Night eating syndrome (NES) is an eating disorder that has historically been under-studied. The current review aims to summarize the most up-to-date research on NES to support better awareness.Since NES was recently included as a formal diagnosis, research on the prevalence of NES is ever evolving. Current studies underscore the high comorbidity between NES and other eating disorders, with additional complexities for patient with comorbid eating disorders. Recent findings also support the association between NES and sleep correlates, a relationship that has remained during the COVID-19 pandemic. Emerging research confirms correlates of distress in NES across cultures. There remain mixed findings between NES and BMI. There is also debate around whether age is a risk factor. Bariatric surgery research has focused on the re-emergence of NES post-operatively. Our understanding of the correlates of NES is increasing. However, research on the treatment for NES remains particularly under-studied and requires further attention. 

/pdf/an-updated-review-of-night-eating-syndrome-an-under-1x43blio.pdf

An Updated Review of Night Eating Syndrome: An Under-Represented Eating Disorder

The authors posit current guidelines and treatment for eating disorders (EDs) fail to adequately address, and often perpetuate, weight stigma. The social devaluation and denigration of higher-weight individuals cuts across nearly every life domain and is associated with negative physiological and psychosocial outcomes, mirroring the harms attributed to weight itself. Maintaining focus on weight in ED treatment can intensify weight stigma among patients and providers, leading to increased internalization, shame, and poorer health outcomes. Stigma has been recognized as a fundamental cause of health inequities. With no clear evidence that the proposed mechanisms of ED treatment effectively address internalized weight bias and its association with disordered eating behavior, it is not hard to imagine that providers’ perpetuation of weight bias, however unintentional, may be a key contributor to the suboptimal response to ED treatment. Several reported examples of weight stigma in ED treatment are discussed to illustrate the pervasiveness and insidiousness of this problem. The authors contend weight management inherently perpetuates weight stigma and outline steps for researchers and providers to promote weight-inclusive care (targeting health behavior change rather than weight itself) as an alternative approach capable of addressing some of the many social injustices in the history of this field.

/pdf/dismantling-weight-stigma-in-eating-disorder-treatment-next-1ig3k99l.pdf

Dismantling weight stigma in eating disorder treatment: Next steps for the field

This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) details metabolic, behavioral health, and disordered eating comorbidities associated with obesity in children. This CPS will be followed by a companion CPS covering further comorbidities, including genetics and social consequences related to overweight and obesity. These CPSs are intended to provide clinicians with an overview of clinical practices applicable to children and adolescents with body mass indices greater than or equal to the 95 th percentile for their ages, particularly those with adverse consequences resulting from increased body mass. The information in this CPS is based on scientific evidence, supported by the medical literature, and derived from the clinical experiences of members of the OMA. The scientific information and clinical guidance in this CPS is based upon referenced evidence and derived from the clinical perspectives of the authors. This OMA statement details metabolic, behavioral health, and disordered eating comorbidities associated with obesity in children. It provides clinical information regarding identifying and treating metabolic, behavioral health, and disordered eating comorbidities associated with obesity in children over the 95 th percentile of weight/height for age. This OMA clinical practice statement details metabolic, behavioral health, and disordered eating comorbidities associated with obesity in children and provides an overview of current recommendations. These recommendations lay out a roadmap to the improvement of the health of children and adolescents with obesity, especially those with metabolic, physiological, and psychological complications. 

