The association between night eating syndrome and GERD symptoms among university students at An-Najah National University in Palestine: a cross-sectional study.

BACKGROUND: Night eating syndrome (NES) is a kind of eating disorder. NES association with gastroesophageal reflux disease (GERD) symptoms among university students is still not fully understood. We aimed to determine the relationship between NES and the presence of GERD symptoms among university students at An-Najah National University in Palestine. METHODS: This study involved undergraduate students from An-Najah National University. The data were collected through online surveys from November to December 2023. The sampling frame involved voluntary sampling, as the data were collected using a structured questionnaire to collect data on sociodemographic variables, medical history, lifestyle habits, nutritional status, GERD risk, and NES. The GERD questionnaire (GerdQ) was used to assess symptoms, while the Arabic version of the validated Night Eating Questionnaire (NEQ) was used to assess night eating. Physical activity was assessed using the short form of the International Physical Activity Questionnaire (SF-IPAQ), and adherence to a Mediterranean diet was assessed using the validated Arabic version of the MEDAS. Both univariate and multivariate analyses were also conducted to assess the study hypotheses. RESULTS: The study involved 554 participants, 59.9% female. A total of 33.4% reported GERD symptoms, with 10.3% having NES. A strong association was observed between GERD and NES and between GERD and physical activity. Night eating syndrome (AOR = 2.84, CI = 1.07-3.19), high physical activity (AOR = 0.473, CI = 1.05-3.19), and non-smoking (AOR = 0.586, CI = 1.27-7.89) were identified as independent predictors of GERD symptoms. CONCLUSION: This study revealed that 33.4% of undergraduate students were at risk of GERD, with night eaters having a greater risk. GERD risk was negatively associated with physical activity level and smoking status. No associations were found between GERD risk and weight status, Mediterranean diet adherence, sociodemographic factors, or sleep disturbances.

Evaluation of night eating syndrome and food addiction in esports players.

PURPOSE: Esports players' training takes long periods and they sit for a long time during competitions, which increases their risk of obesity and urges them to develop inappropriate eating behaviors. In this study, we aimed to investigate the night-eating syndrome and food addiction in esports players. METHODS: This cross-sectional study was conducted with 248 esports players who were members of a university's esports community. The study data were collected using an online questionnaire consisting of the descriptive information form, Night Eating Questionnaire, and Yale Food Addiction Scale. RESULTS: The mean age of the sports players participating in the study was 22.19 ± 5.97 years. Of them, 55.6% had a normal body weight, 13.4% were obese, 54.4% played esports for 3 years or more, 13.3% experienced night eating syndrome, and 21.4% experienced food addiction. While the weekly duration of playing esports and skipping meals were associated with night eating syndrome, the weekly duration of playing esports and smoking were associated with food addiction (p < 0.05). Additionally, although there was no statistically significant difference, the risk of food addiction was 2.12 times higher in those with poor perceived sleep quality. CONCLUSION: We observed that night eating syndrome was very common in esports players and that these individuals were at risk in terms of food addiction. Since esports has a more sedentary structure than traditional sports, we suggest that esports players should be evaluated in terms of their unhealthy eating behaviors and risk of eating disorders.

Taking a Global View of the OSFED Category From Inside and Outside the DSM-5: Comment on Dang et al. 2024.

This Commentary discusses the findings of Dang et al.'s systematic review and metanalysis on the "Other Specified Feeding or Eating Disorder" (OSFED) category in the context of current conceptualizations and main international diagnostic schemes of classification, the DSM-5 and the ICD-11. The aim to reduce less specified eating disorder categories in these classifications has not been completely achieved and OSFED cases remain prevalent. Different definitions of OSFED contribute to difficulties in study selection and limitation of data aggregation in metanalysis, highlighting the need for improving methodologies for studying OSFED subtypes. Although use of either the DSM-5 or ICD-11 scheme concurs with Dang et al.'s main finding that OSFED comprises categories of similar clinical significance to the recognized eating disorders, the ICD-11 includes more people with anorexia nervosa, bulimia nervosa, or binge-eating disorder who would receive a DSM-5 OSFED diagnosis. This may have impacts for epidemiological studies of distribution as well as for identification and treatment of the individual. We support that before creating new eating disorder categories, consideration be given to also broadening current DSM-5 criteria. This approach may result in fewer OSFED subtypes needing elevation to distinct categories, potentially limiting these to just purging disorder and night eating syndrome.

