Conditioning processes and cue exposure in the modification of excessive eating

Excessive eating is one of the principal characteristics of bulimia. Eating more than intended is also a prominent feature both of obese people who are trying to lose weight and normal weight women who are attempting to restrict their food intake. Overeating tends to be triggered by a specific set of cues, which commonly involve either mood disturbances or exposure to "forbidden" food, but may include other environmental cues. It is argued that conditioning processes are relevant both to the establishment of meal patterns in normal subjects and in the maintenance of excessive eating. Treatment procedures have typically followed the general approach of "Self Management" which emphasises reducing exposure to the cues associated with eating. An alternative approach derives from the idea that the association between eating responses (or urges to eat) and external cues may be learned, and therefore should in principle be ameanable to extinction through systematic unreinforced exposure. In this article the possible mechanisms of cue-induced overeating are discussed and the potential utility of cue exposure techniques for the management of excessive eating evaluated.