Chew and spit (sometimes abbreviated as CHSP or CS) is a compensatory behavior associated with several eating disorders that involves chewing food and spitting it out before swallowing, often as an attempt to avoid ingesting unwanted or unnecessary calories. CS can be used as a way to taste food viewed as “forbidden” or unhealthy. Individuals who partake in CS typically have an increased desire for thinness, increased loss of control (LOC) and body dissatisfaction. CS can replace vomiting and/or binging behaviors, or serve as an additional behavior to many eating disorders.
CS has been found in several different eating disorders, making it difficult to find a treatment that works as a cure-all. There is no defined treatment for CS; however, cognitive behavioral therapy (CBT) has been shown to reduce negative behaviors involved in eating disorders including bulimia nervosa and anorexia nervosa.
A recent systematic review on the topic revealed seven themes identified in scholarly articles,[1][2][3][4][5][6] including potential markers of eating disorder severity (regardless of the length of illness contributing to age discrimination). Individuals suffering from CS also showed increased loss of control (LOC), pathological eating, negative emotions and feelings, and body image distortion. CS sufferers may be trans-diagnostic (i.e. appears in individuals who have been diagnosed with any type of clinical or sub-clinical eating disorder).
^Mitchell, J. E.; Pyle, R.; Hatsukami, D.; Eckert, E. (1988-01-01). "Chewing and spitting out food as a clinical feature of bulimia". Psychosomatics. 29 (1): 81–84. doi:10.1016/S0033-3182(88)72425-1. ISSN 0033-3182. PMID 3340710.
^Smith, G. R.; Ross, R. L. (1989-01-01). "Chewing and spitting associated with a protein sparing modified fast and psychosocial stressors". Psychosomatics. 30 (2): 224–226. doi:10.1016/S0033-3182(89)72305-7. ISSN 0033-3182. PMID 2710922.
^Song, Youn Joo; Lee, Jung-Hyun; Jung, Young-Chul (2015-10-01). "Chewing and spitting out food as a compensatory behavior in patients with eating disorders". Comprehensive Psychiatry. 62: 147–151. doi:10.1016/j.comppsych.2015.07.010. ISSN 1532-8384. PMID 26343479.
^Durkin, Nora E.; Swanson, Sonja A.; Crow, Scott J.; Mitchell, James; Peterson, Carol B.; Crosby, Ross (2014-01-01). "Re-examination of chewing and spitting behavior: characteristics within and across eating disorder diagnoses". Eating and Weight Disorders. 19 (3): 315–320. doi:10.1007/s40519-013-0090-3. ISSN 1590-1262. PMID 24357336. S2CID 7875585.
^De Zwaan, M. (1997-01-01). "Chewing and spitting out food in eating disorder". International Journal of Psychiatry in Clinical Practice. 1 (1): 37–38. doi:10.3109/13651509709069203. ISSN 1365-1501. PMID 24926979.
^McCutcheon, R.; Nolan, A. (1995-03-01). "Chewing and spitting out food--a neglected symptom?". The International Journal of Eating Disorders. 17 (2): 197–200. doi:10.1002/1098-108X(199503)17:2<197::AID-EAT2260170214>3.0.CO;2-Q. ISSN 0276-3478. PMID 7757102.
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