Binge eating, disinhibition and obesity

Obese individuals, especially those who are morbidly obese, are more likely to binge-eat and to have Disinhibition, as measured by the Three Factor Eating Questionnaire of Stunkard and Messick (1985). The latter characterises very opportunistic eating behaviour and signifies a readiness to eat. We argue in this chapter that binge eating and Disinhibition are deeply adaptive as 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, with improved food security in industrialized nations and the emergence of obesity at the population level, that they have become maladaptive in terms of health outcomes, and have been medically pathologized. Binge-eating and Disinhibition are no longer responses to uncertainty in food availability has they would have been in the evolutionary past. Rather, there may be other types of uncertainty and insecurity that lead to Disinhibition, binge-eating and obesity, and clinical practice should perhaps turn to examining these as higher-level factors that structure health and illness. These would include stress at work and in everyday lif