Understanding Chewing and Spitting (CHSP) in Eating Disorders

Chewing and Spitting (CHSP) is behavior characterized by chewing and spitting out palatable, energy-dense food instead of swallowing it. Individuals with CHSP aim to experience the flavor of food without consuming its calories. This behavior exhibits aspects of bingeing and restrictive eating, involving both excessive food intake and avoidance of consumption.

Prevalence of CHSP

• A 2018 study among adults: 0.4% (predominantly females)
• A 2019 study among adolescents: Up to 12%

Classification in DSM-V-TR

• Initially regarded as a symptom of bulimia nervosa
• Listed as a potential symptom of Eating Disorder Not Otherwise Specified (EDNOS) in DSM-IV
• In DSM-V and DSM-V-TR, CHSP is not assigned to a specific disorder, as it can occur across various eating disorder diagnoses.

Causes of CHSP

• Family history of eating disorders
• Body image concerns and a desire for control
• Co-occurring mental disorders, such as anxiety, obsessive-compulsive disorder, depression, or drug abuse

Medical Consequences of CHSP

• Dental Issues: Cavities and gum disease due to frequent exposure to sugary foods
• Stomach Problems: Acid reflux or ulcers resulting from stomach acid production without food for digestion
• Weight Gain: Potential consequence of overeating later in the day

Diagnosis and Treatment

• Psychotherapy and nutritional counseling are common recommendations
• Cognitive behavioral therapy (CBT) is often used for CHSP
• Diagnosis involves assessing factors like body image, eating habits, medical history, and lifestyle

Advice for Family Members

• Be aware of possible signs and symptoms of CHSP and other eating disorders
• Encourage seeking professional help, avoiding criticism or judgment
• Demonstrate care and concern for the person's well-being

Conclusion

CHSP can be a symptom of a more significant eating disorder. Early treatment is crucial to prevent further physical and emotional consequences. With professional support, individuals can find healthier ways to manage food-related issues and improve their overall well-being.