Metabolic, behavioral health, and disordered eating comorbidities associated with obesity in pediatric patients: An Obesity Medical Association (OMA) Clinical Practice Statement 2022

Sleep is extremely important for the homeostasis of the organism. In recent years, various studies have been carried out to address factors related to sleep patterns and their influence on food choices, as well as on the onset of chronic noncommunicable diseases. The aim of this article is to provide a scientific literature review on the possible role of sleep patterns on eating behavior and the risk of noncommunicable diseases. A search was performed on Medline (PubMed interface) using several keywords (e.g., “Factors Influencing Sleep” OR “Sleep and Chronic Diseases”). Articles published between 2000 and the present date that relate sleep to cyclic metabolic processes and changes in eating behavior were selected. Changes in sleep patterns are increasingly detected today, and these modifications are mainly caused by work and lifestyle conditions as well as a growing dependence on electronic devices. Sleep deprivation and the resultant short sleep duration lead to an increased appetite via an increase in the hunger hormone (ghrelin) and a decrease in the satiety hormone (leptin). Nowadays, sleep is undervalued, and thus often impaired, with consequences for the performance of various body systems. Sleep deprivation alters physiological homeostasis and influences eating behavior as well as the onset of chronic diseases.

/pdf/sleep-patterns-eating-behavior-and-the-risk-of-2u3163ct.pdf

Sleep Patterns, Eating Behavior and the Risk of Noncommunicable Diseases

OBJECTIVE
This study evaluated the severity ratings for anorexia nervosa (AN) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and an alternative severity rating based on overvaluation of weight/shape, on a range of psychological and biological variables.


METHOD
A sample of 312 treatment-seeking patients with AN (mean age = 25.3, SD = 7.6; mean BMI = 16.8 kg/m2 , SD = 2.4) were categorised using both DSM-5 severity levels (mild/moderate/severe/extreme) and weight/shape (low/high) overvaluation. The severity categories were compared on a range of psychological (e.g., eating psychopathology) and biological (e.g., sodium) variables.


RESULTS
Results showed that the overvaluation of weight/shape appeared better at indexing the level of severity in psychological variables among patients with AN compared to the DSM-5 severity rating with moderate to large effect sizes. Moreover, the DSM-5 mild and moderate severity groups experienced significantly higher eating and general psychopathology than the severe and extreme groups. Finally, neither the DSM-5 nor the weight/shape severity groups differed on any of the biological variables.


CONCLUSIONS
This study provided no support for the DSM-5 severity rating for AN, while initial support was found for the weight/shape overvaluation approach in indexing psychological but not biological correlates.

Assessing severity in anorexia nervosa: Do the DSM-5 and an alternative severity rating based on overvaluation of weight and shape severity differ in psychological and biological correlates?

Night eating syndrome (NES) is currently classified as an Other Specified Feeding or Eating Disorder (OSFED) under the Diagnostic Statistical Manual−5 (DSM-5). This systematic review aims to consolidate the studies that describe the sociodemographic, clinical and psychological features of NES in a population of patients with eating disorders (ED), obesity, or those undergoing bariatric surgery, and were published after the publication of the DSM-5. A further aim was to compare, where possible, NES with BED on the aforementioned variables. Lastly, we aimed to appraise the quality of the studies being included in the review. We conducted a systematic search on three databases (MEDLINE, PubMed and Embase) which resulted in the selection of 22 studies for the review. We included the articles that studied patients with NES and their sociodemographic, clinical and psychological features in a clinical (i.e., ED, obese or bariatric surgery) population, through a quantitative study design. Articles were excluded if the NES patients included in the study had a comorbid psychological disorder, and/or the sample was collected from a university/non-clinical population, and/or the study design was qualitative, and/or NES features were compared with any other disorder, except BED. Our study found that no conclusions about the link between any sociodemographic feature (such as, age, gender, income, etc.) and an NES diagnosis could be made. Further, NES patients presented with elevated ED pathology (including emotional eating and loss of control eating) and higher occurrence of depressive symptoms than controls. Contrary to the literature suggesting that NES and Binge Eating Disorder (BED; an ED subtype which is also comorbid with obesity) patients often report overlapping features, questioning the validity of NES as an ED diagnosis, we found that BED can be differentiated from NES by the higher occurrence of emotional eating, body related concerns and abnormal eating episodes. The review also suggested an overlap between NES and Sleep-Related Eating Disorder. We recommend that it is essential to study NES as an independent disorder to further develop its diagnostic criteria and treatment options, thereby, increasing the quality of life of the patients suffering from this syndrome.

