The Dark and Light Side of Food: Traumatic Life Events in Patients with Night Eating Syndrome

Night eating syndrome (NES) is classified in the Diagnostic Statistical Manual and conceptualized as a delay in the circadian pattern of food intake, reflected by the consumption of large amounts after the evening meal or the ingestion of food after sleep onset. NES reflected by two core criteria: evening hyperphagia, that is, a large caloric intake after the evening meal, nocturnal ingestion, that is, the ingestion of food after sleep onset.

Psychological and psychiatric comorbidity play a significant role in the etiology of eating disorders (EDs) including NES. One of the risk factors, Is a history of traumatic life events and maltreatment. The relationship between traumatic life events and EDs has been widely described, focusing mainly on sexual abuse. Childhood maltreatment, including sexual, physical, and emotional abuse and physical and emotional neglect, has also been found to be a significant risk factor for EDs and NES. Few quantitative studies have examined the history of traumatic life events and history of childhood maltreatment, and trauma of patients with NES . to our knowledge no study examines traumatic life events among patients with NES from their perspectives.

This article aims to describe NES experience, awareness, narratives, and behavior from the perspectives of patients with NES in light of their history of traumatic life events.

Method: Semi-structured interviews based on the phenomenological approach were conducted with 18 women (aged 19–60) diagnosed with NES who seek treatment for EDs.

Results: The analysis of the interviews raised two central themes. The first refers to NES as an experience that represents the darker sides of patients’ behaviors and involves helplessness, contempt, self-loathing, and a loss of control. Patients also related to difficult memories concerning sexual, physical, and emotional abuse and neglect. The second refers to NES as an experience that represents the comforting side of patients’ behaviors and involves soothing, regulating, and emotional disconnecting which enables a sense of calm, control, and the ability to function. Discussion: Empirically, the findings add to our understanding of the relationship between traumatic life events, dissociation, and EDs. Clinically, they highlight the importance of an early assessment of NES and a traumatic life history and suggest giving special treatment attention to the role of dissociation and night eating as a regulatory mechanism in the therapeutic process and alliance.