I have the problem of night eating disorder. I went to therapy for seven weeks, and the problem seemed to lessen, but I am afraid that it is coming back again. I am not even hungry when I eat. I just wake up in the middle of the night and go to the kitchen for food. What can I do to stop this?

Connie

It usually takes much longer than seven weeks for people to work through the multiple issues that are involved in eating disorders or other serious emotional or behavioral conditions. Before I make any further comments or suggestions, I must mention that your best course of action is probably to return to your previous therapist to continue the process you began, which seemed to be successful.

Unfortunately, these days managed care companies and HMOs press for brief therapy, which may address some symptoms but not resolve underlying factors contributing to the conditions or problems. It's kind of like someone taking antibiotics until they don't feel sick anymore, and then stopping before completing the entire medication regimen as prescribed. The illness may be subdued (but not eradicated), lie quiescent for awhile, and then be reactivated or triggered by physical or emotional stress. Where physical illness is involved, the re-emergence of the illness usually occurs when some form of stress suppresses the immune system. In emotional or psychological conditions, the problems can arise again when physical or emotional stressors overwhelm the individual's usual coping skills.

In your case, you might want to think back on when your night-eating originally started, or when it worsened to the point that you first sought therapy. What was going on in your life, and with you, at that time? What were the stressors in your life? What were your daytime eating habits and your attitude toward eating and weight? You could also think back on your previous therapy, see if you can identify what might have helped lessen your night-eating then, and put that back into effect if you've veered away from it.

Many people who engage in night-eating have been restricting what they eat during the daytime in attempts to control their weight. Making sure to eat more during the day, or having an evening snack, can alleviate hunger-related night-eating.

Night-eating may also stem from anxiety or suppressed feelings that surface at night when the person is not occupied by other activities. In such cases the eating may be the body's attempt to ingest material that can be transformed into soothing or calming neurotransmitters. Writing in a journal at night, when you go to the kitchen to eat, might be a way of identifying emotional or psychological issues that you could later address in the light of day.