Dear Alice,

I have been chewing and spitting large amounts of food (pretty much always sweet stuff — pastries, chocolate, etc.)almost every night for 8 or 9 months. I am eating a healthy, balanced diet otherwise, maybe a little on the lower caloric side (1300-1500 calories per day). My chewing and spitting sessions usually follow a balanced meal. I know this is a type of eating disorder. I have done a lot of research online and I know that there are side effects, although they vary depending on who you ask. Some sites mention that chewing and spitting activates the release of insulin and results in hyperinsulinemia, insulin resistance and weight gain. Is this true? How long would it take to develop these problems? Are these reversible if I were to stop this behavior?

Dear Reader,

Eating disorders may take a variety of patterns and symptoms, including chewing and spitting out food. For more information on eating disorders and calorie intake, check out Ideal Caloric Intake, Eating Disorders vs. Normal Eating, and Do I have an eating disorder? in the Go Ask Alice! fitness and nutrition archives. Discussing this issue with a health care provider or counseling professional is recommended to address the core reasons for why you may be chewing and spitting out your food.

As you found on your web search, it's difficult to determine specific side effects from chewing and spitting food, as these tend to vary from person to person. Keep in mind, however, that a variety of side effects occur when a person is not getting enough calories and nutrients, as is the case with a number of eating disorders. Chewing and spitting food is regarded as a restrictive behavior that is related to anorexia nervosa and may be a sign of an eating disorder. It would not be farfetched to conclude, then, that chewing and spitting food may lead to more severe disordered eating behaviors, which may be dangerous physically and mentally. Stress and/or anxiety may also play a role in the chewing and spitting of food; again, a health care provider or counseling professional would best be able to determine what may be going on.

You mentioned that you began chewing and spitting out food eight to nine months ago. You may want to ask yourself why you began to your chew and spit out your food, and why sugary foods. For example, were you feeling stressed/anxious? Has body image played a role in chewing and spitting out food? Have you been feeling hungry?

It seems as though you are concerned that you may have an eating disorder. Your level of self-awareness is a great start to addressing the situation. You've also noted your caloric intake may be on the lower side. While calorie needs do vary from person to person, most individuals will need a bit more than you are currently consuming. You may want to consider contacting a health care provider (including a nutritionist) or counseling professional for help. If you are a student at Columbia, you can make an appointment with a health care provider or nutritionist from Medical Services by calling x4-2284 or by logging in to Open Communicator. You can also make an appointment with a counseling professional from Counseling and Psychological Services. If you would like additional resources, check out the response to Eating disorder support resources on the Web in the Go Ask Alice! fitness and nutrition archives.

Good luck,


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