Is chew and spew REALLY all that bad?

I have a friend that told me that I'm one step away from an eating disorder when I chew and spew. REALLY!? She didn't mean it badly. She knows why I do it and was poking fun at me. But, since I am an Olympic Worrier, it makes me think...is it bad?

So, is it?

If there's something I REALLY want to taste but I know I can't eat it, I'll put it ever so delicately into my mouth...chew it...savor it...take in the divine flavor - then SPLAT! Spit it down the drain. Now, I only do this at home...with my own family.

I don't like doughnuts persay, but, Krispy Kreme Pumpkin Spice Donuts are calling me something wicked! I feel a chew and spew event closing in on me.

Your opinions, similar stories, harsh words and reality slaps are all appreciated, no matter what.

I don't think it is an eating disorder per say. I think it is more of a mind thing. You want to taste these things, but you don't want to get sick. So you chew and spew. I don't think I could do that. I would get it in my mouth and it would automatically go down my throat. I think if I got sick from whatever I was not supposed to eat, I wouldn't want it anymore. Funny thing is, that since my surgery, things that I used to LOVE just do not taste the same to me. They do not taste good to me. I had a cheesesteak( minus the bread) and it did not satisfy me. There is a bakery near me that does alot of SF bakery items. They have a SF cheesecake that is TO DIE FOR!! I did a protein pumpkin pie that actually tasted pretty good!

I guess what I am trying to say is maybe you should not  even try it! I tell myself when I see a candy bar or a cake that I want. I say to myself that it is poison to me and that I will get sick....then I do not want it! I do believe it is mind over matter.....

Hope this helps,

Beth

I would agree. It is bad. Very bad.

It's an abnormal relationship with food, and in the long run, could very well lead to binging and purging. Being blunt, I'd be surprised if it didn't.

The words you use to describe your experience with this behavior are passionate and poetic. It's prettying up a dirty truth. It's chewing up food and spitting it into the sink. I'm pressed to find anything divine or savory about that.

Were I you, I'd nip this habit in the bud, before it grows into something you're going to have a much harder time controlling.

Ouch, but, I get it. I agree it's not a pretty habit and if it's really bad, I better stop it. It's not like it's daily. I HATE puking. But, I also know that I have to break up with many foods.

I also agree that most foods don't taste the same and actually taste gross now. I hope pumpkin spice donuts is one of those things. It's stuff like 2 bites of macaroni and cheese, birthday cake, pbj sandwiches...never like a whole piece of cake, or a whole sandwich...just a bite. I rationalize it by saying, I just want to TASTE it. Swallowing it is not necessary.

Norman, your words will ring in my head from here on out. I truly do NOT want an eating disorder. Thank you for the reality check. Oh, and I HATE puking, so binging and purging sounds like torture!

Personal opinion only... all of us here have an eating disorder in some version.  We were all over eaters at some point.  You may be substituting one for another.  (I am by no means an expert on any of this and this is only my opinion). 

I think you may be able to find alternate versions that are more WLS friendly to taste and swallow.  I would not want to start down a slippery slope of one bite of "X" that leads to more bites etc and then actually eating it. 

These are all choices we make for ourselves everyday about what we put in our mouths and what we swallow.  The question is.. do you think its a wise choice?  do most or not all of us make bad choices periodically .. absolutely.. but we move on from them... I'd venture to say YES.

GL with your 'chew' and 'spew' dilemma

I have to add...elsewhere in the OH boards I HAVE seen this behavior described as a fast track to disordered eating. Different disordered eating than we are used to, but disordered nonetheless.

I'll be blunt here. You are playing with fire. Pushing the boundaries in a dangerous way. Then being proud that you "didn't inhale." So to speak. 

You also sabatoge yourself from the GOOD feelings of passing by the crap that got you through the door of a surgeon's office in the first place.

Everyone makes their own decisons, but we all made a big one when we signed on for this journey. All of us are human and all of us have moments of "wanting". The battle is fought on the battleground of those wants...in the aisles of the grocery stores....at tables in our favorite restaurants.

Remember, if you gamble, there is a risk that you will lose. I'd get to a therapist and deal with it head on. Not bent over the sink. (How gross, to be honest.)

Yes.  It's called Ednos, or Eating Disorder, Not Otherwise Specified.

http://www.nytimes.com/2010/01/19/health/19eat.html

Narrowing an Eating Disorder

By ABBY ELLIN Published: January 18, 2010

The year was 1988, and I was a college student on my junior year abroad, traveling aimlessly through the Middle East and Europe. My backpack was crammed with shorts and T-shirts, bathing suits and sarongs, my Walkman and Grateful Dead tapes. And oh, yes, a scale, buried deep beneath layers of socks. Having been a chubby adolescent — and having spent six summers at fat camp — I was terrified of gaining weight.

  Unfortunately, nothing gave me as much pleasure as eating, which I did with abandon.

To maintain some semblance of control, I divided my eating into Food Days and Nonfood Days: that is, days when I consumed vast amounts, and days when I policed my caloric intake with military precision. The routine kept my weight in check, more or less. Never mind that it was insane.

