Taking Steps Toward a Consensus on Night Eating Syndrome Diagnostic Criteria

Night eating syndrome (NES) is included in the Diagnostic and Statistical Manual for Mental Disorders, 5th edition, as an example of "Other Specified Feeding or Eating Disorders" with minimal guidance about how to define and operationalize NES. The literature suggests that research practices vary widely, making it difficult to draw conclusions about the public health burden of, effective interventions for, or policy implications relevant to NES. This Forum article seeks to illustrate the lack of definitional agreement to underscore the need for a consensus about NES diagnostic criteria, and to propose steps toward closing knowledge gaps and achieving consensus.

We searched PubMed and PsycINFO titles and abstracts, using "NES" as the search term, for research articles published in English between January 1, 2013 to August 12, 2024 with sample sizes of NES > 10 and ages 18 or older. Eligible articles were coded for NES definitions and assessment method used to diagnose participants with NES and for information about comorbidity of NES and any other eating disorder (ED).

Seventy-three articles met inclusion criteria. Most commonly, NES was diagnosed using a diagnostic criteria set (35/73) or a symptom score threshold (34/73); among the former, only eight studies employed DSM-5 NES criteria. Thirteen studies, varying widely in methodology, examined comorbidity with other EDs, most commonly binge-eating disorder where comorbidity was high.

Heterogeneity of definitions and assessment impede progress in the study of NES. We propose strategies for developing a consensus definition and addressing research gaps.