Taking Steps Toward a Consensus on Night Eating Syndrome Diagnostic Criteria.

BACKGROUND: Night eating syndrome (NES) is included in the Diagnostic and Statistical Manual for Mental Disorders, 5th edition, as an example of "Other Specified Feeding or Eating Disorders" with minimal guidance about how to define and operationalize NES. The literature suggests that research practices vary widely, making it difficult to draw conclusions about the public health burden of, effective interventions for, or policy implications relevant to NES. This Forum article seeks to illustrate the lack of definitional agreement to underscore the need for a consensus about NES diagnostic criteria, and to propose steps toward closing knowledge gaps and achieving consensus. METHOD: We searched PubMed and PsycINFO titles and abstracts, using "NES" as the search term, for research articles published in English between January 1, 2013 to August 12, 2024 with sample sizes of NES > 10 and ages 18 or older. Eligible articles were coded for NES definitions and assessment method used to diagnose participants with NES and for information about comorbidity of NES and any other eating disorder (ED). RESULTS: Seventy-three articles met inclusion criteria. Most commonly, NES was diagnosed using a diagnostic criteria set (35/73) or a symptom score threshold (34/73); among the former, only eight studies employed DSM-5 NES criteria. Thirteen studies, varying widely in methodology, examined comorbidity with other EDs, most commonly binge-eating disorder where comorbidity was high. CONCLUSION: Heterogeneity of definitions and assessment impede progress in the study of NES. We propose strategies for developing a consensus definition and addressing research gaps.

OSFED Subtypes: The Need for Better Definitions.

Other specified feeding and eating disorders (OSFED) is a diagnostic category in DSM-5 describing individuals with clinically significant eating behavioral disturbances that do not meet criteria for full-threshold eating disorder diagnoses. OSFED includes five example subgroups: atypical anorexia nervosa, sub-threshold bulimia nervosa, sub-threshold binge-eating disorder, purging disorder, and night eating syndrome. A recent review of OSFED by Dang et al. aims to examine differences between OSFED and full-threshold eating disorders as well as between OSFED and healthy populations but is limited by the lack of clear definitions of OSFED subtypes and methodological differences across studies. Clearer diagnostic definitions for OSFED subtypes are needed. Consideration should also be given to indicators of lifetime history of full-threshold conditions, diagnostic drift, and remission criteria as OSFED categories undergo further study.

Taking a Deeper Dive Into OSFED Subtypes: A Meta-Analysis and Systematic Review.

OBJECTIVE: To compare all other specified feeding or eating disorders (OSFED) groups (atypical anorexia nervosa [AN], purging disorder [PD], night eating syndrome [NES], subthreshold bulimia nervosa [sub-BN], and subthreshold binge-eating disorder [sub-BED]) to threshold eating disorders (EDs [AN, BN, and BED]) and control groups (CGs) on measures of eating and general psychopathology. METHOD: We conducted a comprehensive search in PsycINFO, Medline, Embase, and CINAHL on all published studies from January 2013 to February 2024 using DSM-5 diagnostic criteria via clinical interviews or well-established diagnostic tools. We also undertook a quality appraisal using an adapted version of the Downs and Black criteria and registered the review with PROSPERO (ID: CRD42022314495). RESULTS: Overall, our meta-analyses (n = 33 eligible studies) indicated that the combined OSFED and several specific OSFED subtypes displayed comparable levels of eating psychopathology to full-threshold EDs. Our systematic review (n = 33 eligible studies) found individuals with OSFED to have comparable levels of eating and general psychopathology to full-threshold EDs, but higher levels of eating and general psychopathology than CGs. These findings were specifically attributed to atypical AN and NES. There was a lack of evidence available for sub-BN and sub-BED. Studies mainly met the quality appraisal criteria. The main limitations identified in the included studies were insufficient reporting of their statistical power (78%) and no adjusting for potential confounding factors (67%). DISCUSSION: Findings support the conceptualization of atypical AN, and NES as clinically significant EDs with similar severity to full-threshold EDs.

