Consequences of Chewing and Spitting

Chewing and spitting is when a person chews food (often something they find tasty or calorie dense) but spits it out before swallowing [1]. People may chew and spit because they want to enjoy the taste of food while trying to avoid eating it. This may be because of concerns about body weight or shape, food, or eating [1].

Although chewing and spitting can sometimes feel like a way of managing difficult thoughts or feelings about food and eating, it can become distressing and difficult to stop. It can also have an impact on your physical health, mental wellbeing and everyday life.

Frequently engaging in chewing and spitting is associated with:  

• Increased psychological distress.

• Other behaviours aimed at controlling weight or shape.

• Poorer health-related quality of life.

• Physical complications, particularly when the behaviour is frequent or happens alongside other eating disorder behaviours [1, 2, 4].

Research suggests that chewing and spitting is not an effective way to control weight [1]. It can also become a pattern that is difficult to break, particularly when it is used to manage anxiety, stress or worries about food and eating. Negative consequences of chewing and spitting far outweigh any perceived benefit of the behaviour.

If you are struggling with chewing and spitting, you are not alone and you do not need to manage it on your own. Support from a health professional can help you understand what is driving the behaviour and find other ways to cope.

Psychological Consequences

People who engage in chewing and spitting tend to report: 

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

• Temporary pleasure, comfort or relief from the behaviour, followed by difficult feelings such as shame, guilt and self-disgust afterwards[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 which can further lead to increased anxiety, depressed mood and feelings of loneliness and isolation [4].  

• Feeling that chewing and spitting is very addictive in nature and they can feel out of control and trapped in a vicious cycle [1, 4, 5]. Some people may find themselves planning when and where they will chew and spit, or developing particular routines around the behaviour. This can take up a lot of time and energy and may interfere with everyday life.

Physical Consequences

Chewing and spitting may affect your mouth, teeth and digestive system, particularly when it happens frequently. Possible impacts include:

• Tooth sensitivity or damage, cavities, tooth loss and pain or soreness in the jaw and facial muscles from frequent or prolonged chewing [4].

• Feeling tired or experiencing headaches [4].

• Changes to menstrual periods, particularly when chewing and spitting occurs alongside food restriction or other eating disorder behaviours [4].

• Stomach ulcers or digestive problems [1].

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

The physical effects can vary from person to person. If you are experiencing pain, dental problems, digestive symptoms or other physical changes, it is important to speak with a healthcare professional.

Social Consequences

Chewing and spitting can also affect relationships and everyday life, including:

• Feeling shame, loneliness or isolation, particularly when the behaviour is kept secret.

• Spending a lot of time and energy planning, carrying out or hiding 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 make it harder to stay connected with the people who are important to you and can place strain on relationships.

• Spending significant amounts of money on food that is ultimately not eaten, which can create financial stress.

If any of this sounds familiar to you, or to someone you care about, support is available.

Chewing and spitting can be difficult to talk about, but you deserve support without judgement. You do not need to wait until the behaviour is “bad enough” to ask for help.

A healthcare professional can work with you to understand what is happening, explore what might be contributing to the behaviour, and find supportive, individualised ways to help.

• 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