Binge Eating, Disinhibition and Obesity

Abstract

Obese individuals, especially those who are morbidly obese, are more likely to binge-eat and to express disinhibition, a trait which characterizes very opportunistic eating behaviour and signifies a constant readiness to eat. We argue in this chapter that binge eating and disinhibition are evolved mechanisms for dealing with one of the most fundamental of insecurities, that of food, especially in seasonal and unpredictable environments. It is only in recent decades in industrialized nations, with improved food security and the emergence of obesity at the population level, that such mechanisms have become detrimental in terms of health outcomes and have been medically pathologized. Binge eating and disinhibition are no longer responses to uncertainty in food availability as they would have been across evolutionary history, or in parts of the world where there continues to be food insecurity. Rather, there may be other types of uncertainty and insecurity that lead to disinhibited eating and binge eating as evolutionarily based responses to stress which can lead to obesity, and there is scope for clinical practice to give greater emphasis to such responses as higher-level factors that structure health and illness. These would include stress-inducing factors at work and in everyday life.