Guidelines for Rigorous and Reproducible Research on Other Specified Feeding or Eating Disorder: Commentary on Dang et al. (2024).

Dang et al.'s review concludes that atypical anorexia nervosa (atypical AN), purging disorder (PD), and night eating syndrome (NES) are clinically significant and severe eating disorders (EDs). However, findings are unlikely to alter their status in future editions of the DSM due to limitations in the literature to date. Guidelines are offered to promote rigorous and reproducible research on other specified feeding or eating disorder OSFED. First, published research diagnostic criteria for atypical AN, PD, and NES should be consistently used to ensure findings across studies reflect the same conditions. Second, operational definitions are recommended for "recurrent" as at least twice within a 3-month period, minimum duration as at least 1 month, and "significant weight loss" as >5% BMI reduction within 1 month. Third, Thomas's and Gydus's trumping scheme for differential diagnosis of OSFED subcategories is endorsed but should prioritize identifying treatment targets based on medical morbidity over mirroring existing diagnostic algorithms. Fourth, a systematic approach for establishing clinical significance is recommended that explicitly notes medical risk associated with malnutrition, purging and nonpurging behaviors, and relevance of marked distress related to binge eating and body image disturbance. Adoption of these guidelines will facilitate necessary research on clinical utility.

A proposed trumping scheme for other specified feeding or eating disorder: Comment on Walsh et al., 2023.

The recent systematic review by Walsh, Hagan, & Lockwood (Int J Eat Disord, 2022) highlights the importance of further distinguishing atypical anorexia nervosa (atypical AN) from other feeding and eating disorders. The lack of a trumping scheme within other specified feeding or eating disorder (OSFED) hinders intervention selection in the clinical context and reduces reliability of diagnostic classification in research samples. Thus, we propose a trumping scheme within OSFED that mirrors the existing diagnostic algorithm in the main DSM-5-TR feeding and eating disorders section. According to this scheme, a diagnosis of atypical AN would override all other OSFED subcategories. Subthreshold bulimia nervosa (BN) would trump subthreshold binge-eating disorder (BED) and purging disorder; purging disorder would trump subthreshold BED and night eating syndrome; night eating syndrome would trump subthreshold BED; and subthreshold BED would trump subthreshold avoidant/restrictive food intake disorder (ARFID)-a novel presentation that we propose adding under the OSFED umbrella to parallel the existing subthreshold classifications for the main feeding and eating disorders. We hope this proposed OSFED trumping scheme will improve intervention selection and diagnostic reliability in clinical and research contexts, and serve as a catalyst for future research on these newly recognized-but common and impairing-feeding and eating disorder presentations.

Prevalence of night eating syndrome among inbound call centre employees in Kuala Lumpur, Malaysia.

Background: Night eating syndrome (NES) is described as a disordered eating pattern relative to sleep, where consumption of food occurs in the evening and night. Numerous studies had been conducted in various populations but studies on (NES) among call centre employees are limited. Aim: This study aimed to determine the prevalence of NES and its determinants among selected inbound call centre employees in Kuala Lumpur, Malaysia. Methods: In this cross-sectional study, a total of 217 inbound call centre employees were recruited through random sampling. A self-administered socio-demographic and work-related questionnaire was used to collect data on the background of the respondents. Information on NES and well-being was obtained by using the Night Eating Questionnaire (NEQ) and World Health Organisation-Five Well-Being Index (WHO-5) respectively. Data on dietary intakes, smoking habits, alcohol intakes and life stress were acquired using a Simple Lifestyle Indicator Questionnaire (SLIQ) while eating behaviour of the respondents was studied using the Three-Factor Eating Questionnaire (TFEQ-18). Results: The mean age of the respondents was 24.1 ± 6.0 years. The prevalence of NES was 12.0% (95% CI = 8.12-17.24). The binary logistic regression identified that NES is significantly associated with adequate exercise (AOR = 4.250, p = 0.012) and emotional eating (AOR = 6.510, p = 0.014). Conclusion: This study showed that the prevalence of NES was high in the call centre and repeated nocturnal eating can have multiple adverse health effects. Therefore, promoting healthy eating habits are crucial to reduce the impacts of NES.

