There were the "bad" foods that I considered "off-limits." Candies, cakes, donuts, cookies, ice cream, white bread, sugared cereals, crackers, juice, soda, smoothies, granola bars, pretzels, brownies, waffles, pancakes, anything rich or carby or satiating. Denying myself these foods was easy for a while; dieting provided intense feelings of power and elation. But I'm going to beat the proverbial dead horse and reiterate what so many of us have already heard: diets don't work.

Soon, my cravings for carbs became overwhelming, especially since I'm extremely active. During my heaviest times of restriction, I was running upwards of 50 miles a week. I would bake sweets, but not eat them. I would look up recipes for elaborate pies and cakes and pastries, fantasizing about eating them. Soon, I discovered something called Chewing and Spitting, or CHSP, which I now know is a classic sign of disordered eating. I reasoned that I could let myself taste something good, but I couldn't let myself swallow it. This isn't a lovely behavior to write about, much less engage in, but it needs to be said. There were times in college when I would lock myself in my dorm room, slowly chewing and spitting a bag of cookies, or bagels, or cereal. This cost me a lot of money, a lot of time, and a lot of shame.

For some, chewing and spitting is a a symptom of an eating disorder such as anorexia or bulimia. For others, it is an obsessive compulsive habit used to manage stress or anxiety. For most, it is a behavior rooted in fear of certain foods and what those foods will do. This study found that roughly 34% of patients with eating disorders admit to chewing and spitting, although an even greater number likely do not, or cannot, admit it.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals in the United States and much of the world as the authoritative guide to diagnosis mental disorders. The most recent version used is the DSM-5, which doesn't place chewing and spitting under any single disorder because it is occurs across all eating disorders. In other words, those with anorexia, bulimia, binge eating disorder, or other specified feeding and eating disorders can suffer from chewing and spitting.

Aside from the monetary costs of chewing and spitting, negative physical consequences can occur, such as: swollen salivary glands, stomach ulcers, dental problems like cavities or tooth decay, and hormonal imbalances. One study that found chewing and spitting causes an increase in ghrelin, a hormone that promotes hunger. Many people with eating disorders don't suffer from only one; long periods of restricting (anorexia) can lead to bingeing, which often leads to purging.

Dr. Kathryn Kinmond writes, "Chewing and spitting may increase hunger levels in patients with anorexia nervosa, leading to feelings of a lack of control over eating. This may counteract the patients’ rigid control over food intake and promote more chewing and spitting (or binge eating), resulting in a downward spiral."

Studies have found that individuals with more severe symptoms of eating disorders engage in CHSP more often. However, those without clinically diagnosed eating disorders may also chew and spit, such as athletes following strict diets, people with diabetes, and those who have undergone bariatric surgery. Regardless of why someone chews and spits, it is a disordered eating habit, and a highly shameful one at that. Although many people chew and spit in an effort to lose weight (or simply not to gain weight), the behavior often results in weight gain, because about one-third of the calories chewed are ingested. Gaining weight often leads to increased feelings of shame and exacerbates existing disordered habits.

Eating disorders often co-exist with other psychological disorders and can be deeply rooted in pain or trauma. Food is life-giving, and denying oneself food is an extremely tangible form of self-punishment, rooted in shame, trauma, or emotional distress.

I previously wrote about how to spot signs of an eating disorder (read it here), but there are some additional signs of chewing and spitting: traces of chewed food in the trash, purchasing large quantities of foods or foods gone missing, eating in private or out of the house, secretive behavior during meals, and generalized shame around eating. If you or someone you know is suffering from an eating disorder, it is extremely important to seek professional help. Contact the NEDA helpline at (800) 931-2237, find an Eating Disorders Anonymous (EDA) meeting near you HERE or find a treatment center near you HERE.

xoxo

Sarah Rose