Chewing and spitting out food as a compensatory behavior in patients with eating disorders.
OBJECTIVE
Recent studies suggest that chewing and spitting out food may be associated with severe eating-related pathology. The purpose of this study was to investigate the relationship between chewing and spitting, and other symptoms of eating disorders. We hypothesized that patients who chew and spit as a compensatory behavior have more severe eating-related pathology than patients who have never engaged in chewing and spitting behavior.


METHODS
We divided 359 patients with eating disorders into two groups according to whether they engaged in chewing and spitting as a compensatory behavior to lose weight or not. After comparing eating-related pathology between the two groups, we examined factors associated with pathologic eating behaviors using logistic regression analysis.


RESULTS
Among our 359 participants, 24.5% reported having engaged in chewing and spitting as a compensatory behavior. The chewing and spitting (CHSP+) group showed more severe eating disorder symptoms and suicidal behaviors. This group also had significantly higher scores on subscales that measured drive for thinness, bulimia, and impulse regulation on the EDI-2, Food Craving Questionnaire, Body Shape Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, and Maudsley Obsessive Compulsive Inventory.


CONCLUSIONS
Chewing and spitting is a common compensatory behavior among patients with eating disorders and is associated with more-pathologic eating behaviors and higher scores on psychometric tests.
Yonsei L Eating Disorder Clinic, Seoul, Republic of Korea.
Youn Joo
YJ
Song
Yonsei L Eating Disorder Clinic, Seoul, Republic of Korea.
Jung-Hyun
JH
Lee
Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: eugenejung@yuhs.ac.
Young-Chul
YC
Jung
D000328:Adult; D001835:Body Weight; D004328:Drive; D005247:Feeding Behavior / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000473:pathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008409:Mastication; D008875:Middle Aged; D009042:Motivation; D010555:Personality Inventory; D011594:Psychometrics; D011795:Surveys and Questionnaires