Slippery Slope

June 2013

Week 2

 

 I continue to assessing and documenting my life with NES, always keeping in mind that the struggle is ever present especially in the now.

I am a long way from combating Night Eating Syndrome. I’ve made great strides in accepting that I have this condition and am actively working towards a healthier life and lifestyle. My struggle with this disorder is more prevalent now because I am seeing the reality of it. Writing this blog is a way for me to relieve my mind of some of the facts and feelings associated with this disorder. This is my attempt at taking a stand and be accountable for my actions no matter the root source or the outcome.

I’ve been doing fairly well managing my NES this past year, much better than a few years ago. For the most part, I am able to consume more of my caloric intake before 7pm which is monumental for me. In the past my caloric intake was next to nil during the day. Even though I would start eating around 4:30-5:00pm, I would only take a few bites before hoarded the rest for later.

This week I have been experiencing a little more stress then my norm and I find myself reverting back to some of my old ways. I am picking up on a definitive pattern. The onset of binge eating tends to occur when stress levels are on the rise; daytime appetite decreases rapidly as I fast approach full binge mode, that is, if I’m not careful. Note to self…continue working on managing stress. Can’t stop stressors from occurring, but I can change how I deal with them. There is one good thing in all of this...I am identifying the problems and working towards correcting them. Besides, beating myself up about this is not going to help. Let’s face it, it took more than a day to develop this disorder and it’s certainly going to take more than a day to cure it.

My most recent binge happened a few days ago. I hoarded some food from dinner specifically to consume during late night hours. I was fully aware of what I was doing and proceeded anyway. The urge was strong and I gave into it. I did not want to fight it and possibly cause a bigger binge. That night, I tried several things to relax like playing music or writing. This helped for a while, but I still could not fight the urge to feed before sleeping.  So I did. I consumed the foods designated for my night time feed and then off to sleep I went. The next day, I forgetting to eat breakfast. I did not eat a morsel until about 2:30pm. Not good, but not my worst. Of course eating later in the day throws everything off. I still cooked dinner, but opted to eat much later than my new norm.

The next day, I didn’t eat anything until after 5pm. This is getting very bad. I’m heading towards a bigger binge. I can feel it. I have to get focused and get back on track with my eating. It is imperative. I can’t afford to continue going backwards. I’ve come too far and my health is on the mend. I don’t ever want to get as sick as I was before buckling down to combat this dreaded thing.

Since Friday, my stressful period has calmed and all is well. Yesterday and today I ate breakfast, lunch, dinner and a snack. So far I do not have the urge to binge tonight. I've already put away the left overs from dinner. Now I’ve got to come up with a better strategy for maintaining a healthy eating plan during high stress times. I've really got my work cut out for me with this one.

There are slippery slopes on this journey and last week I slipped pretty hard. But I’m regaining my footing and so onward and upward…one step at a time…one day at a time.

Food: A Link between Discomfort and Dysfunction

Many disorders are born out of dysfunction.

I grew up in a highly dysfunctional family. I'm sure you've heard stories like this before. I was trapped in the middle of my father's absolute control and my mother's need for perfection. An illusion forced upon the meek. On the other side of the door was our audience. No one knew the happenings behind the closed door. No one except a cousin who occasionally saw more than she bargained for.

My parents were entrepreneurs. They owned a barber shop and a convenience store. Dad worked and mom was a homemaker. We had two cars, but only one worked at any given time. My mom in her eternal quest for perfection, would wash and shine both cars so they looked brand new. It didn't matter that her car wasn't drivable as long as it looked good. It was perfectly acceptable that there was no leaving the house without permission. Mom would lobby for cab fair whenever she needed to run errands. She was allotted a small of time to get everything done. There was always a mad dash to clean the house, which was never dirty, run the errands and have dinner ready before dad came home...and then we'd wait. Dinner was never to be served before dad's arrival. Sometimes we'd have to wait for hours.

