Night eating syndrome as a metabolic-inflammatory disorder: comprehensive phenotyping through a cross-sectional analytical study in middle eastern young adults

Abstract Background Night Eating Syndrome (NES) is characterized by evening hyperphagia and eating at night and has important metabolic and psychological implications. Despite growing clinical awareness, extensive research that integrates appetite-regulating and stress hormones, metabolic and inflammatory markers, is still limited. This study examined appetite-regulating and stress hormone concentrations, metabolic-inflammatory status, body composition, psychological, and behavioral characteristics of NES in treatment-seeking Middle Eastern adults. Methods Eighty adults (median age 21 years; 85% female) presenting with nocturnal eating concerns underwent body composition analysis, fasting biochemical assays, 24-hour dietary recall, and validated Arabic questionnaires. Based on a Night Eating Questionnaire score of ≥ 25, participants were classified into the NES screening-positive group ( n = 38, 47.5%) or the comparison group ( n = 42, 52.5%). Mann–Whitney U tests compared groups, with Benjamini–Hochberg false-discovery-rate correction applied within conceptually related families of comparisons; exploratory binary logistic regression identified independently associated factors. Results Participants screening positive for NES had higher body mass index (27.80 vs. 20.65 kg/m²), visceral fat level (14.00 vs. 6.50), leptin (+ 52%), insulin (+ 50%), estimated insulin resistance (+ 39%), C-reactive protein (+ 58%), and interleukin-6 (+ 51%) than the comparison group (all multiplicity-adjusted p ≤ 0.039). Median depression, anxiety, stress, emotional-eating, and insomnia-severity scores were higher in the NES screening-positive group than in the comparison group (all multiplicity-adjusted p ≤ 0.002). Exploratory multivariable analysis identified emotional eating, smoking, body mass index, insomnia severity, and depressive-symptom severity as factors independently associated with NES screening status. Conclusions Screening-positive NES status was associated with behavioral and psychological characteristics alongside metabolic and inflammatory differences; however, the cross-sectional design does not establish causality or temporal ordering. The observed metabolic differences in this young cohort support the importance of early clinical assessment and longitudinal investigation. The findings support further evaluation of integrated approaches addressing emotional eating, smoking, sleep disturbances, depressive symptoms, and metabolic health in Middle Eastern clinical populations.