title: Chewing and spitting in eating disorders and its relationship to binge eating.
abstract: OBJECTIVE
  This study examined (i) the frequency of chewing and spitting and (ii) its association with other pathological eating behaviors in eating-disordered inpatients. We hypothesized a positive association between chewing and spitting and binge eating given the phenomenological similarities between these disordered eating behaviors.
  
  
  METHODS
  Frequent chewers/spitters were compared with those who did not regularly engage in this behavior with regard to diagnosis, psychometric test results, and associated eating pathology.
  
  
  RESULTS
  Chewing and spitting was not associated with elevated bingeing. Rather, frequent chewers/spitters exhibited higher levels of restrictive eating behaviors and the behavior was more prevalent in younger patients.
  
  
  CONCLUSIONS
  Contrary to our predictions, chewing and spitting is more closely associated with restrictive than with binge behaviors. This suggests that most individuals chew and spit small portions of food. The behavior is frequent, occurs across diagnostic groups, and may be associated with greater psychopathology. Future studies should clarify the amount of food consumed during chew/spit episodes and the presence of a sense of loss of control.
authors.affiliation: School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA. Aguarda@jhmi.edu
authors.forename: Angela S
authors.initials: AS
authors.lastname: Guarda
authors.forename: Janelle W
authors.initials: JW
authors.lastname: Coughlin
authors.forename: Molly
authors.initials: M
authors.lastname: Cummings
authors.forename: Angela
authors.initials: A
authors.lastname: Marinilli
authors.forename: Nancy
authors.initials: N
authors.lastname: Haug
authors.forename: Michael
authors.initials: M
authors.lastname: Boucher
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Heinberg
mesh_terms: D000328:Adult; D002032:Bulimia / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D002400:Cathartics / Q000008:administration & dosage; D039721:Diagnostic and Statistical Manual of Mental Disorders; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008409:Mastication; D015995:Prevalence; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000453:epidemiology
chemical_list: D002400:Cathartics