Night Eating Syndrome in Class II-III Obesity: Metabolic and Psychopathological Features

Objective: To investigate the relation of metabolic disorders and psychological features with the Night Eating Syndrome (NES) in individuals with moderate-to-severe obesity. Design: Cross-sectional observation. Subjects: 266 consecutive subjects with class II-III obesity, entering an in-patient weight-loss program. Measurements: Subjects who reported to consume either a large amount of their caloric intake after the evening meal (roughly self-assessed as ≥ 25% of daily calories) or the presence of nocturnal feeding at the Night Eating Questionnaire (N=49) were interviewed by the Night Eating Syndrome History and Inventory (NESHI). Assessment also included the clinical/biochemical parameters of the metabolic syndrome and several questionnaires of psychopathology. NES was diagnosed by NESHI criteria (evening hyperphagia (≥25% of daily food intake after the evening meal) and/or waking at night to eat at least three times a week) in the last three months. Results: Twenty-seven participants (10.1%) met NESHI criteria. No differences were observed between participants with and without NES as to age, BMI, prevalence of metabolic syndrome, Binge Eating Scale and Body Shape Questionnaire. NES participants had significantly higher scores of Beck Depression Inventory (BDI) and Impact of Weight on Quality of Life. Among NES cases, the BDI score was indicative of moderate depression in18.5% of cases and of severe depression in 44.4%. Logistic regression analysis, adjusted for confounders, identified the BDI score as the only variable significantly associated with the diagnosis of NES. Conclusion: Diagnosing NES does not help identify obese individuals with specific medical complications, but indicates more severe psychological distress and depression.