What is chew and spit disorder?
Chewing and spitting behavior is a pattern of disordered eating that occurs when someone chews food but spits it out instead of swallowing it. The behavior is typically considered an attempt to get pleasure from eating without ingesting calories.
CHSP has not been officially pathologized nor described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the record of all medically-recognized mental health conditions.
Instead, CHSP is considered an eating disorder not otherwise specified (EDNOS).1 This umbrella term describes patterns of disordered eating behavior that have been seen in clinical practice but have not yet been understood as specific conditions.
Who gets CHSP disorder?
While CHSP has not been thoroughly studied in and of itself, patterns of this behavior have been noted in patients hospitalized for other disordered eating patterns and mental health issues.
One study found that 21% of patients in a hospitalization program for eating disorders reported engaging in CHSP behavior once a week before their hospitalization.2
In general, these patients were also found to engage in behaviors such as excessive exercise, laxative abuse, and restrictive dieting as part of their disorder.2
Side effects of chewing and spitting food
Even though the DSM hasn’t officially described chewing and spitting disorder, the behaviors generally involved in this condition have been connected to some physical consequences.
Chewing is the first step in the digestive process, which typically sets off a chain reaction in the body, anticipating an influx of food. However, when no food arrives, some of the mechanisms put into motion by chewing can potentially cause problems.
Dental issues, such as cavities, gum disease, and gastrointestinal distress, such as acid reflux, are possible, thanks to the stomach acid that gets churned up when chewing takes place.3 Excess stomach acids can also lead to stomach ulcers.5
Some behavioral signs that may indicate someone is chewing food and spitting it out, include:
- Eating alone
- Avoiding events or occasions that center around meals
- Lying about eating
Diagnosis of CHSP disorder
As CHSP remains officially unrecognized as a disorder, no current methods exist to diagnose the issue.
Instead, physicians may make a “clinical" diagnosis,” which is when they base a diagnosis on factors like a patient's description of how they feel, visible signs and symptoms, behavioral severity, and a patient's history, as opposed to medical tests.
Many physicians may frame chewing and spitting food out as a symptom of other eating disorders rather than a disorder in its own right. These doctors are more likely to see chewing and spitting behaviors in the same vein as laxative abuse or excessive exercise and may understand it as an indicator that other disordered eating habits are going on or worsening.
Treating chew and spit disorder
Since there aren't official eating disorder diagnoses for chew and spit disorder, there are no official treatment recommendations for this condition. However, some general tips may help someone overcome the urge to use compensatory behaviors like spitting out their food.
Building a balanced diet could help someone avoid common triggers for disordered eating. Proper nutrition can help people feel more naturally satiated and help eliminate cravings that might tempt someone to use CHSP.4
And incorporating “bad foods" into a regular diet by learning to enjoy them in moderation can help remove the stigma behind the substance, giving someone less reason to spit these foods out.4
Eating mindfully and intuitively
Changing one’s perspective can be just as powerful as changing one’s diet.
Mindful eating, which promotes staying present, eating slowly, and focusing on the sensory aspects of food, can help someone cultivate a greater sense of gratitude for what they’re eating and build a healthier relationship with food in general.4
Intuitive eating is a similar practice, which focuses on tuning in to the body’s hunger cues and giving it what it wants, when it wants, without feeling any attached guilt.
At Within Health, we want to help all people create healthier, happier relationships with their food and the world around them. Contact our team to learn more about treatment for an eating disorder or CHSP.