Association of participants who screened positive for night eating syndrome with physical health, sleep problems, and weight status in an Australian adult population.

BACKGROUND: Night eating syndrome (NES) is a unique eating disorder characterised by evening hyperphagia and nocturnal ingestions which cause significant distress and/or impairment in functioning. Despite the growing literature, NES remains poorly understood and under diagnosed. As such, this study aims to compare the prevalence of physical health conditions in participants with NES when compared to participants without an eating disorder (ED) and participants with other eating disorders (including anorexia nervosa (AN), binge eating disorder (BED) and bulimia nervosa (BN)) in a general population Australian sample of adults. METHODS: The data for this study were obtained from the 2017 Health Omnibus Survey (HOS) a multi-stage, cross-sectional survey, conducted by Harrison Research in South Australia. This current study focused on 2547 participants over 18 years of age and specific questions from this population survey including those related to participant demographics and health. RESULTS: This study identified that participants who screened positive for night eating syndrome (spNES) when compared to participants with other eating disorders (ED) or no ED diagnosis, were significantly more likely to have an increased age, be female, have lower levels of education and have lower household income. Additionally, the spNES group was significantly associated with sleep apnoea (p = 0.031), insomnia or other sleep problems (p < 0.0001), increased BMI (p < 0.0001), increased levels of pain/discomfort and lower physical health-related quality of life. Hypertension, hypercholesterolemia, and diabetes were not significantly associated with the spNES group or the "other ED" group which included participants with AN, BED, BN. CONCLUSIONS: Several physical health problems were found to be significantly associated with the spNES group including sleep problems, increased BMI, increased levels of pain and lower self-reported physical health-related quality of life. Consequently, future research exploring the complex interaction between NES and these medical conditions may provide further insight into the diagnosis, screening tools and management of NES. Additionally, this study highlights the need for future studies which use larger population-based samples. LEVEL OF EVIDENCE: Level III. Evidence obtained from well-designed cohort or case-control analytic studies.

The association between night eating syndrome and health-related quality of life in Korean adults: a nationwide study.

PURPOSE: Quality of life may be influenced by the presence of eating disorders. This study investigated the association between night eating syndrome (NES) and health-related quality of life in the general population. METHODS: Data were from the 2019 Korea Community Health Survey. The presence of NES was determined using the Night Eating Questionnaire. Health-related quality of life was measured using the 3-level EuroQoL-5 Dimension Index. Multivariable linear regression analyses assessed the association between NES and health-related quality of life. Subgroup analyses were performed based on daily sleep duration. RESULTS: A total of 34,434 individuals aged 19 years or older were included in the study population. Participants with NES (ß = - 4.85, p < 0.001) reported poorer health-related quality of life scores than those without NES. Decreases in health-related quality of life scores among those with NES were greatest in those who slept over 8 h daily (ß = - 12.03, p = 0.004), followed by those who slept less than 6 h (ß = - 5.90, p = 0.006) and participants who slept between 6 and 8 h (ß = - 3.40, p = 0.026) daily. CONCLUSION: Individuals with NES were more likely to have a lower health-related quality of life than those without NES. These findings highlight the potential importance of considering NES in investigating the health-related quality of life. LEVEL OF EVIDENCE: Level III, well-designed case-control analytic studies.

The association between episodes of night eating and levels of depression in the general population.

