If a similar endemic involved more explicit physical symptoms, an epidemiological approach would search for a physical or infectious agent as the cause of the malady. Agent X need not be a single substance, but may be a collection of operators in the food supply, affecting susceptible individuals. Agent has the property of triggering compulsive eating associated with aversion to the effects of overeating. The gratification or reward of eating is unmistakable. The model of all want and desire is hunger.
Pleasure has a great deal to do with satisfying hunger.
Our basic drives for food, comfort, love, warmth, and security merge as we try to establish and maintain relationships and a home environment. Eating patterns are important social determinants. Eating together indicates social acceptance and tends to cement social relationships. Many complex food-related transactions emerge in family groups. Implicit food contracts often reflect reward and punishment strategies.