In the beginning...

Around the age of ten life took another terrible turn. It was at a routine well check where I was deemed obese. A word I had never heard before, but knew it was something bad. I weighed in at 101 pounds. Nothing much was said that day. A few days later a new routine was set. Get up, get ready for school, step on the scale and then breakfast. If a pound or two was gained that potentially earned me a beating before school. If that was the case, mom would apply alcohol and salves to the whelps and cuts, then have me change into long sleeves if necessary.

Meal portions were dramatically shrunken. I was always being hungry. Every evening, my parents would enjoy having desert after dinner. For obvious reasons, I was denied this privilege, but had to remain seated at the table until dinner was done. On weekends dad would bring candy, soda, cakes and chips home from our store. It was a welcomed treat.

An opportunity has arisen. My parent's room was right next to mine. On Saturday nights they'd close the door. Late night in the quiet of dark I'd sneak to the kitchen to steal treats. I had to be fast and always have an alternate plan should one of my parents come out of their room unexpected. There were many areas between the kitchen and my room where I could quickly stash the goods and act as if I had gotten up for a glass of water. Sometimes I'd say a quick prayer in hopes that they not find my wares before going back to bed. A binging hoarder in the making and my hoard...food.

My focus on the consumption food became one of the links between heightened levels of discomfort and dysfunction.

Food is now my enemy and my friend...my fixation.

Where do I begin?

A few years ago I was forced to make some hard decisions about my eating disorder, Night Eating Syndrome (NES).

At present time NES is not in the DSM IV/V.

The three main components identifying NES are Morning Anorexia, Night Binging and Insomnia. There is hope for us. Binge Eating Disorder recently added to the DSM-V under (EDNOS) Eating Disorder Not Otherwise Specified has given way to the possibility of two new additions to the DSM-V, Purging Disorder and NES.

I have been ignoring NES for 25 years. Three years ago my health took a turn for the worse. It quickly became evident that I needed to change my ways or else I would surely die. So I claimed my dirty little secret, frequent night time binges, and began looking into steps I could take to make positive life changes.

First steps toward recovery:

Acknowledge having an eating disorder.
Increase awareness of my own eating patterns. Note how I feel before/during and after meal times.
Identify possible beginning of NES behaviors.
Assess feelings, emotional state and reasoning behind late night eating.
Contact Psychologist to begin work on underlying issues.

No matter if you binged last week, last night or just a few minutes ago, it's not too late to get on the road to recovery.

 

 

Related Articles:

 

Night Eating Syndrome: Should it be Included in the DSM-V 

http://www.psychotherapybrownbag.com/psychotherapy_brown_bag_a/2009/10/night-eating-syndrome-should-it-be-included-in-dsmv.html

 



Night Eating Disorder
http://www.allianceforeatingdisorders.com/night-eating-syndrome

Issues for DSM-V: Night Eating Syndrome
http://ajp.psychiatryonline.org/article.aspx?articleID=99701

What is Night Eating Syndrome?

Night eating syndrome, or NES, also "midnight hunger", is an emerging eating disorder diagnosis, which primarily characterizes an ongoing, persistent pattern of late-night binge eating.^[1][2] NES was originally described by Dr Albert Stunkard in 1955^[3] and is currently proposed for inclusion in the next edition of the Diagnostic and Statistical Manual of Mental Disorders.^[4] The diagnosis is controversial; its validity and clinical utility have been questioned^[5] and there are currently no official diagnostic criteria. - Wikipedia.com

More information on the Characteristics of NES
http://jama.jamanetwork.com/article.aspx?articleid=191250

There are several night time eating disorders listed in varying resources. So while looking up more information you may want to check into these...

