Consequences of Chewing and Spitting

Chewing and Spitting (CHSP) is a behaviour where a person chews food- often something they find tasty or calorie dense- but spits it out before swallowing [1]. CHSP is often attempted by individuals as a way to ‘taste’ food they enjoy without actually eating it, in an attempt to control body weight or shape [1]. While it may seem like a less harmful alternative to other eating disorder behaviours, it is actually a sign of psychological distress and has been linked to several serious complications. 

Frequently engaging in CHSP is associated with:  

• Increased psychological distress 

• Severe weight control behaviours 

• Poorer health related quality of life 

• Physiological complications, such as eventual weight regain [1, 2, 4].  

Available research suggests that CHSP is an ineffective method to control weight, as researchers hypothesise that the body responds and adapts to frequent use of CHSP and may lead to oral or digestive complications [1].  

Impacts of CHSP far outweigh any perceived benefit of the behaviour. If you are struggling with CHSP, please speak to a health professional. 

Psychological Consequences

People who engage in CHSP tend to report: 

• Lower quality of life, related to both their mental and physical health.  

• Temporary pleasure from the behaviour, followed by distress and other negative feelings including shame, guilt and self-disgust after an episode [1, 3, 4]. While the act of chewing might temporarily feel like a way to soothe stress or escape from reality, it is almost always followed by a crash in mood and a feeling of being out of control [4] which can further lead to increased anxiety, depressed mood and feelings of loneliness and isolation.  

• Sometimes also engaging in ‘binge-type’ episodes, where they CHSP lots of food in a very short time [5]. This in turn can lead them to feel out of control and trapped in a CHSP cycle. 

• Feeling that CHSP is very addictive in nature and they can feel trapped in a vicious cycle [1, 4, 5]. They may plan a CHSP episode and perform particular ‘rituals’ or behaviours in conjunction to CHSP. This can become very exhausting and ultimately provides no benefit. 

Physical Consequences

CHSP may have significant impacts on the body, such as: 

• Sensitive or damaged teeth because the mouth constantly produces acid and saliva in anticipation of food that never arrives [1].

• Cavities, lost teeth, and pain in their face and jaw muscles from excessive chewing in those who engage in this behaviour for a long time [4].  

• Feeling constantly tired or heavy, or suffering from frequent headaches [4].

• Experiencing irregular menstrual periods [4]. 

• Development stomach ulcers [1].

• Unintended weight gain if food is swallowed by mistake [1, 4].

Social Consequences

CHSP can have significant social impacts, including: 

• Shame, loneliness and social isolation as CHSP usually occurs in secret.  

• CHSP taking over one’s life; leading an individual to invest a great deal of energy into maintaining the behaviour.  

• Avoiding going out to dinner with friends or family gatherings, or choosing to stay home alone so they can engage in the behaviour without being seen. This can place a great deal of strain on friendships, families, and personal relationships.  

• A significant financial cost, as individuals may spend large amounts of money on large quantities of food that are ultimately wasted. 

If any of this resonates with you, or with someone you care about, support is available. 

A healthcare professional can work with you to understand what’s happening and find supportive, individualised care.  

• Aouad P, Hay P, Soh N, Touyz S. Chew and spit (CHSP): a systematic review. J Eat Disord. 2016;4(1):23. 

• Aouad P, Hay P, Soh N, Touyz S. Prevalence of chew and spit and its relation to other features of disordered eating in a community sample. Int J Eat Disord. 2018;51(8):968‑72. 

• Aouad P, Hay P, Soh N, Touyz S, Mannan H, Mitchison D. Chew and spit (CHSP) in a large adolescent sample: prevalence, impact on health‑related quality of life, and relation to other disordered eating features. Eat Disord. 2019;1‑14. 

• Aouad P, Morad A, Hay P, Soh N, Touyz S, Rhodes P. Chew and spit (CHSP): an interpretative phenomenological analysis (IPA). Eat Behav. 2020;38:101388. 

• Guarda AS, Coughlin JW, Cummings M, Marinilli A, Haug N, Boucher M, Heinberg LJ. Chewing and spitting in eating disorders and its relationship to binge eating. Eat Behav. 2004;5(3):231‑9