Key Takeaways
Chewing and spitting (CHSP) is a disordered eating behavior in which food is chewed for taste and then spit out instead of swallowed. It often signals an underlying eating disorder and can harm teeth and digestion over time. Stopping CHSP usually means treating the root disorder with therapy and professional support, not willpower alone.
- CHSP is a symptom of disordered eating, not a harmless habit, and frequently overlaps with other eating disorders.
- Repeated chewing and spitting can contribute to dental erosion, cavities, and digestive problems.
- Cognitive behavioral therapy and a multidisciplinary treatment team are the primary evidence-based approaches.
- Identifying triggers and rebuilding a healthier relationship with food are central to recovery.
- Professional eating disorder treatment offers the strongest path to lasting change.
Introduction
Chewing and spitting, commonly known as CHSP, is a form of disordered eating behavior characterized by chewing food and then spitting it out instead of swallowing. This behavior is often associated with eating disorders such as bulimia nervosa, anorexia nervosa, and eating disorder not otherwise specified (EDNOS). While it might seem like a harmless way to avoid weight gain, chewing and spitting can cause severe physical and psychological consequences. Adults struggling with CHSP often find themselves trapped in a cycle of distress, shame, and body image concerns. Understanding how to stop chewing and spitting is crucial for recovery, and specialized treatment programs, like those at Eating Disorder Solutions (EDS) in Texas, provide effective therapies to help individuals regain control over their eating behaviors and improve their quality of life.
What is Chewing and Spitting Disorder?
Chewing and spitting disorder (CHSP eating disorder) involves chewing food and then spitting it out without swallowing. Unlike typical eating behavior, where food is consumed for nourishment, patients with this disorder engage in this behavior either to avoid weight gain or to control anxiety associated with eating certain foods, often those they experience as ‘forbidden’ or anxiety-provoking. This behavior is more than just occasional food tasting; it becomes a compulsive pattern that can severely impact mental health and physical wellbeing. CHSP is recognized as a disordered eating feature and can occur alongside other disorders, including bulimia nervosa and anorexia nervosa, or as part of binge eating episodes without swallowing the food. Research describes chewing and spitting as a compensatory behavior seen across eating disorder diagnoses (Song et al., 2015), and one clinical study found that roughly one in three people in eating disorder treatment reported the behavior (Guarda et al., 2004). It is important to note that despite the absence of food ingestion, the behavior can lead to similar health problems as more traditional eating disorders.
Symptoms and Psychological Drivers of CHSP
Individuals with the chewing and spitting behavior often experience intrusive thoughts about food, weight, and body image. Key symptoms include frequent chewing of food followed by spitting it out before swallowing, avoidance of swallowing to prevent weight gain, and feelings of shame, guilt, or distress after episodes. Psychological drivers include body dissatisfaction, compulsive tendencies, anxiety, and an intense fear of weight gain. This behavior can serve as a coping mechanism to manage stress or emotional discomfort related to eating or body image. Despite its use as a control strategy, the behavior often exacerbates mental distress and is linked to co-occurring conditions like depression and anxiety. Among people in inpatient eating disorder care, chewing and spitting has been associated with greater overall psychopathology and behavioral severity (Makhzoumi et al., 2015). Patients with eating disorders exhibiting CHSP may also demonstrate other disordered eating patterns, including binge eating, sometimes followed by spitting food out to avoid calorie intake.
Dental and Gastrointestinal Consequences of Chewing and Spitting
Even though food is not swallowed, chewing and spitting disorder can cause significant dental and gastrointestinal (GI) issues. Constant exposure of teeth to food acids and sugars without swallowing, combined with the mechanical action of chewing, can lead to enamel erosion, increased cavities, tooth sensitivity, and gum problems. Additionally, frequent spitting can irritate oral tissues. GI consequences may arise because the act of chewing triggers digestive enzyme production. This can cause discomfort, bloating, and other GI symptoms when no food reaches the stomach. There is also the potential for salivary gland enlargement from repetitive chewing. Repeated engagement in CHSP increases the risk of long-term harm both physically and psychologically. A systematic review of the available research notes that, although the behavior remains understudied, it is linked to dental and gastrointestinal effects and to meaningful psychosocial distress (Aouad et al., 2016).
Therapy Options to Stop Chewing and Spitting
Stopping chewing and spitting requires an integrated therapeutic approach tailored to each individual’s needs. Because chewing and spitting has not been studied as a standalone condition, no treatment has been developed specifically for it; instead, it is generally addressed within evidence-based eating disorder care (Aouad et al., 2016). Cognitive Behavioral Therapy (CBT) is a first-line approach for many eating disorders and focuses on identifying and changing the thought patterns and behaviors that reinforce CHSP. Exposure therapy can help patients gradually reintroduce problematic foods while managing anxiety and urges to spit. Other effective interventions include Dialectical Behavior Therapy (DBT), which improves emotional regulation, and nutritional counseling that provides structured guidance around healthy eating behaviors. Group therapy and support networks can also facilitate recovery by reducing isolation. At Eating Disorder Solutions (EDS), personalized treatment plans and adult-specific programs help patients overcome CHSP eating disorder behaviors and address the underlying psychological drivers, promoting sustainable recovery.