Nocturnal Hyperphagia
http://en.wikipedia.org/wiki/Kleine%E2%80%93Levin_syndrome

Nocturnal Eating Disorder
http://en.wikipedia.org/wiki/Nocturnal_sleep-related_eating_disorder

Parasomia (SRED) Sleep Related Eating Disorder (also linked to NED)
http://en.wikipedia.org/wiki/Parasomnia

EDNOS Eating Disorder Not Otherwise Specified

Exert from http://www.eatingdisordersonline.com/explain/ednos.php

According to the Diagnostic and Statistical Manual, 4th Edition there exists a category of eating disorders that do not meet the specific criteria for the two defined disorders, Anorexia Nervosa and Bulimia. When people exhibit behaviors in the spectrum of disordered eating but do not meet all the criteria for Anorexia Nervosa or Bulimia, they are given a diagnosis of an Eating Disorder Not Otherwise Specified (EDNOS). Over one-half to two-thirds of people diagnosed with eating disorders fall into the category of EDNOS. More people are diagnosed with EDNOS than Anorexia Nervosa and Bulimia combined.

Binge Eating Disorder (BED) is the only type of eating disorder under the category of EDNOS. A person meets the definition of having EDNOS if they have exhibit all the criteria for Anorexia Nervosa but have regular menstruation or a normal body weight, or if they exhibit all the criteria for Bulimia but purge less than two times per week or for a duration shorter than three months, or if only small amounts of food are purged, or if a person spits out food rather than swallowing it.

People diagnosed with EDNOS can experience the same negative psychological, social, and physical consequences as a person diagnosed with Anorexia Nervosa or Bulimia. The seriousness of their condition is no different than that for people diagnosed with specific disorders. The only difference is that the person may experience a spectrum of disordered eating behaviors and these behaviors may change over time.

Although BED is the only one of the types of eating disorders categorized under EDNOS, people who are considered to have Sub Therapeutic Anorexia Nervosa or Sub Therapeutic Bulimia are also given a diagnosis of EDNOS. To have Sub Therapeutic Anorexia Nervosa or Bulimia means that a person displays some but not all of the criteria for the full-blown condition.

Read more about EDNOS

Huffington Post
http://www.huffingtonpost.com/2013/01/04/eating-disorders-ednos-dsm-5_n_2398373.html

Wikipedia.com
http://en.wikipedia.org/wiki/Eating_disorder_not_otherwise_specified


Educate yourself

It's going to take some time before NES enters the realm of legitimized eating disorders. In the meantime you will need to education yourself on the subject and take carful not of your relationship with food.

Have your information handy when approaching medical professionals for help. NES is not commonly known or spoken off in general medicine. If your medical professional is not familiar with the term Night Eating Syndrome, you may want to try a couple of the other terms listed with exception the EDNOS which umbrellas only one eating disorder, Binge Eating in the DSM-IV/V.

My Experience

A seemingly lack of interest of the subject has been my experience with medical professionals. Though my concerns duly noted, they are still unaddressed. There is no definitive diagnosis so it is simply put into my file as a general note.

Medical professionals can be rather harsh when dealing with weight related issues. They don't understand for many, "obesity" is a band aid for internalized emotional scars. A self made barrier of protection. Obvious distain for one's heaviness and harsh words do not help the situation.

NES is very real and can be a debilitating disorder. I have lived with NES for 28 years and it has taken me until 3 years ago to figure out ways and strategies to begin helping myself.

I strongly recommend seeking council to help with this process. NES has a root and one of the ways to combat any problem is to find the root source. Having a psychologist to help you strategies your way back to a healthy relationship with food is key.

More Reading Materials about NES

Overcoming Night Eating Syndrome: A Step-By-Step Guide To Breaking The Cycle
by, Kelly C. Allison, PH.D., Albert J. Stunkard, MD, with Sara L. Their

Night Eating Syndrome
by Frederic P. Miller (Editor), Agnes F. Vandome (Editor), John McBrewster (Editor)

Night Eating Syndrome
Research, Assessment, and Treatment
Edited by Jennifer D. Lundgren, Kelly C. Allison, Albert J. Stunkard