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About Night eating syndrome

a. The characteristics of this syndrome

The syndrome is characterized by the following symptoms:

- Lack of eating in the morning (morning anorexia).

- Depressive feelings or low mood level during daytime, sometimes even typical depression.

- Difficulties of falling to sleep. Staying wake at night.

- Agitation and restlessness during night. 

- Night eating, often as much as 4 times each night, and usually of carbohydrate-rich food (sugar and satrch).

- Sleeping between each eating session. Each eating session makes it easier for the person to fall to sleep, but the sleep only lasts as long as there is an elevated level of carbohydrates in the blood.

- The eating pattern result in half or more of the intake of food occure between dinner and the morning.

- The eating pattern often result in a greater than normal food intake during a 24 hour's time, but the total food intake is not extreme, as for example by binge eating.

- The eating pattern is often followed by feeling of guilt in the day-time.

- The pattern must persist for at least 2 months before the diagnosis night eating syndrome is appropriate.


b. The physiological mechanisms and causes of night eating syndrome

People suffering from this disease have constantly an elevated level of the stress hormone cortisol. They have a reduced level of the hormone melatonine necessary for normal sleep. They also have less of the hunger-reducing hormone leptin during night.

10 % of of obese persons seem to be suffering from night eating syndrome, but not everyone suffering from this syndrome is over-weight.

The origine of the syndrome may be a prolonged elevated stress,  and an abnormal way of reacting to stress.

Since the syndrome includes a strong habit pattern, the different parts of the habit pattern may enforce each other and make the condition persist. Not eating breakfast in the morning, results in reduced blood sugar levels with subsequent depressive feelings, restlessness and fatigue. And ten the eating of carbohydrate rich food will result in an excessively elevated blood sugar level that falls rapidly again with new attcks of low mood, fatigue and restlessness.


c. Treatment of night eating syndrome

Since persons suffering from this disease have an elevated level of cortisol, a hormone produced by the adrenal medulla, a possible specific organic reason for this elevated level should be searched for, and if found treated.

Since a stress pattern often is an important element of the cause, the measures to reduce the dayly stress levels probably will help against the condition.

- Factors or conditions making stress at work or in family life should be eliminated.

- Psychological councelling may be of help.

- Since the syndrome includes a strong habit pattern, one should try to break this pattern. It is difficult to change habits when the reason behind the habist are fundamental physiological patterns. However, one can still manage to do something in that direction.  Allways eating breakfast in the morning can be a good beginning of new and better habits.

- A habit of regular training, for example jogging or swimming, often reduces the stress levels, and makes it easier to fall to sleep in the night.

- A supplement of the amino acid Tryptophan may elevate the level of melatonine and make a person sleep better.

- Dayly meditation has shown to reduce stress, and may help.

- One should try to eat food with a low glycemic index. This is food that causes a slow elevation of the blood sugar, and then causes the blood sugar level to be stable for a long time. The food shall not contain refined sugar or starch. It should contain all necessary nutrients, including proteins, fat and slowly absorbable carbohydrates. Such food are: Full corn bread or cereals, fish, seafood, vegetables, poultry, lean meat and  fruit without added sugar or fat. Also drink water and to some extend pure juices.


What about all those diets out there - what is a good diet cure?

You can find a plethorea of weight loss diets on the market or solicitated from weight loss experts or gurus. These diets can be grouped in four cathegories:

- Those simply not working; 

- Those not working and dangerous to your helath;

- Those that are effective but will hurt your health at the same time;

-  Those working and are good for your health.

All the diets that are effective and good for your health in some way or another help you to gain full controle of the amount of food and the type of food you take in, and of other aspects of your lifestyle, like your theraining and activity level.

It is simply not possible to loose weight without first gaining full controle of your lifestyle habits. Some supplements and tricks can help, but you must also consider your lifestyle and chenge it the right way. A good diet cure will learn you new and better over-all lifestyle habits. Other characteristics of good diet cures are the following:

- They allow you to get enough protein, vitamins and minerals each day.

- They regulate the amount of fat, the amount of carbohydrates or both that you take inn each day.

- They contain however some amount of both fat and carbohydrates each day since you need some of these nutrients.

