Focus on ....Chew and Spit Disorder
Chew and Spit Disorder (CSD) is by no means a new form of Eating Disorder (ED).
Many people who experience Anorexia Nervosa, Bulimia Nervosa, Binge Eating etc. also experience CSD. Nevertheless, it should be noted that some people experience CSD but don't necessarily other EDs. It is important to consider CSD in its own right.
CSD does not currently feature in DSM-5.
CSD is literally what it says: it involves chewing food, enjoying taste and texture, then spitting it out instead of swallowing it. Amount of food chewed, then spat out can vary from relatively small amounts to large amounts. It can often cost the person a considerable amount of money to purchase the food in CSD.
Many with CSD don’t feel it is particularly serious/harmful. However, there many damaging consequences associated with CSD which why it’s important health professionals acknowledge CSD and individuals seek help and support as soon as possible.
Some of damaging consequences associated with CSD include:
* It can lead to malnutrition and food deprivation as the food being chewed is spat out and rarely eaten or swallowed. This means that the person doesn’t receive any nutritional value from food. In this respect, CSD is similar to food restriction, starvation and purging by vomiting.
* The actual process of ‘chewing’ and then ‘spitting’ can evoke negative feelings - guilt, shame, anxiety, low
mood etc. This may, in turn, initiate further ED behaviour to cope with these negative thoughts/feelings.
* CSD can lead to stomach ulcers. You can see and smell the food. The body
thinks that food is going to be consumed. The body then produces stomach acid
in preparation for food, anticipating the food actually being swallowed and
digested. However, if the person spits out the food rather than swallows it,
excess of acid and digestive enzymes remain in stomach. This can, over time,
lead to stomach ulcers. This can also lead to the development of diabetes.
* The process above can make weight gain, not weight loss, more likely. Repeated CSD and
dysregulation of insulin can over time increase a person’s appetite, meaning they
are hungrier, more often. This may cause them to engage in even more CSD
behaviour and so increased hunger and vicious cycle starts again. Over time, the
person is increasingly likely to engage in bingeing behaviour to satisfy hunger.
* CSD can also lead to mouth ulcers and cause damage to teeth. This is especially
so when chewing and spitting involves sugary foods: quantities of sugar
remaining in the mouth are larger than if the food was actually eaten properly
and swallowed. This excess sugar can rot teeth and cause mouth ulcers which
become very painful.
* CSD can also cause swollen glands. This is caused by repeated spitting out.
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(by Alexandra O'Brien, Talking EDs, 2012, 2019. All rights reserved)