Proportion of night eating syndrome in Arab population of Oman



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Night eating syndrome is an eating disorder, characterized by a delayed circadian pattern of food intake.

Night eating syndrome is not the same as binge eating disorder, although individuals with night eating syndrome are often binge eaters. It differs from binge eating in that the amount of food consumed in the evening/night is not necessarily objectively large nor is a loss of control over food intake required. It was originally described by Dr. Albert Stunkard in 1955 and is currently included in the “Other Specified Feeding or Eating Disorder” category of the DSM-5.

Individuals with night eating syndrome feel like they have no control over their eating patterns, and often feel shame and guilt over their condition.

Night eating syndrome affects an estimated 1.5% of the population, and is equally common in men and women, according to the National Institute of Mental Health.



Dear Readers,


Please find below a study on night time eating disorder syndrome (NES) in Oman. NES is an eating disorder which requires effective treatment. If you think someone has Night Eating Syndrome (NES), please seek help immediately.

According to Walden Eating Disorders Treatment, ‘Individuals with night eating syndrome are often obese or overweight, which makes them susceptible to health problems caused by being overweight, including high blood pressure, diabetes and high cholesterol. Those who are obese increase their risk of heart diseases, many types of cancer and gallbladder disease.

Individuals with night eating syndrome often have a history of substance abuse, and may also suffer from depression. They typically report being more depressed at night. They also frequently have sleep disorders.’


Proportion of night eating syndrome in Arab population of Oman




  • Fahad Zadjali   Email author,
  • Aaisha Al-Bulushi,
  • Fatma AlHassani and
  • Mustafa Al Hinai
Journal of Eating Disorders20153:43

Received: 11 November 2015

Accepted: 15 November 2015

Published: 25 November 2015




Globally obesity has reached epidemic proportions with alarming rates in the Arabian Gulf countries. The impact of behavioral eating habits and in particular night eating syndrome (NES) have not been emphasized in the region. This study assessed the proportion of NES in an Omani Arab adult population sample.


A night eating syndrome questionnaire (NEQ) was distributed to Omani adults above the age of 20.


Out of the 454 respondents, 26.4 % endorsed evening hyperphagia while nocturnal ingestion was present in 4.7 % of the respondents. In addition, 1.5 % of the respondents met the NES criteria.

Conclusions and implications

The proportion of NES in Omani adult population is similar to the reported rates in general world populations. In conclusion, night eating syndrome is present in the Omani Arab adults and should be taken into account in national management for increased obesity trends in the region.


Night eatingObesityMiddle EastEvening hyperphagia

Obesity is a condition of high morbidity and a major concern in the Arabian Gulf region with prevalence ranging between 15 and 48 % in adults [123] and 20.5 % in Oman [4]. The rising trend of obesity leads to social and economical challenge to the Omani government.

Night eating syndrome (NES) is an example of delayed circadian intake of food that was first noted in obese individuals [5]. It is mainly characterized by evening hyperphagia and nocturnal awakening with ingestion of food. The estimated prevalence of night eating syndrome in the general population is 1.5 %, 15 % among obese individuals and 42 % among morbid obese individuals [67]. The extent of NES in the Middle East region has not been studied. The purpose of this study is to estimate the proportion of NES in a general Omani adult population sample.


A previously published and validated NES questionnaire (NEQ) was used to assess night eating [8]. Questions were divided into 4–5 Likert scales and both Arabic and English translations were provided (Table 1). The NEQ was distributed online to staff and students of Sultan Qaboos University. Respondent were selected based on age ≥ 20 years and Omani nationality. The study protocol was approved by the University ethics committee (code: MREC#632). Data were analyzed using SPSS software (version 19) and questions were tested for internal validity using Cronbach’S alpha test with item deletion.

Table 1

Items of night eating syndrome questionnaires (NEQ)

Item #



How often do you feel that you eating at night more than morning and afternoon?


When was your first meal in the day?


How is your appetite in the morning?


Do you have trouble in getting into sleep?


Number of times per night you get awake while sleeping.


Do you eat when you wake up at night?


Do you eat to make yourself sleepy before bedtime?


Do you control your eating in the evening time?


Out of 454 responded-participants (mean age 33 ± 5), 231 (50.9 %) were men and 223 (49.1 %) were women. The NEQ has a maximum score of 35 and individuals with night eating syndrome were defined using the standard NEQ cut-off point of 25 and a trend toward NES when NEQ score is between 20 and 24 [9]. Cronbach’s alpha reliability for the total scale was 0.5.

The average score of NEQ was 17.3 ± 3.2 in the study population. Seven individuals met the criteria of NES (1.5 %, 95 % C.I: 0.8–3.2) and 92 individuals (20.3 %, 95 % C.I: 16.8–24.2) showed a trend toward NES. There was no significant gender difference between the NES groups (Chi-square P-value 0.326). Proportion of NES was higher in men (2.2 %) compared to 0.9 % in women. Based on self-report from the NEQ, 26.4 % of the sample endorsed evening hyperphagia while nocturnal ingestion was present in 4.7 % of the respondents. Morning anorexia was present in 26 % of the respondents.


This study assessed night eating syndrome among Omani adults using an online version of the NEQ. Within the study population, 1.5 % met criteria for night eating syndrome, which is similar to international general population prevalence of 0.5–1.5 % [6].

The high prevalence of overweight and obesity among Arab countries is attributed to multiple factors including rapid nutrition transition, high socioeconomic status, physical inactivity and genetic admixtures [1011]. Eating behavior and circadian rhythm are proving to be important factors in the etiology of obesity. In obese individuals NES is more frequent and the majority of patients undergoing bariatric surgery may have NES [6]. Inclusion of self reported body mass index was a limitation in the study and association between NES and obesity was not assessed. This limitation suggests the need for further exploration of the NES in both obese and non-obese individuals in Arabs.

In conclusion, the proportion of night eating syndrome in Omani adults is similar to its prevalence in general population. Night eating syndrome maybe preventable among obese patient and it should be considered in management of obesity.


Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.


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© Zadjali et al. 2015

Treating Night Eating Syndrome

As with other eating disorders, successful treatment of night eating syndrome typically requires a combination of therapies.

Treatment for night eating syndrome typically begins with educating patients about their condition, so they are more aware of their eating patterns and can begin to identify triggers that influence how they eat. Just identifying that they have night eating syndrome and that it is not their fault can be an important first step toward recovery.

Treatment of night eating syndrome also includes nutrition assessment and therapy, exercise physiology, and an integration of cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), interpersonal therapy (IT) and stress management. An additional online component may also help patients gain control over their disorders.

It is important for individuals with night eating syndrome to change their behavior by changing their beliefs. If they believe that they are powerless to change the way they eat, they will not be able to change.

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Islam and Eating Disorders founded in 2012 – run by Maha Khan, the blog creates awareness of Eating Disorders in the Muslim world, offers information and support for sufferers and their loved ones.

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