Thisciane Ferreira Pinto

Night eating syndrome: How to treat it?

Night eating syndrome (NES) is characterized by caloric intake ≥ 25% of total daily after dinner and/or by two or more weekly nocturnal awakenings accompanied by food ingestion. Causes of NES are not entirely clear and seem to involve a desynchronization between the circadian rhythms of food ingestion and sleep, resulting in a delayed pattern of food intake. Estimates of the prevalence of NES in the general population are around 1.5%, and although much higher frequencies have been described in obese individuals, a causal relationship between NES and obesity is not clearly established. Since the first NES reports, several treatment modalities have been proposed, although, in many cases, the evidence is still insufficient and there is no consensus on the ideal approach. In order to conduct a critical review of proposed treatments for NES since its original description, a systematic search of articles published in journals indexed in Medline/Pubmed database in the period 1955-2015 was performed. Seventeen articles addressing non-pharmacological and pharmacological therapies met the selection criteria. Based on the articles analyzed, we conclude that serotonergic agents and psychological interventions, particularly cognitive behavioral therapy, have been shown to be effective for the treatment of NES. A combination of non-pharmacological and pharmacological therapies must be considered in future studies on the treatment of these patients.

Effects of bariatric surgery on night eating and depressive symptoms: a prospective study

BACKGROUND Night eating syndrome (NES) is characterized by a delayed pattern of food intake and is clinically defined by the presence of evening hyperphagia, nocturnal ingestion, morning anorexia, and sleep problems. Although most studies report an association of obesity, depressive mood, and NES, very little is known about the impact of bariatric surgery in the course of this syndrome, particularly in patients with depressive symptoms. OBJECTIVES To assess the effects of bariatric surgery on night eating and depressive symptoms. SETTING Tertiary hospital, Brazil. METHODS Sixty patients consecutively submitted to bariatric surgery were included in the study. Baseline depressive symptoms were assessed by the Beck Depression Inventory-Short Form (BDI-SF) and night eating by the Night Eating Questionnaire. Measurements were repeated postoperatively for comparison. RESULTS Participants were predominantly female (M/F = 9/51). Mean (±SD) age was 34.7±9.2 years and body mass index was 46.04±7.52 kg/m². On average, BDI-SF scores improved after bariatric surgery (9.77±7.01 versus 4.70±4.60; P = .001). Patients with baseline depressive symptoms (BDI-SF>4), in contrast to those without, showed a significant improvement in Night Eating Questionnaire scores (16.03±7.73 versus 12.80±7.76; P = .01), despite a similar postoperative reduction in weight. CONCLUSION Bariatric surgery is associated with a reduction in depressive symptoms. After the surgical intervention, improvement of night eating can be observed predominantly in patients with preoperative depressive symptoms. These findings are consistent with the hypothesis of an important role of mood problems in NES.