Symptom Watch: Chewing and Spitting

This common behavior in eating disorders may be indicative of deeper problems

Join Our Community of Science Lovers!


On supporting science journalism

If you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.


When you want the taste of food but none of the calories, it might seem like a harmless compromise to chew it up and spit it out, but new findings show otherwise. Chewing and spitting is common among patients receiving inpatient treatment for eating disorders, and previous research has linked the practice with greater illness severity. A study published last year in Eating Behaviors confirmed those results and was the first to investigate co-occurring symptoms and personality traits. A third of the 324 inpatients studied reported that they had engaged in chewing and spitting during the eight weeks before admission to the hospital, and 21 percent did so at least once a week. When compared with patients who did not engage in this behavior or did so less than once a week, the higher-frequency group had a more troubling list of symptoms: they restricted food intake more often, exercised more excessively, had increased use of diet pills and laxatives, and had higher levels of depression, neuroticism and body dissatisfaction.

The findings suggest that chewing and spitting could be a marker of severity for eating disorders. “It may be an ‘add-on’ behavior that is more likely to develop over time as an individual's illness becomes more severe, and the person's repertoire of disordered eating behaviors increases,” says Saniha Makhzoumi, now a predoctoral intern in clinical psychology at Lucile Packard Children's Hospital at Stanford University, who co-authored the study with eating-disorder researchers at the Johns Hopkins University School of Medicine. Despite the greater pathology found among such patients, their short-term response to treatment was similar to that of other patients. The bottom line: watch out for this behavior as an indicator of worsening illness, but remember that treatment can help.

Tori Rodriguez is a journalist and psychotherapist based in Atlanta. Her writing has also appeared in the Atlantic, Women's Health and Real Simple.

More by Tori Rodriguez
SA Mind Vol 27 Issue 1This article was published with the title “Symptom Watch: Chewing and Spitting” in SA Mind Vol. 27 No. 1 (), p. 12
doi:10.1038/scientificamericanmind0116-12b

It’s Time to Stand Up for Science

If you enjoyed this article, I’d like to ask for your support. Scientific American has served as an advocate for science and industry for 180 years, and right now may be the most critical moment in that two-century history.

I’ve been a Scientific American subscriber since I was 12 years old, and it helped shape the way I look at the world. SciAm always educates and delights me, and inspires a sense of awe for our vast, beautiful universe. I hope it does that for you, too.

If you subscribe to Scientific American, you help ensure that our coverage is centered on meaningful research and discovery; that we have the resources to report on the decisions that threaten labs across the U.S.; and that we support both budding and working scientists at a time when the value of science itself too often goes unrecognized.

In return, you get essential news, captivating podcasts, brilliant infographics, can't-miss newsletters, must-watch videos, challenging games, and the science world's best writing and reporting. You can even gift someone a subscription.

There has never been a more important time for us to stand up and show why science matters. I hope you’ll support us in that mission.

Thank you,

David M. Ewalt, Editor in Chief, Scientific American

Subscribe