OBJECTIVE: Research has suggested that a correlation may exist between depressive mood and episodes of night eating. This study aimed to examine whether having episodes of night eating was associated with increased levels of depression. METHOD: This study used data from the 2019 Korea Community Health Survey and the study population consisted of adults aged ≥19 years. Depression levels were measured using the Patient Health Questionnaire-9. We investigated the patients' general characteristics using t-tests and analysis of variance. The association between depression levels and episodes of night eating was analyzed using a multivariable linear regression analysis. Subgroup analysis was conducted based on daily sleep duration. RESULTS: We analyzed 34,358 individuals and found higher average depression scores (ß: 4.99, p < .001) in those with episodes of night eating than those without. Large effect sizes were found for differences in depression scores between participants with and without episodes of night eating. The magnitude of this increase was particularly pronounced in individuals who reported 9 or more hours of sleep per day. DISCUSSION: An association was found between levels of depression and episodes of night eating as individuals with episodes of night eating were more likely to have higher depression scores. Our findings suggest the potential need to consider night eating when addressing the mental health of the general population.

'In the night kitchen': A scoping review on the night eating syndrome.

BACKGROUND: First described in 1955, night eating syndrome refers to an abnormal eating behavior clinically defined by the presence of evening hyperphagia (>25% of daily caloric intake) and/or nocturnal awaking with food ingestion occurring ⩾ 2 times per week. AIMS: Although the syndrome is frequently comorbid with obesity, metabolic and psychiatric disorders, its etiopathogenesis, diagnosis, assessment and treatment still remain not fully understood. METHODS: This review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines; PubMed database was searched until 31 October 2020, using the key terms: 'Night Eating Syndrome' AND 'complications' OR 'diagnosis' OR 'drug therapy' OR 'epidemiology' OR 'etiology' OR 'physiology' OR 'physiopathology' OR 'psychology' OR 'therapy'. RESULTS: From a total of 239 citations, 120 studies assessing night eating syndrome met the inclusion criteria to be included in the review. CONCLUSION: The inclusion of night eating syndrome into the Diagnostic and Statistical Manual of Mental Disorders-5 'Other Specified Feeding or Eating Disorders' category should drive the attention of clinician and researchers toward this syndrome that is still defined by evolving diagnostic criteria. The correct identification and assessment of NES could facilitate the detection and the diagnosis of this disorder, whose bio-psycho-social roots support its multifactorial nature. The significant rates of comorbid illnesses associated with NES and the overlapping symptoms with other eating disorders require a focused clinical attention. Treatment options for night eating syndrome include both pharmacological (selective serotonin reuptake inhibitors, topiramate and melatonergic drugs) and non-pharmachological approaches; the combination of such strategies within a multidisciplinary approach should be addressed in future, well-sized and long-term studies.

Adult attachment anxiety is associated with night eating syndrome in UK and US-based samples: Two cross-sectional studies.

Previous research has shown that "attachment anxiety" is a robust predictor of disinhibited eating behaviours and that this relationship is underpinned by difficulties in managing emotion. Night eating syndrome (NES), a proposed eating disorder characterized by evening hyperphagia, nocturnal awakenings to eat, and morning anorexia, is also associated with eating to manage emotion. Across two studies (N = 276 & N = 486), we considered a relationship between attachment anxiety and NES. In Study 1, we hypothesised (pre-registered) that attachment anxiety would predict NES score and that this relationship would be mediated by disinhibited eating. Participants were asked to complete questionnaire measures of attachment orientation, disinhibited eating (emotional and uncontrolled eating) and NES. Our parallel mediation model confirmed a direct relationship between attachment anxiety and NES (p < .001) and showed an indirect path via both emotional (95% CI: 0.15-0.63) and uncontrolled eating (95% CI: 0.001-0.36). In Study 2, we showed that fear of negative evaluation of eating significantly mediated a reversed relationship between attachment anxiety and NES (95% CI: 0.02-0.04). Finally, across both studies we used a novel tool to assess "eating to cope". We showed a relationship with emotional eating but failed to show a robust relationship with NES. Attachment orientation may represent a potential intervention target for night eating syndrome. Future research should consider a longitudinal approach to strengthen our understanding of directionality amongst these factors.

