Chewing and Spitting Behavior

Reprinted from Eating Disorders Review
July/August 2011 Volume 22, Number 4
©2011 Gürze Books

The phenomenon of chewing and spitting (CS) is still little understood despite being relatively common among eating disorders patients. As reported in a poster session at the International Conference on Eating Disorders in Miami in April, chewing and then spitting out food is associated with greater eating pathology and is reported in all types of eating disorders. To better understand the implications of this behavior, Nora A. Durkin and colleagues at the University of Minnesota and University of North Dakota School of Medicine analyzed data from 985 participants who presented for outpatient treatment from 1985 to 1996. Lifetime rates of CS varied across eating disorders diagnoses: in anorexia nervosa patients, 38.2%; in patients with bulimia nervosa, 33.7%; and among those with eating disorders not otherwise specified, 24.7%. CS was also significantly related to binge eating and use of compensatory behaviors, including higher rates of binge eating, laxative use, diuretic use, exercise, fasting, skipping meals, and eating small or low-calorie meals. Patients who used CS also had lower current, highest, lowest, and goal body mass indexes (BMIs) compared to those who did not report CS. Patients who reported CS were younger compared to those who did not report it. Collectively, these findings indicate that CS is associated with greater eating pathology and is not equally prevalent across eating disorder diagnoses. Future research should clarify the correlates, mechanisms, and functions of CS in eating disorders. According to the authors, clinicians should be alert for this unusual behavior, as it may carry implications for progression of illness and treatment.

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