- They allow you to eat 3- 5 times each day, so that you do not starve.

- They allow you to eat a varied mixture of food types, they do not base a good prortion of the food intake upon just a narrow category of tood types or only one food type.

- They prescibe natural food that has not been heavily processed.

Types of weight reduction programs to stear away from

There are a lot of weight reduction programs on the market that can make you loose weight fast in the short run, but can make sick too and that often will make you gain even more weight once the slimming program is over. Here are a list of some particularities often found in such programs:

- The program is based on days or periods with plain starving.

- The program is based on a period where you mostly eat only one sort of food.

- The program is based on skipping of meals, eventually with consuming some zero-calory concentrate instead of meals.

. The porgram is based on consuming food with only proteins and no carbohydrates and fat.

- Zero fat programs or zero carbohydrate programs. It might be useful to try out consuming less carbohydrates and more fat, or less fat and ome more carbohydrates, but zero consume of either fat or carbohtdrates is not good.

About Weight Loss Surgery

Surgery to achieve weight loss is only done when diet, exercize and medications have not given the wanted result after long time and the person has so much excessive fat that it threatens the life, or makes him severely handicapped.

Candidates for this type of surgery must according to traditional criteria either have a BMI (body mass index) of 40 when the obesity does not yet have created serious complications. If the obesity allready gives complication, surgery will often be done with a BMI of 35 or more. There is however a movement to perform this type of surgery for patients with a BMI down to 30.

Such surgery gives the result by restricting physically the amount of uptake of nutrients from the intestines, which can be done either by hindering the patient to consume as much food as before or by hindering much of the nutrients taken in by mouth from being taken up from the digestive tract.

Gastric banding surgery

By this method an adjustable ring is mounted around the upper part of the stomach ventricle that restricts the passage of food. The surgery is easy to perform, is usually done with a minimally invasive approach through small holes, can be reversed and requires short hospital stay.

After the surgery the patient is able to eat only slowly so that the total amount eaten each day diminishes greatly. The slow rate of food intake also gives hormons signalling satiety time to work before the stomach is full.

Gastric sleeve surgery

By this method one cuts away a great portion of the stomach ventricle from that part where the esophagus goes in and the small intestine goes out. This part is sewn togeather so that it resembles a tube. The part cut loose, is usualy taken out.

After the surgery the patient will be able only to eat small meals, but he also must eat some more meals a day than before. The small intestine will however keep its full capacity to take up nutrients.

Gastric bypass surgery

By this method one separates the upper part of the stomach ventricle from the rest of the stomach. This upper parte is then connected into the samall intestine a long way further down. This creates an Y-structure. One arm of the Y goes up to the stomach ventricle. No food will pass through this arm, but the secretes from the liver will be delivered through it down to the rest of the small intestine. The other arm of the structure is the connection up to the upper stomach part and esophagus.

After this most of the ventricle and the upper portion of the small intestine will stay separated from the rest of the digestive tract, but can be reconnected again if wanted.

After this surgery, the patient will only have a small ventricle volume he can fill during meals and the space for uptake of nutrients will also be reduced.

Special care after surgery

Since the digestive system has less ability to take up nutrients after these types of surgery, the patient must live on a diet rich in protein, vitamins and minerals. He must take an extra supply of vitamins and minerals, and especially vitamin B12. He must also eat more often each day to get the amount of food and water he needs.

Adverse effects and dangesr of weight loss surgery

The changes in the stomach ventricle will of cource be uncomfortable to the patient, because he cannot eat so much as before. There is also the danger that he will be able to eat only too little, othat he looses more weight than wanted.

The manipulations of the small intestine have the advantage that the patient can eat as before. However, it can cause too less of vital nutrients to be absorbed, like minerals and vitamins. The absorbtion capacity can also get so low that he looses too much weight. By hard physical activity in warm weather, the patient can also get severely dehydrated because he absobes too little of the fluid he consumes.

The patient can also get into the situation that he must eat unplesantly great amount of food to get all the nutrients needed.

These statements have not been evaluated by the Food and Drug Administration. This information is nutritional in nature and should not be construed as medical advice. This notice is required by the Federal Food, Drug and Cosmetic Act.