In the realm of eating disorders, there are many behaviors that, while troublesome and harmful, may not be viewed as a disorder because they have no DSM diagnosis.
However, one study points out that “eating disorders are characterized by abnormal eating behaviors directed at avoiding weight gain or inducing weight loss .”
Determining the question of whether or not certain behaviors constitute a “disorder” isn’t as important as answering the question of whether or not the behaviors are harmful. In the case of Chewing and Spitting Disorder (CHSP), the answer to this is “yes.”
The exact behavior of CHSP is as it sounds, an individual chews and spits out their food without swallowing it. It does not have its own diagnosis in the DSM but is viewed as a pathological compensatory behavior that individuals engage in “to enjoy the taste of foods they would normally deny themselves or to consume larger quantities of food than they would typically ingest while avoiding the undesirable consequences of weight gain .”
CHSP is considered a feeding AND restricting behavior that displays characteristic of various eating disorders. It is similar to Binge Eating Disorder (BED), and Bulimia Nervosa in that individuals tend to consume high-calorie foods that they wouldn’t normally eat.
However, CHSP behaviors are also restrictive in a similar manner to Anorexia Nervosa in that the food is not actually ingested. Numerous studies have found CHSP to be equally common in patients with anorexia, bulimia, and OSFED (Other Specified Feeding and Eating Disorders).
As such, CHSP is not tied to any one disorder but does serve as an indicator of the severity of an individual’s eating disorder  with chewers/spitters exhibiting more disturbed eating behaviors  as well as more preoccupation with diet and weight and higher scores in depression, anxiety, and obsession .
Researchers have studied the pathology behind CHSP and found that the compulsion of the behaviors may be due, in part, to the soothing effect they have on the brain’s reward pathways . The chewing behaviors provide a perceived orosensory reward that makes the individual feel as if they’re eating without actually digesting any food.
This concept of “having your cake and (not) eating it, too” is both mentally and physically unhealthy and incredibly harmful. When we chew our food, our body triggers the stomach to release an acid that assists in proper digestion.
The body does not stop this process when the food is not ingested, therefore, leaving the stomach full of acid that can cause ulcers and digestive problems. CHSP also causes typical problems associated with eating disorders such as malnourishment and the complications that coincide with it.
Chewing and spitting behaviors are highly addictive and can lead to “social exclusion, severe food obsession, self-loathing, guilt, and remorse .” Finally, financial difficulties can be a consequence for those that chew and spit large quantities of food regularly .
CHSP and eating disorders are not mutually exclusive. You do not have to have CHSP to have an eating disorder. However, CHSP is rarely, if ever, present without the existence of an eating disorder.
If you are displaying chewing and spitting behaviors, you need to seek help immediately, as they are likely symptoms of a larger issue that, over time, could become extremely dangerous and harmful.
About the Author: Margot Rittenhouse is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims and offenders, and severely mentally ill youth.
As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.
References: Guarda, A. S., et al. (2004). Chewing and spitting in eating disorders and its relationship to binge eating. Eating Behaviors, 231-239.
 Song, Y. J., Lee, J., Jung, Y. (2015). Chewing and spitting out food as a compensatory behavior in patients with eating disorders. Comprehensive Psychiatry, 62, 147-151.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published on October 11, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on October 11, 2017.
Published on EatingDisorderHope.com