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Adolescents Are Falling Prey to Chew and Spit, a Relatively Unknown Eating Disorder

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Dec 19, 2019

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Image Credit: Marina Marković

When it comes to disordered eating, anorexia nervosa and bulimia nervosa are often the first eating disorders that come to mind due to their place in the greater conversation around beauty standards and body image. However, due to this spotlight, lesser-known and newly developing malaises often slip through the cracks. One such eating disorder is ‘chew and spit’ (CHSP), which involves chewing on foods to satisfy a craving and then spitting them out in order to avoid caloric intake.

Chew-and-spit is not a recent discovery, though the condition is often associated with binge and purge tendencies associated with bulimia nervosa. According to Mirror Mirror, an eating disorder help platform, “The CHSP behavior allows pleasure for the person eating yet in a controlled and restrictive way. These individuals often struggle with allowing themselves to enjoy food which feels pleasurable, and the behavior allows the meeting of needs without the feeling of becoming ‘out of control.’ It can be used as an attempt to comply with a meal plan in eating disorder recovery, yet the individual becomes overwhelmed with the amount or type of food on the meal plan and is unable to follow through. By using this behavior, rather than restricting food, it can also avoid confrontation with people about their eating disorder by creating the façade of eating.”

Though CHSP is not officially a part of the Diagnostic and Statistical Volume V, as it was removed in 2013 due to lack of prevalence, a new study challenges this decision. Of more than 5,000 adolescent children in New South Wales, Australia, 12.2% reported having weekly chew-and-spit episodes during the course of one month. The study, published in Eating Disorders: The Journal of Treatment and Prevention, also states that the prevalence of this disorder is much higher in adolescents than in adults, who have a 0.4% prevalence.


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“There aren’t any available screening tools for these behaviors so it is much easier to fly under the radar. … It is so taboo so people aren’t forthcoming about the behavior,” Phillip Aouad, co-author of the study, told BuzzFeed News. He added, “There have been cases where people have actually mentioned this to their clinicians and they have been ignored because they thought it wasn’t a big issue.”

Of the teenagers examined, 10.2% of boys and 15.1% of girls reported episodes of this behavior. Symptoms, according to Aouad, include “increased psychological distress, overeating, fasting, weight and shape concerns, laxative abuse and vomiting,” reported Buzzfeed News. The study believes that individuals who currently engage in CHSP are mainly those with eating disorders, medical patients, bariatric patients, and athletes.

However, like all eating disorders, chew-and-spit is treatable. While little literature specifically addresses chewing and spitting, a combination of psychotherapy and nutrition-related treatments for symptoms related to mental illness and disordered eating could help.

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Written By Aditi Murti

Aditi Murti is the senior culture writer at The Swaddle, with an interest in cultural analysis, environment, and the science of mental health.  Write to her using aditi@theswaddle.com, or find her on social media @aditimurti.

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