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Steps and Strategies for How to Stop Chewing and Spitting
Learning how to stop chewing and spitting begins with awareness and professional support. Strategies include:
1. Tracking triggers and urges: Keeping a journal to identify when and why the chewing and spitting behavior occurs.
2. Developing alternative coping mechanisms: Using mindfulness, stress reduction, or grounding techniques during moments of urge.
3. Structured meal planning: Eating balanced meals at regular intervals to reduce compulsive behaviors.
4. Seeking therapy: Engaging in CBT or DBT with a licensed eating disorder specialist.
5. Avoiding restrictive dieting: Since restrictive eating can increase urges to chew and spit, a focus on nutritional balance is essential.
6. Building a supportive environment: Involving family, friends, or support groups can reinforce recovery goals.
If you or a loved one struggle with chewing and spitting disorder, contacting specialized treatment centers like EDS in Texas is an important step toward healing.
Additional Insights on Disordered Eating Behaviors
Chewing and spitting is best understood as one feature of disordered eating rather than a problem that stands on its own. It often appears alongside bulimia nervosa, anorexia nervosa, binge eating disorder, and other specified feeding or eating disorders (OSFED), and for some people it can be an early sign that a more serious pattern is developing (Durkin et al., 2014). Recognizing the behavior, naming the urges that drive it, and getting evaluated by an eating disorder professional are the first steps toward lasting recovery.
| Aspect | Chewing and Spitting Disorder (CHSP) | Other Eating Disorders |
| Behavior | Chewing food then spitting out without swallowing | Varies: includes bingeing and purging, restriction, or overeating |
| Physical Effects | Dental erosion, GI discomfort, salivary gland issues | Electrolyte imbalances, malnutrition, digestive problems |
| Psychological Drivers | Body image dissatisfaction, anxiety around weight gain | Similar drivers plus additional mood or impulse control issues |
| Treatment Approaches | CBT, DBT, exposure therapy, nutritional counseling | CBT, family-based therapy, nutritional rehab, medications |
Frequently Asked Questions
Can chewing and spitting affect you physically even if you do not swallow the food?
Yes. Even without swallowing, chewing and spitting food can cause dental problems such as enamel erosion, cavities, and gum irritation. It may also lead to gastrointestinal discomfort because digestive processes are triggered without food reaching the stomach.
I can’t stop chewing and spitting. What should I do?
If you find yourself unable to stop chewing and spitting, seek professional help immediately. Treatment options like Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) can help address the underlying psychological drivers and provide coping strategies. Contacting an eating disorder specialist, such as those at Eating Disorder Solutions, is a crucial step.
What actually helps someone stop chewing and spitting?
Effective methods include identifying triggers, developing alternative coping mechanisms, engaging in therapy, following a structured meal plan, and avoiding restrictive diets. Working closely with clinicians who specialize in eating disorders ensures a tailored approach to recovery.
Do treatments for chewing and spitting really work?
Yes, evidence-based treatment techniques designed to stop chewing and spitting behavior have been shown to work, especially when delivered by trained professionals. Programs that integrate therapy and nutritional support can help patients regain healthy eating behaviors over time.
References
- Aouad P, Hay P, Soh N, Touyz S. Chew and Spit (CHSP): a systematic review. J Eat Disord. 2016;4:23. doi:10.1186/s40337-016-0115-1
- Guarda AS, Coughlin JW, Cummings M, et al. Chewing and spitting in eating disorders and its relationship to binge eating. Eat Behav. 2004;5(3):231-239. doi:10.1016/j.eatbeh.2004.01.001
- Song YJ, Lee JH, Jung YC. Chewing and spitting out food as a compensatory behavior in patients with eating disorders. Compr Psychiatry. 2015;62:147-151. doi:10.1016/j.comppsych.2015.07.010
- Makhzoumi SH, Guarda AS, Schreyer CC, Reinblatt SP, Redgrave GW, Coughlin JW. Chewing and spitting: a marker of psychopathology and behavioral severity in inpatients with an eating disorder. Eat Behav. 2015;17:59-61. doi:10.1016/j.eatbeh.2014.12.012
- Durkin NE, Swanson SA, Crow SJ, Mitchell J, Peterson CB, Crosby R. Re-examination of chewing and spitting behavior: characteristics within and across eating disorder diagnoses. Eat Weight Disord. 2014;19(3):315-320. doi:10.1007/s40519-013-0090-3
Resources and Support
If you or someone you love is struggling, support is available. If you are in crisis or need immediate help, call or text 988 to reach the 988 Suicide and Crisis Lifeline, a free, confidential service available 24/7.
If you or a loved one are struggling with chewing and spitting disorder, don’t wait to seek help. Contact Eating Disorder Solutions in Texas today at (855) 245-0961 to start your recovery journey with compassionate and expert care.
Related Reading
- Purging Disorder: Symptoms, Risks, and Treatment Options
- Night Eating Syndrome: Signs, Causes, and How to Get Help
For more educational articles and resources on eating disorder recovery, visit our Educational Resources page.
