Dear Alice,

I have been chewing and spitting large amounts of food (pretty much always sweet stuff — pastries, chocolate, etc.) almost every night for eight or nine months. I am eating a healthy, balanced diet otherwise, maybe a little on the lower caloric side (1300 to1500 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,

It’s great that you’re taking the first step and reaching out to find ask for more information about the health impacts of your eating behavior. When it comes to chewing and spitting food (CHSP), it’s no longer recognized as a diagnosable eating disorder. However, it’s still considered a disordered eating behavior, because it’s associated with restrictive eating behaviors (such as calorie counting and avoiding fat, sugar, or certain foods that are thought of as “bad”), diet pill or laxative use, and excessive exercise, as well as other eating disorders, such as binge eating, anorexia, or bulimia. In addition to the related health issues you mention, CHSP also has other physical and mental health impacts. While some of these health consequences are treatable, it may be worth exploring what triggers CHSP in an effort to establish a healthy relationship with food and eating for a more long-term resolution.

First: a look at how this behavior can affect your health — especially when it's paired with an eating disorder. A few health issues that could arise include:

  • Cavities and gum disease
  • Excessive stomach acid due to your body trying to digest food that isn’t there
  • Weight gain from overeating to compensate for limiting how much you eat
  • Unhealthy view of food and eating

Now, more specifically to your question about CHSP and insulin. It’s unclear whether CHSP itself results in hyperinsulinemia and insulin resistance — though there's some evidence to show that tasting sweet food releases a small amount of insulin. However, habits such as skipping meals and only eating one large meal a day has been associated with changes in metabolism and insulin; in fact, these practices may increase your blood insulin levels, encouraging your body to store fat rather than digest it.

Reader, 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. To address the health impacts of this behavior, consider exploring the reasons behind the behavior (or what triggers it). Asking yourself a few questions can help get the process started. What influenced you to begin to chew and spit out your food? Some people chew and spit their food as a way to taste foods that they consider “forbidden” or “bad” instead of ingesting it. What is it specifically about sugary foods? Were you feeling stressed or anxious when you began chewing and spitting? Has body image played a role in chewing and spitting out food? Have you been feeling hungry? Thinking about your responses to these questions and talking them over with a mental health professional may help you get a better understanding of your current eating patterns and build a healthier relationship to food. If you don’t feel ready to reach out just yet, the National Eating Disorders Association (NEDA) has an anonymous screening tool that can walk you through a set of questions to determine your risk for an eating disorder and link you to helpful information and resources.

Lastly, you've also noted your current caloric intake may be on the lower side. While calorie needs do vary from person to person, most adults will need a bit more than you’re currently consuming to keep their body properly fueled. To learn a bit more about your individual needs, you may also want to consider speaking with a health care provider or a registered dietician for more information and support.

Alice!

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