New Information
about Night-Eating Syndrome Defines Treatment & Characteristics
January / February 2005
Characterized by morning anorexia, evening hyperphagia and
frequent waking and eating throughout the night, night-eating
syndrome (NES) is a disorder that affects thousands of obese
and non-obese individuals. NES is the focus of various research
at Penn Behavioral Health, and Penn psychiatrists recently
completed a clinical trial that has demonstrated the dramatic
benefits of the medication, sertraline.
As reported in the International Journal of Eating Disorders,
January 2004, 17 eligible patients received sertraline (Zoloft™)
in a 12-week open-label, non-blind trial. “All 17 participants
improved significantly and approximately two-thirds of the
study participants showed great improvement up to and including
complete remission,” says Albert
J. Stunkard, MD, director
emeritus of the Weight and Eating Disorders Program in the
Department of Psychiatry at the Hospital of the University
of Pennsylvania. In 2004, Penn psychiatrists completed a
new double-blind, placebo-controlled trial using Zoloft™ for
NES which further confirms the effectiveness of the medication.
Assumed to be a condition primarily affecting obese people,
another study published in the International Journal of Eating
Disorders, March 2004, discovered that normal weight people
can also have NES. Penn psychiatrists studied 40 obese and
40 non-obese participants with NES who were almost identical
in behavior. “The major difference between these two
groups was that the non-obese participants were about 10
years younger. This poses a very interesting question—which
came first the obesity or the night eating? We believe NES
is a pathway to the obesity,” explains Dr. Stunkard. “When
the night eating is controlled, patients will often lose
a significant amount of weight without even trying.” Approximately
one percent of people in the general population, five percent
of obese people and up to 25 percent of people who undergo
obesity surgery have NES.
Initially, NES was believed to be a disorder of the biological
rhythms of eating and sleeping, but in a separate study,
Penn psychiatrists found that the biological rhythm of sleeping
is undisturbed. “Although the patient’s sleep
is of much poorer quality, the biological rhythm of sleep
is dissociated from the biological rhythm of eating. This
is the first disorder in which biological rhythms have been
dissociated,” says Dr. Stunkard.
In NES, the biological rhythm that controls food intake
is shifted approximately six hours later. People with this
disorder don’t begin eating until as late as 12 noon
and they eat until midnight or 1 am and then very frequently
wake up and eat. The awakenings average about 20 minutes
and the patients are convinced they need to eat in order
to get back to sleep.
For individuals who live out of state or the country, Penn
psychiatrists have developed a unique long-distance study
in which they work closely with the patient’s primary
care physician to determine the appropriate Zoloft™ dosage
and monitor the patient’s progress. More than 30 patients
have been successfully treated.
Dr. Stunkard and colleague Kelly C. Allison, PhD, psychologist
in the Weight and Eating Disorders Program and an instructor
at the University of Pennsylvania School of Medicine, have
also developed a cognitive behavior therapy program to treat
NES.
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Referring Physicians: To speak with a Penn physician
or refer a patient, contact PennHealth through the secure online
referral form or by calling
1-800-789-PENN
(7366). |
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