When do you stop eating? When you're full or when you feel like it?

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Do you know when you are full? And if you do, do you stop eating or try and stuff a little more in? I know when its time for me to stop eating and I'm always good about stopping. But i've seen people that are almost a thousand lbs. I think its sad but I just wonder how some one could let themselves get that far out of control with eating. It's one thing to be over weight, but to almost eat yourself to death is almost suicide