Plenty of people enjoy a midnight snack now and then. But if you often feel a strong urge to raid the refrigerator well after dinner is done, you could be experiencing an eating disorder known as night eating syndrome (NES).

If you have NES, you regularly overeat before bedtime or in the middle of the night. You may wake up and think, “I’ll never get back to sleep if I don’t eat something.” You feel ashamed of your nighttime binge in the morning, but since you’re full, you skip breakfast. At night, the cycle may start all over again.

“The more it happens, the more you are programming your brain to get up in the night and eat,” says Sondra Kronberg, MS, RD, director of the Eating Disorder Treatment Collaborative's outpatient program F.E.E.D. in Jericho, New York. Kronberg is also a spokesperson for the National Eating Disorders Association, a national non-profit organization.

Related: How to Get Help for Out-of-Control Eating

Do you have night eating syndrome?

To figure it out, Kronberg says it helps to pay close attention to how you feel about your food, weight and body.

“You may have late night snacks and feel fine,” she says, “but if it creates turmoil and conflict in your life and you have disdain for yourself, that’s often a sign that you have an eating disorder.”

Here’s what a NES diagnosis usually involves, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, the leading reference for people in the field of mental health):

  1. You regularly eat late at night, either after dinner or in the middle of the night. (Usually this means getting at least 25 percent of your daily calories after dinner.)
  2. You are aware you are eating a lot late at night (as opposed to sleep-related eating disorder, in which you are often unaware of your nighttime eating).
  3. The eating is causing you distress.

Related: Are You Sleep-Eating Without Knowing It?

Researchers have also developed a brief Night Eating Questionnaire to help in diagnosing NES.

According to the National Institute of Mental Health (NIMH), just over 1 in 100 Americans have night eating syndrome. It’s more common than anorexia or bulimia and appears to affect women and men equally.

What’s behind night eating syndrome

If you have night eating syndrome, your hormones may be partly to blame. Experts have found that people with NES may have increased levels of cortisol (the stress hormone) throughout the day and lower than average levels of melatonin (which helps us sleep) and leptin (which keeps us from feeling hungry) at night.

If you suffer from insomnia, depression or substance abuse, you’re more likely to have NES, according to a 2015 article published in the Neuropsychiatric Disease and Treatment journal.

Some experts worry that college students are at increased risk, but Kronberg points out that it is hard to distinguish between common college student behaviors — such as drinking, staying up late and eating late — and eating disorders. “Lots of people binge and eat late at night in college, but the ones who are genetically predisposed to eating disorders are going to carry that forward in their lives after college, while others can just move on,” Kronberg says.

How to get help

You can start by calling the National Eating Disorders Association hotline. Its volunteers provide confidential counseling and support. “The first step is to become more aware of the behavior and decide to change it,” says Kronberg.

Experts usually recommend a collaborative treatment approach that involves a therapist, a nutritionist and a medical doctor. It usually includes:

Nutrition support. “Treatment usually starts by making sure you are eating right during the day, getting enough nutrition, so you aren’t craving and deficient at night,” says Kronberg.

Therapy. Cognitive behavioral therapy (CBT) may help you change your eating patterns and interrupt thoughts that link night eating to sleep, according to Kronberg. Strategies include journaling, writing down all the foods you eat, meditating, exercising and improving your sleeping environment. Often small changes in your habits can help you overcome the urge to binge at night.

Psychotherapy can also help you identify underlying traumas that might be causing you the night binging. “There’s usually a psychological and emotional component that therapy can help uncover,” according to Kronberg.

Medication. If your doctor thinks medication is in order, you may be prescribed an antidepressant, specifically, a selective serotonin reuptake inhibitor (SSRI). “We often recommend SSRIs, or antidepressants,” notes Kronberg, “but that alone won’t do it.” Studies show these medications help only when they’re combined with other treatments, she notes.

Related: Could Your Son Have an Eating Disorder?

Mary Purcell is a freelance writer and health researcher in Piedmont, Calif., with expertise in policy analysis. She has a master's degree in Latin American studies from Georgetown University.