Anorexia and bulimia are the two most talked-about eating disorders, but according to Metro, such an “easy categorization of disordered eating can be troubling”. But these two very serious conditions entail much more than anorexia as ‘not eating a lot’ and bulimia as ‘throwing up after food’ as they are often perceived, so in the aftermath of Eating Disorder Awareness Week which takes place between February 26 to March 4, let’s look at the less obvious and lesser-known signs.
As a society, we have today arrived at a point where restrictive diets, completely cutting out food types, or being aware of every addition kilogram, are considered pretty much standard, often making warning signs such as obsessive calorie counting, binge-eating, or unhealthy emotional relationships go unnoticed.
What is even more worrying is that lack of awareness about eating disorders other than anorexia and bulimia sometimes makes risky and telling behavior like chew and spit go unnoticed.
Chew and spit – also known as c/s and CHSP – is an eating disorder that manifests itself in the food being chewed and then spat out instead of being swallowed. Indulging in the behavior is an attempt to taste the food without taking in any calories and many people who chew and spit don’t see it as an eating disorder because there is no vomiting or abstination from food involved.
Chewing and spitting often involves binging on ‘treat’ foods such as snacks rich in sugar or fat and is often displayed as a symptom by those experiencing other disorders, such as bulimia or anorexia, although it can also be a standalone behaviour.
Despite this, chew and spit isn’t officially recognised as an eating disorder in its own right and doesn’t find itself in the Diagnostic and Statistical Manual of Mental Disorders. Instead, it is usually placed among the ‘other eating disorders’, together with avoidant or restrictive food behaviour, rumination disorder, and pica.
“In terms of the chew and spit we don’t have exact statistics on how many people are affected by it,” Beat, the UK’s leading eating disorder charity told Metro.co.uk. “The way the stats are collected for eating disorders, in general, makes it very difficult to establish an accurate prevalence.”
“Before the latest change in diagnostic criteria, it was estimated that of those with eating disorders, 10% were anorexic, 40% were bulimic and the rest fall into the EDNOS category which included the feeding disorders as well as binge eating.”
(Picture: Erin Aniker for Metro.co.uk)
According to Beat, chewing and spitting is characterized as being “repetitive, voluntary, and habitual bringing up of food that might be partly digested”. The lack of diagnostic data around the behavior which usually comes with a ‘deep sense of shame’ means there are currently no guidelines in place regarding treatment.
“I know it’s gross, but I keep doing it,” a 26-year-old woman who chews and spits told Metro.
“I don’t do it all the time, just when I’m eating ‘bad’ stuff. It’s easy. I feel really ashamed of it. I’d never want anyone to know that I was spitting out my food, because I know they wouldn’t understand why.”
In addition to the mental symptoms, chew and spit also takes a physical toll on the body which is tricked to expect the food making its way down the digestive system by the food being chewed, which releases stomach acids, digestive enzymes, and insulin. The acids can cause damage to the stomach, causing pain, ulcers, and longterm digestive issues. and the increase in insulin changes the metabolism, which makes returning to a standard eating pattern more and more difficult.
While this is a seldom-talked-about issue, it is far from uncommon. If you are struggling with it, we strongly encourage you to muster the courage to talk to your GP about your feelings around food. Treatment through consulting or therapy will give you chance to ditch the feelings of shame and regain control over your life.