,
• belief of "not being able to sleep without eating".

Many patients feel embarrassment or shame and struggle to talk about it, which is why NES can be underestimated for a long time or confused with other conditions, such as binge eating or sleep disorders.

What does it depend on?

The etiology is multifactorial: psychological, neurobiological, endocrine and genetic factors come into play, along with chronic stress and often comorbidities such as anxiety, depression, obesity, and diabetes.

Diagnosis and treatment:

A correct clinical assessment must rule out other eating or mood disorders. The most effective management is multidisciplinary and may include:
• psychotherapy (in particular CBT specific for NES),
• regulation of the sleep–wake rhythm,
• relaxation techniques,
• phototherapy,
• in some cases, under specialist evaluation, SSRIs.

NES is not a lack of willpower, but a real disorder that involves biological rhythms, emotions, and brain functioning. Recognizing it is the first step to targeted intervention and significantly improving quality of life, sleep, metabolic health, and psychological well-being.

https://www.ncbi.nlm.nih.gov/books/NBK585047/