Snacking the Night Away

By Sally Squires
Tuesday, January 17, 2006

"Help, I need tips for not overeating at home," wrote a Lean Plate Club member during a recent Web chat.

At the office, this Virginia resident is a model of healthy habits. But at home, it's such "a downward spiral of eating" that this reader delays going home after work to avoid eating -- and even considers gorging at dinner to help prevent constant snacking afterward.

Sound unusual? Think again. Many people "attempt to control their eating during the day and then lose control at the end of the day when they're starving," notes psychologist Gayle Brooks, clinical director of the Fort Lauderdale- based Renfrew Center, which treats eating disorders. "That's when this can move into compulsive behavior."

Just ask this Lean Plate Club member from San Francisco. "I rarely overeat when I'm around other people," she noted in a recent chat. "All my friends marvel at how 'good' I am. They don't know what goes on behind closed doors! When I'm home alone, I have very little self-control. . . . I will devour anything that isn't nailed down . . . and I feel disgusting afterwards."

That's just another example of the emotional toll of "disordered eating" -- compulsive overeating considered less pathological than anorexia or bulimia, but still with serious health and psychological risks. While there appears to be a spectrum of disordered eating, two types in particular are under study.

One is binge-eating disorder, which involves compulsively eating up to a day's worth of calories in two hours or less. The other is night-eating syndrome. People with this syndrome either consume at least 25 percent of daily calories after dinner as a bedtime snack or wake up at least three times a night to eat.

Not surprisingly, all these extra calories add up to a lot of unwanted pounds that can increase the risk for heart disease, diabetes, arthritis, sleep apnea and certain types of cancer.

Exactly how many people are affected is still sketchy. But clinical experience and a few studies suggest that about 2 percent of the general population has disordered eating. That means these syndromes occur more frequently than anorexia and rival the incidence of bulimia, says University of Pennsylvania psychologist Kelly C. Allison. Plus, Allison says, plenty of people "suffer from these things at a subclinical level as well."

While binge eating and night eating may seem similar, research suggests that they are two distinct conditions. An occasional bout of overeating or a couple of midnight feeding frenzies are not likely signs of illness. But when such episodes are frequent or severe, there may be a problem. Here are some ways to look at -- and possibly control -- problem eating:

Ask: Am I in control? Craving food well beyond the amount needed to satisfy hunger is a warning sign of disordered eating. Another is finding it difficult to stop eating. So if you find yourself frequenting all-you-can-eat restaurants or regularly standing in the kitchen sampling the chocolate cake, then the chips, then a spoonful of ice cream and so on, you may have a problem.

Check what you eat after dinner . Constant noshing is a warning sign. Large bedtime "snacks" to help you sleep can be symptom of night-eating syndrome, as can stowing food in the bedroom.

Eat breakfast . Even if you binged the night before, eating breakfast is the best way to get back on track. A recent Yale University study examined the eating patterns of nearly 200 obese men and women with binge eating disorder and found that breakfast was the meal they skipped most often.

Eat at least three meals daily . It may help control overeating. People with disordered eating patterns often skip meals, find themselves ravenous, then don't feel satisfied when they do eat. In the Yale study, participants with binge eating disorder who ate three meals per day weighed significantly less and had significantly fewer binges than those who regularly skipped meals.

Close the kitchen at night . There's no evidence to suggest that calories consumed at night are metabolized any differently than daytime calories. But closing the kitchen means that you're less likely to engage in mindless eating. "So figure out a reasonable time to get out of the kitchen after you have cleaned up for the night," Allison says. For the same reasons, avoid eating in front of the television.

If symptoms persist, seek medical assistance. Left untreated, disordered eating can quickly add pounds. Consider psychotherapy to treat depression, anxiety or other emotional problems that may fuel your excessive eating. Nutritional counseling and exercise training may help. A small study at the University of Pennsylvania found that the antidepressant Zoloft may help treat night-eating syndrome. While many antidepressants can cause people to gain weight, Zoloft appears to be "weight-neutral," Allison says, so it's unlikely to add pounds. ยท

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