/pdf/night-eating-syndrome-in-patients-with-obesity-and-binge-bv15y6h0.pdf

Night Eating Syndrome in Patients With Obesity and Binge Eating Disorder: A Systematic Review

A systematic review and meta-analysis on the DSM–5 severity ratings for eating disorders.

Atypical anorexia nervosa (AAN), purging disorder (PD), night eating syndrome (NES), and subthreshold bulimia nervosa and binge-eating disorder (Sub-BN/BED) are the five categories that comprise the 'Other Specified Feeding or Eating Disorder' (OSFED) category in the Diagnostic and Statistical Manual for Mental Disorders (DSM-5). In this review, we examine problems with the diagnostic criteria that are currently proposed for the five OSFED types. We conclude that the existing diagnostic criteria for OSFED are deficient and fall short of accurately describing the complexity and individuality of those with these eating disorders (EDs). Therefore, to enhance the quality of life of people with OSFED, diagnostic criteria for the condition should be applied uniformly in clinical and research settings. 

There is nothing as inconsistent as the OSFED diagnostic criteria.

ABSTRACTUsing a male eating disorder (ED) sample, this study assessed the clinical utility of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) severity indices for males with anorexia nervosa (AN) and bulimia nervosa (BN) and compared it to an alternative transdiagnostic severity categorisation based on drive for thinness (DT). The participants included 143 males with an ED (60 [42.0%] AN and 83 [58.0%] BN) diagnosis, who were classified using these two severity classifications. The different severity categories were then compared based on ED symptoms, general psychopathology, and personality traits. Our results revealed that the DSM-5 “mild” and DT “low” severity categories were most prevalent in the AN and BN male patients. Clinically significant findings were strongest for the DT categorisation for both AN and BN. The current findings provide initial support for an alternative transdiagnostic DT severity classification for males that may be more clinically meaningful than the DSM-5 severity indices. AcknowledgmentsWe thank the following funding bodiesDisclosure statementNo potential conflict of interest was reported by the author(s).Data availability statementThe datasets generated during and/or analysed during the current study are not publicly available due to ethical restrictions to protect the confidentiality of the participants but are available from the corresponding author on reasonable requests.EthicsAccording to the Declaration of Helsinki, the present study was approved by the Clinical Research Ethics Committee (CEIC) of Bellvitge University Hospital (Ref. PR146/14) and written and signed informed consent was obtained from all participants.Patient consent statementInformed consent was obtained from all individual participants included in the study.Supplementary materialSupplemental data for this article can be accessed online at https://doi.org/10.1080/10640266.2023.2259682Additional informationFunding• Centres de Recerca de Catalunya (CERCA) Programme/Generalitat de Catalunya for institutional support - Ministerio de Economía y Competitividad (PSI2015-68701-R) and Delegación del Gobierno para el Plan Nacional sobre Drogas (2017I067).• Instituto de Salud Carlos III (ISCIII) [Fondo de Investigacion (FIS) PI14/00290 and PI17/01167].• The SLT006/17/00246 grant, funded by the Department of Health of the Generalitat de Catalunya by the call ”Acció instrumental de programes de recerca orientats en l’àmbit de la recerca i la innovació en salut”.• The FEDER funds/European Regional Development Fund (ERDF); a way to build Europe.The Biomedical Research Centre in Physiopathology of Obesity and Nutrition (Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición: CIBERObn) and Centre for Mental Health Network (Centro de Investigación Biomédica en Red de Salud Mental: CIBERSAM) are both initiatives of ISCIII). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.AGP AG is supported by a pre-doctoral Grant of Fundación Carolina and the Secretaría de Relaciones Exteriores de los Estados Unidos Mexicanos (Foreign relations secretary of the United States of Mexico). 

How to assess eating disorder severity in males?The DSM-5 severity index versus severity based on drive for thinness.

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