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Chewing and Spitting: Having Your Cake and Eating it Too?
By Trisha Gura

In the HBO documentary, “Thin,” a fly-on-the-wall look at four patients checked into an eating-disorder clinic, one of them, Brittany, 15, tells her secret ritual: chewing and spitting. She and her mother would buy bags of candy, chew it, taste it and spit it out before swallowing. To Brittany, these episodes were nostalgic mother-daughter moments. The teen was bonding to her mother, who, not surprisingly, also has an eating disorder.

Brittany is by no means alone. Numerous bloggers (see below)
are lamenting similar experiences. These girls and women latch onto what appears to be a newfound thinness gimmick only to agonize when it backfires: they gain weight anyway, suffer gastrointestinal problems, and ultimately, fall into or back upon eating disorders, anorexia, bulimia, and a hodge-podge of symptoms labeled “eating disorder not otherwise specified” (Steve, link these terms to my dictionary).

What is it?
Chewing and spitting out food is an old eating-disordered behavior only now coming to light. It’s the latest trend in eating disorders, not because the behavior is new, rather because the online community is rapidly passing around the secret around. The mechanism is simple: a person who chews and spits puts food in his or her mouth, tastes it, chews it and then spits it out without swallowing in the hopes of getting some enjoyment out of food, while not having to suffer the weight-gain consequences.

Is it an eating disorder?
Some experts say, yes. Others say, no. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the proverbial Bible of psychiatric illness, does not list “spitting and chewing” as a separate, diagnosable eating disorder.

Yet, chewing and spitting is nonetheless part of the eating disorder landscape. That is because chewing and spitting is a misguided calorie-control technique, a “food issue.” Individuals with true eating disorders -- anorexia, bulimia and eating-disorder-not-otherwise-specified – use the technique in a creative attempt to have one’s cake and eat it too. Sort of.

Is it harmful?
Absolutely. Here are four good reasons.

1. A person who chews and spits is not allowing essential nutrients into the body. Therefore, the behavior is akin to starvation dieting and/or purging by vomiting.

2. Ulcers (because food in the mouth triggers acid release in the stomach) and jaw pain are in possibly in store for regular chewers and spitters.

3. Weight gain, not weight loss is the most likely consequence. The body reacts in unforeseen ways to continual chewing and spitting. Seeing, smelling, hearing about and even the hint of food can trigger the release of insulin. This hormone regulates blood sugar and is a major player in diabetes. Tasting food releases salivary enzymes and also triggers the release of insulin. Excess insulin is a dieter’s worst nightmare, because the hormone stirs appetite, making a person feel hungrier, wanting to chew and spit more. Here lies the addiction to chewing and spitting, which like bingeing and purging can be daunting to try and quit. Heightened appetite also triggers eventual weight gain, something easily evidenced by simply reading the bloggers’ laments. If a person chews and spits long enough, they can fall into a state hyper-insulinemia, producing too much insulin, which sets him or her up for insulin resistance, metabolic syndrome, and eventually diabetes.

Finally, a person who chews and spits is probably harboring deeper fears about his or her weight and body image. These fears-- and all preoccupations with thinness and dieting-- are the foundation of all eating disorders. If you chew and spit, you are setting yourself up for a serious disorder later in life.


How do I get healthy?
The first step is to admit that chewing and spitting is neither a fun game, a secret trick to stay thin, nor a mother-daughter bonding experience. Eating disorders get passed down to children, in part, by modeling. So stop the behaviors with you.

Seek help. To be healthy, you are going to need to face your deeper fears about weight and body image and that is not easy.

But rest assured, you are not alone. Eating disorder experts and the medical community are fast onto this new trend, searching for ways to best help those who are in trouble.

Remember most of all that it is your mind, your body and your life to live. You can take charge.

Blogs Covering "Spitting and Chewing"

http://www.findingbalance.com/interact/panel/answer.asp?ID=217

http://fishyvb.something-fishy.org/showthread.php?t=493

http://www.vegsource.com/talk/eatingissues/messages/7617.html

Copyright (C) 2007 Trisha Gura, Ph.D. www.trishagura.com

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