Obesity results from persistent failure by the brain to balance food intake with energy needs, resulting in a state of chronic energy surplus. Although there are many factors that predispose individuals to weight gain and obesity, the current review focuses on two ways eating behavior may be influenced by sensitivity to interoceptive signals of hunger, satiety, and metabolic energy reserves. First, obesity may be related to hypersensitivity to interoceptive signals of hunger, leading to positive alliesthesia for food cues that undermine attempts to change unhealthy eating behaviors. Second, overeating and obesity may arise from an inability to accurately detect interoceptive signals of satiety and positive energy balance. The findings reviewed herein demonstrate that obesity may be related to altered interoception, and warrant the continued development of novel obesity interventions aimed at promoting interoceptive awareness.