Those who use eating as a pseudo-solution for personal problems share an inability to identify hunger properly and distinguish it from other kinds of bodily needs or emotional excitement. It is impossible to control a function or a need if you are unaware of it. During compulsive eating, patients feel driven to eat against their will. They even eat food which they normally dislike. They don't experience hunger, enjoyment or satisfaction with this kind of eating. They do get a temporary relief from their inner feelings of anxiety or depression which they have mistakenly perceived as "a need to eat", but this satisfaction is short-lived and the cycle of "not feeling well" and eating without satisfying their real needs repeats endlessly.

The idea that an instinct or urge as basic as hunger is not automatic from birth, but must be learned in order to be managed effectively, was initially surprising. However, when a strict distinction was made between the psychological action to consciously feel this need as "hunger", and genuine hunger, the importance of this learning process was realized.