Personality traits and night eating syndrome in women with bulimia nervosa and binge eating disorder.

PURPOSE: Previous research suggests that eating disorders may be associated with certain personality profiles; however, there is limited research investigating associations with night eating syndrome (NES). This research suggests harm avoidance personality trait is higher in NES individuals than in the general population, however, evidence of associations with other personality traits is inconsistent. To understand which personality traits are associated with NES symptoms, the current study aimed to improve understanding of the relationship between NES symptoms and a range of personality traits, addressing limitations in the earlier literature in this area by controlling for common confounders. METHODS: Baseline data were analysed from an outpatient psychotherapy trial for 111 women with bulimia nervosa or binge eating disorder. Pre-treatment measures of personality traits (measured with the Temperament and character inventory-revised) and NES symptoms (measured with the Night eating questionnaire) were used. Regression analyses tested associations between these variables, adjusting for potential confounders, including age and ethnicity. RESULTS: Low cooperativeness scores were associated with greater NES symptoms in the multivariable model (mean difference: - 0.10, 95% confidence intervals: - 0.20 to - 0.01, p = 0.033). There was weak evidence of associations between both high harm avoidance and low self-directedness personality traits and greater NES symptoms. CONCLUSIONS: This study adds to the limited research measuring associations between a range of personality traits and NES, addressing limitations of previous research. Weak evidence for an association between high harm avoidance and low self-directedness and increased NES symptoms was found. A novel association was found between low cooperativeness and greater NES symptoms. Further research is needed to validate its presence in those with and without comorbid eating disorders and to examine the relative change in NES, eating disorder symptoms and personality scores in treatments focusing on cooperativeness. LEVEL OF EVIDENCE: Level IV (cross-sectional data from a randomised controlled trial, CTB/04/08/139).

[Can night eating syndrome and sleep quality have strong relations with quality of life in early adulthood?]

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.

The nature of night eating syndrome: Using network analysis to understand unique symptomological relationships.

OBJECTIVES: Despite the initial characterization of night eating syndrome (NES) in 1955, the definition and operationalization of its symptoms has varied considerably. To standardize the definition of NES and its symptoms, Allison et al. developed research diagnostic criteria. Even so, conceptualization and intervention of NES remains guided by medical models, which assume that pathology is driven by a distinct, underlying causal mechanism. Conversely, recent work on other eating disorders (EDs) has used network analysis to reconceptualize ED psychopathology and treatment by identifying (a) unique relationships between key symptoms, and (b) the symptoms most central to specific EDs. The present study examined NES symptoms through network analysis to identify the most central symptoms within the NES network. METHOD: Regularized partial correlation networks were estimated using 144 individuals in a community sample diagnosed with NES. Participants completed semi-structured interviews, self-report measures, and food/sleep diaries to measure NES symptoms, nonspecific health domains (e.g., sleep disturbance, overall mood, stress, and circadian rhythm functioning), and transdiagnostic ED symptoms. RESULTS: Depressed mood, poor sleep quality, and a strong urge to eat upon awakening at night were highly central to the psychopathology network for NES and were significantly more central than most other NES symptoms and nonspecific health domains. DISCUSSION: This study provides insight on the unique symptomological relationships of NES and sets the stage for future work that can identify causal linkages among NES symptoms. These symptoms represent key elements of the core psychopathology of NES and should represent primary targets for intervention.

DSM-5 eating disorder prevalence, gender differences, and mental health associations in United States military veterans.

