Chew and Spit Disorder: What Is It & How to Cope

Chewing and Spitting Out Food

Chew and Spit Disorder: What Is It & How to Cope

Table of Contents

Written By:
Jennifer Huddy, MS, RD

Key Takeaways

Chances are, you’ve heard of anorexia and bulimia. These are what we tend to imagine when thinking about eating disorders. However, many other eating disorders and disordered eating behaviors exist that are lesser known but still considered serious. One example is the act of chewing and spitting out food. 

In this context, chewing food and spitting it out is not done because the person dislikes the taste of the food or something is wrong with it. The behavior is done intentionally and repeatedly to avoid calorie intake and weight gain. 

Chewing and spitting food is a disordered eating behavior commonly practiced with highly palatable foods that are high in calories, sugar, fat, and salt. Due to the pleasure gained from the taste of these foods and the fear that these foods will cause weight gain, the person will chew the food until it is time to swallow, then spit it out. 

If you or a loved one engages in this eating behavior and are wondering how to stop chewing and spitting food out, it is important to seek help. The first step is awareness of the signs and symptoms, health risks, and treatment options. 

Chew and Spit Disorder

When a person regularly chews food and spits it out as a method of weight control, it is known as “Chew and Spit Disorder” or CHSP. Chew and Spit Disorder has not been very well studied. Despite this, we know that CHSP is more common in adolescents, particularly females.

Chewing and spitting is most commonly seen as a symptom of a diagnosed eating disorder. It was initially thought to be associated with bulimia, with the chewing and spitting behavior used as an alternative to purging. However, CHSP can also be present in binge eating disorder as well as restrictive eating disorders such as anorexia

In addition, specific populations might be more susceptible to Chew and Spit Disorder. Individuals who must follow a strict diet, such as athletes, people with diabetes, and people who have had bariatric surgery, may adopt this disordered eating behavior as a way to enjoy foods that fall outside their diet plan. 

Signs and Symptoms

Since Chew and Spit Disorder is known to co-occur with eating disorders, common eating disorder signs and symptoms such as intense food restriction, binge eating, and frequent purging may also be present. The individual may already have an eating disorder diagnosis when the chewing and spitting behavior is identified. 

Other top signs and symptoms of CHSP include:

  • Frequent chewing and spitting out food
  • Body image concerns
  • Fear of gaining weight
  • Anxiety and other mood problems
  • Food cravings 
  • Weight fluctuations
  • Dental issues
  • Gastrointestinal problems such as acid reflux
  • Guilt and shame around eating habits
  • Social isolation 
  • Compensatory behaviors including diet pills, laxatives, and over-exercise
  • Orthorexia (rigid diet mentality around eating “clean”)

Health Risks of Chew and Spit Disorder

Chewing and spitting out food may seem harmless, but there are numerous health risks of this disordered eating behavior. Firstly, if chewing and spitting occur frequently enough, it can lead to malnutrition and weight loss due to undereating. On the flip side, weight gain can also occur due to compensatory eating later in the day. 

Dental issues can also arise from excessive chewing and frequent exposure to sugary foods. Digestive issues may occur since chewing stimulates stomach acid, and when food does not enter the stomach, it can cause discomfort or acid reflux.

There are psychological and social effects of CHSP, including guilt and shame following episodes of chewing and spitting and increased risk of mood disorders. As with other eating disorders, social isolation may occur due to engaging in disordered eating habits in private. 


Diagnosis and Treatment

Chew and Spit Disorder is not classified as an eating disorder in the DSM-5. This is likely because chewing and spitting food is considered a “trans-diagnostic behavior,” meaning it can be a symptom of many eating disorders

Unfortunately, the lack of clear diagnostic criteria makes CHSP challenging to identify and treat. If doctors or health care providers identify that chewing and spitting behavior is present in a patient, they should screen that patient for an eating disorder.

Research has not been done specifically on treating Chew and Spit Disorder. However, since it overlaps with other eating disorder pathology, a similar treatment approach can be taken, which includes nutritional therapy and psychotherapy. Of course, if the individual does have a diagnosed eating disorder, the chewing and spitting behavior will likely be addressed as part of eating disorder treatment. 

Work with a Dietitian Online

If you are experiencing CHSP and don’t know how to stop chewing and spitting food out, Nourish can help. You'll receive high-quality, compassionate care from our registered dietitians, who are experts in eating disorders and disordered eating behaviors. 

Access care easily with virtual appointments that are covered by insurance. Get started today with Nourish. 

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