Chewing and Spitting Disorder: Signs and Symptoms

While many people struggle with clinically diagnosed eating disorders such as anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED), many more deal with something less defined: a form of disordered eating.

The phrase can refer to any number of behaviors involving unhealthy relationships with food, eating, and body image. One form of disordered eating is chewing and spitting (CHSP), which involves refusing to swallow food so it can’t be digested.

What is Chew and Spit Eating Disorder?

As its name suggests, chewing and spitting disorder involves chewing food but spitting it out before it can be swallowed. The motivation for the behavior typically concerns weight control or avoiding weight gain.¹

Although chewing and spitting disorder—sometimes called chew and spit disorder—has “disorder” in its name, it can be challenging for a clinician to formally diagnose. The condition is not defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which lays out the specific criteria for diagnosing mental health disorders.

Part of the reason CHSP may be so hard to pin down is that the behavior can occur as part of an eating disorder or exist on its own. In any case, chewing and spitting behavior is understudied, and the mental, physical, and emotional connections to the behavior are likely under-reported.¹

Characteristics of Chewing and Spitting Disorder

The broader disordered eating patterns of chewing and spitting are still poorly understood. However, the behavior is often thought to involve food that’s enjoyable but high in calories.¹

CHSP behavior is often tied to negative emotions, particularly shame. Stress may worsen the condition, and people may use CHSP to establish control over stress. In addition to weight control, people may also use it as a form of escapism or self-soothing from their problems.³

Chew and Spit Eating Disorder Risks

CHSP can occur in anyone at any point in their life, but certain circumstances may increase the risk of engaging in this type of behavior. Some people who may be more susceptible to chewing and spitting include:^1,4

• Adolescents and young people
• People with an eating disorder
• People who have diabetes
• Those who are undergoing (or have recently undergone) bariatric surgery
• Athletes following strict dietary guidelines

Chewing and spitting behavior can have other health consequences, including:⁵

• Cavities and gum disease
• Digestive distress from excess stomach acid created to break down food that’s never swallowed
• Eventual weight gain from overeating related to this restrictive behavior

While understudied, chewing and spitting disorder is likely also connected to issues around body image, self-esteem, and other mental health concerns. In one study, up to 21% of people with official eating disorder diagnoses reported chewing and spitting at least once a week.⁶

People with CHSP may also engage in bingeing episodes, which can make them feel out of control and trapped in a CHSP cycle. The behavior can become addictive and ritualistic, which eventually becomes draining. People may spend large amounts of time maintaining the disorder, which can strain relationships.⁷

Finding Help for Chew and Spit Disorder

If you or a loved one is experiencing chewing and spitting or other disordered eating behaviors, it’s time to seek help.

Even if chewing and spitting do not happen alongside a clinically-diagnosed disorder, it often indicates a deeper problem, such as anxiety or depression. Any time an unhealthy relationship with food presents, it’s important to address the potential issues that may be driving the disordered eating behavior.

If you or a loved one exhibits chewing and spitting behaviors, you may want to consult your therapist or primary care physician. These experts can help diagnose the problem or refer you to a treatment program. You can also directly seek out an eating disorder specialist to explore the root of the issue, prevent symptoms from worsening, and get the help you need—and deserve.

Eating Disorder Hope Staff

The EatingDisorderHope.com editorial team comprises experienced writers, editors, and medical reviewers specializing in eating disorders, treatment, and mental and behavioral health.