OBJECTIVE: Little is known about prevalence estimates of new and revised DSM-5 eating disorders diagnoses in general, and especially among high-risk, underserved and diverse eating disorder populations. The aim of the current study was to determine prevalence, gender differences and correlates of DSM-5 eating disorders in veterans. METHOD: Iraq and Afghanistan war era veterans (N = 1,121, 51.2% women) completed the Eating Disorder Diagnostic Scale-5 and validated measures of eating pathology and mental health between July 2014 and September 2019. RESULTS: Overall more women than men (32.8% vs. 18.8%, p < .001) reported symptoms consistent with a DSM-5 eating disorder. Prevalence estimates (women vs. men) for the specific diagnoses were: Anorexia Nervosa (AN; 0.0% vs. 0.0%), Bulimia Nervosa (BN; 6.1% vs. 3.5%), Binge-Eating Disorder (BED; 4.4% vs. 2.9%), Atypical AN (AAN; 13.6% vs. 4.9%), Subclinical BN (0.0% vs. 0.2%), Subclinical BED (1.4% vs. 0.6%), Purging Disorder (2.1% vs. 0.7%), and Night Eating Syndrome (NES; 5.2% vs. 6.0%). Women were more likely to have BN or AAN, and there was no difference for BED or NES among genders. The eating disorder group had a higher mean BMI, and significantly greater eating pathology and mental health symptoms than the non-eating disorder group. DISCUSSION: Approximately one-third of women, and one-fifth of men, reported symptoms consistent with a DSM-5 eating disorder diagnosis. These high prevalence estimates across genders, and associated mental health concerns, suggest an urgent need to better understand and address eating disorders in military and veteran populations.

Addiction-like response in brain and behavior in a rat experimental model of night-eating syndrome.

STUDY OBJECTIVES: Individuals ailing from night eating syndrome (NES) consume more than 25% of their daily food intake during the normal sleep time, delaying their sleep or waking up in the middle of the night to eat. This study explored two experimental conditions resembling NES in Wistar rats by offering palatable food during the sleep phase, alone or combined with sleep delay. Also we explored their impact on addiction-like changes in the brain and behavior. METHODS: Experiment 1 explored the brain response after a first NES-like event; experiment 2 and 3 explored addiction-like behaviors c-Fos and FosB/ΔFosB in corticolimbic regions after 4 weeks exposition to NES-like conditions and after one week of withdrawal, respectively. For all 3 experiments 6 experimental groups were used: 1. Control; 2. Restricted access (1 h) to high-sugar diet (HSD) or to 3. high-fat diet (HFD); 4., Sleep delay for 4 h (SD) (from ZT0-ZT4, rats using slow rotating wheels); 5. SD + HSD; 6. SD + HFD. RESULTS: A first event of eating a palatable diet with or without SD was sufficient to stimulate c-Fos and ΔFosB. Along 4 weeks of exposure to the palatable diets rats exhibited escalation and binge eating, which was highest for the HFD. At this stage, SD did not influence behavioral changes nor the neuronal response. After one-week in withdrawal, rats exhibited craving and effort to obtain their palatable diet. The brains of rats previously exposed to sleep delay maintained high levels of FosB/ΔFosB in the accumbens shell and high c-Fos activation in the insular cortex. CONCLUSIONS: In our experimental models of NES-like a HFD in the sleep phase and SD are risk factors to develop binge eating and addiction-like behaviors.

Dietary patterns of patients with binge eating disorders with and without night eating.

OBJECTIVE: This study aimed to compare dietary patterns (timing and frequency of binge episodes, caloric intake and macronutrient composition) of patients with binge eating disorders (BE) with and without night eating syndrome (NES). DESIGN: The study includes 59 women (18-60) who sought treatment for Eating Disorders (EDs) and were diagnosed with BED or BN (BE) with or without NES. They were divided into two groups: NES-BE and BE-only. The participants kept 7-day, 24-h food diaries and completed demographic and depression questionnaires. RESULTS: NES-BE reported significantly a higher frequency of binge days and binge episodes during the week, and more energy and fat consumption than BE-only. CONCLUSIONS: Individuals with NES-BE exhibit higher levels of eating pathology than individuals with BE-only. Thus, NES-BE may not be simply a variant of BED or BN but rather a separate entity that may lead to a more severe disorder and require early assessment and more intensive and suitable treatment. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.