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Monday, December 22, 2014

History of the Night Eating Syndrome. Part 2

Posted by William on April 6, 2012

At the time the first paper on the night eating syndrome was published, in 1955, there was no concept of eating disorders and such a concept did not arise for more than 25 years. Before that, diagnosis was poorly regarded in the field of psychiatry, particularly by the psychoanalysts, as exemplified by Karl Menninger whose 1962 book, “The Vital Balance,” proposed that all diagnosis in psychiatry be done away with.

With the waning influence of psychoanalysis, interest in diagnosis increased, an increase that can be measured by the mounting number of disorders in the successive editions of the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association. It was the publication of Russell’s 1979 paper on “bulimia nervosa” that provided the impetus for the designation of eating disorders as a special group (Psychological Medicine 1979; 9:429–448). This disorder, the cardinal features of which were vomiting following a binge, in order to prevent weight gain, was introduced with the proposition that it was very resistant to treatment. The importance of diagnosis is illustrated by the fact that, within two years of the publication of Russell’s paper, there were three successful reports of the treatment of bulimia nervosa. Subsequent years have seen an explosion of research on treatment, which has become increasingly effective. Russell’s report awakened interest in eating disorders but none that involved obesity. For many years, eating disorders meant anorexia nervosa and bulimia nervosa.

In recent years “binge eating disorder” has been proposed to describe persons who binge but do not engage in compensatory behaviors, such as vomiting, to control their body weight. This disorder has not been accepted as a diagnosis in the Diagnostic and Statistical Manual.

During this time progress was made in our understanding of the night eating syndrome, although it, too, has not been accepted into the Diagnostic and Statistical Manual. Most studies of the night eating syndrome have attempted to determine the prevalence of the disorder, which, as noted above, is far more common than the recognized eating disorders. Recruiting for a study of binge eating disorder allowed us to determine for the first time the relative frequency of the two disorders (binge eating disorder and the night eating syndrome) (Stunkard et al, International Journal of Obesity, 1996; 20:1–6). In this sample, self selected as it was for binge eating disorder, this disorder was somewhat more prevalent (20 percent) than was the night eating syndrome (14 percent).

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