Narcolepsy and Eating Disorders

Narcolepsy consists of the well-known features of daytime sleepiness and cataplexy. A common but lesser known part of the syndrome is weight gain. Back in the 1930s, an early researcher reported that 57% of his patients with narcolepsy were also overweight or obese (Medicine 1934; 13:1). Compared to the general population, narcoleptic patients have a clear increase in body mass index (BMI, kg/m2) and preferential storage of fat in the abdomen (Eur Arch Psychiatry Clin Neurosci 2001; 251:85).

Identifying abnormal night eating

Identifying abnormal nocturnal eating is critically important for patient care and for public health as well. Carlos H. Schenck, MD, and M.J.
Howell, MD, of the University of Minnesota Medical School, Minneapolis, recently reported that two conditions break the nighttime fast pattern and are associated with weight gain as well as medical and neuropsychiatric comorbidities (Curr Treat Options Neural 2009; 11:333).

Sleep-related eating disorder is characterized by isolated instances of nocturnal eating, whereas the night-eating syndrome is a circadian delay in meal timing, which leads to evening hyperphagia, nocturnal eating, and morning anorexia. Both conditions are treatable and are potentially reversible forms of obesity. For sleep-related eating disorder, the antiseizure medication topiramate and dopamineragic agents have both shown promising results, and nocturnal eating associated with NES has responded well to the antidepressant sertraline.