Chewing and spitting: A step closer to an eating disorder

In these days of radical body consciousness, just when you've heard it all – excessive dieting, bingeing and purging, exercise addiction to name but a few – another extreme method of achieving a low body weight rears its ugly head. In this case, the method is called chewing and spitting.

Chewing and spitting involves exactly what you'd imagine – that is, loading your mouth with food, chewing it and then spitting it out before swallowing. And while it may not exactly be anything new, even eating disorders experts don't know much about this type of behaviour.

"We don't see a vast amount of people who chew and spit," says Dr Peter Rowan, consultant psychiatrist at Cygnet Hospital Ealing's Eating Disorders Unit. "It clearly is a symptom that can sit with and be part of an eating disorder. It is an abnormal eating behaviour in as much as it's driven by the fact that one is hungry and yet one does not want to have the calories – a way of avoiding food but at the same time indulging oneself."

People who chew and spit are, however, at a higher risk of developing a full eating disorder such as bulimia or anorexia, claims Dr Rowan. "But they may not seek help for their behaviour because they probably think there's no urgent need," he adds "Plus part of them probably knows that chewing and spitting isn't entirely normal, so they may even be a bit ashamed about it."

Since there is no way of discovering how many people use chewing and spitting as a way of controlling their calorie intake, it may be more common in the general population than most experts think. For instance, it even made an episode of Sex and the City, where lead character Carrie met an old (and formerly chubby) friend in an LA restaurant, who – to his dinner companion's horror – proceeded to spit out his steak after giving it a good chew.

Meanwhile, one study on chewing and spitting among patients with eating disorders has revealed that the behaviour is more associated with restrictive eating rather than bingeing – which means that the majority of the people taking part in the study were chewing and spitting out small portions of food but on a frequent basis. The study, carried out by researchers from John Hopkins University, Baltimore and published in the journal Eating Behaviours, also suggests that chewing and spitting is more common among younger eating disorders patients.

Getting help

Though many people who indulge in chewing and spitting may not think they have a problem, Dr Rowan recommends anyone who uses this type of behaviour to seek expert help.

"Anyone who uses chewing and spitting as a means of restricting their food should go and see their GP and ask to be referred to a dietician or a doctor with a special interest in eating disorders who can help them to learn how to control their eating and body weight in a way that's less likely to allow them to drift down the path towards a full eating disorder," he says.

The EDU at Cygnet Hospital Ealing offers outpatient and inpatient treatment for a full range of eating disorders. To find out more, log on to Cygnethealth.co.uk.