No one at my college health center knew what to do with me. Clearly, I wasn’t anorexic; I was slightly round, in fact. I didn’t purge, so bulimia was out. To my distress, the counselors told me there was nothing they could do for me and sent me on my way.

Today, I would probably qualify for a diagnosis of “eating disorder not otherwise specified," usually known by its acronym, Ednos. In the current edition of the Diagnostic and Statistical Manual of Mental Disorders, it encompasses virtually every type of eating problem that is not anorexia or bulimia.

Though its name is less familiar, it is diagnosed more often than those two disorders — in 4 percent of American women each year, according to the National Eating Disorders Association. (The association does not have statistics on men.) Subsets of Ednos include binge eating disorder, purging disorder, night eating syndrome, chewing and spitting out food, and even picky eating.

But the diagnosis baffles many clinicians, who call it ambiguous, vague and unwieldy. And so the American Psychiatric Association is overhauling its definition of Ednos for the next edition of the diagnostic manual, known as D.S.M.-5, to be published in 2013.

“The consensus is that Ednos is ‘too big,’ meaning it is being used more frequently than is desirable, as that label does not convey much specific information," said Dr. B. Timothy Walsh, a professor of psychiatry at Columbia who is chairman of the eating disorders work group for the new manual.

Dr. Walsh said the panel was “considering a range of ways to reduce the frequency with which that very broad category is used." For now, though, Ednos remains the nation’s most common eating disorder. A September 2009 study in The International Journal of Eating Disorders found that Ednos was often a way station between an eating disorder and recovery or, less commonly, from recovery to a full-blown eating disorder.

While traveling with a scale in your backpack is not one of the criteria, preoccupation with weight and food is. So are severe chronic dieting, frequent overeating, night eating syndrome, purging disorder and possibly compulsive exercising. If that sounds a little vague — find me one woman who isn’t preoccupied with her body size — psychologists make a distinction.

“The eating has to be disordered in some way, as does the behavior relating to eating," said Ruth H. Striegel-Moore, a professor of psychology at Montana State University. “Also, it has to lead to some kind of impairment. For instance, some women will not go to parties because they’re worried about eating.

“If you’re restricting yourself so much that it affects your work negatively, you would meet the criteria for Ednos."

Even so, many clinicians say the diagnosis is just too roomy.

“One of the difficulties with Ednos is that there’s a lot of diversity within that category," said Craig Johnson, director of the eating disorders program at Laureate Psychiatric Clinic and Hospital in Tulsa, Okla. “Because there are different presentations that not all clinicians are familiar with, there’s a risk that people who have disordered eating who could benefit from clinical attention won’t know that they have a problem."

Indeed, one reason the panel wants to change the guidelines is to help patients with eating problems recognize them even if they do not exhibit any of the traditional symptoms.

Kris Shock, for example, used laxatives and restricted her food for years, but she never threw up or binged, and her weight was average. She did not seek psychiatric help for what she and her husband called her “eating problem" until age 31, when she became addicted to the diet pill ephedra, she said in a recent interview.

Now 37 and the director of a child care center in Atlanta, Ms. Shock said that when she finally got her diagnosis of Ednos, “it was like, ‘Ah, I am sick enough to get help and have the recovery experience.’ "

Most health insurance policies do not cover Ednos. (Ms. Shock refinanced her home to pay for her week-and-a-half-long stay at a residential treatment center.) Yet people with it are at risk for many of the same medical problems that afflict anorexics or bulimics, including osteoporosis, heart attacks, hormone imbalance and even death. A study in the Oct. 15 issue of The American Journal of Psychiatry reported that the mortality rate associated with Ednos exceeded that for anorexia nervosa and bulimia.

With that in mind, many doctors blur the diagnostic lines just so their patients can get insurance coverage. A chewer and spitter might be classified as bulimic, Dr. Striegel-Moore said; an almost-anorexic would fall under binge eating disorder.

Clinicians say patients like these often need to feel they have a “real" eating disorder.

“A lot of patients feel this stigma if they know they’re diagnosed with Ednos: ‘Obviously, I’m not good enough to be anorexic,’ " said Nicole Hawkins, director of clinical services at Center for Change, an eating disorder treatment center in Orem, Utah. “I’ve had many patients feel that they need to lose more weight so they lose their period so they can change the diagnosis. Patients really feel they have to get ‘better’ at their eating disorder to deserve treatment."

That is how Stacey Taylor felt. Ms. Taylor, 26, a prekindergarten teacher in Alexandria, La., said she had been dieting since age 7; at 16, she lost 70 pounds, and from then until age 25 she purged and abused diet pills, diuretics and laxatives. Although she vomited 3 to 11 times a day, she was never classified as bulimic because she did not binge, and her weight was never low enough to be anorexic.

“The doctors would look at me and say, ‘You don’t look like you have an eating disorder — go home and get something to eat,’ " she recalled, adding that she didn’t think she was “sick enough" to need help, either.

Some doctors say weight requirements should be eliminated for all eating disorders in the new diagnostic manual. Deb Burgard, an eating disorder specialist in Los Altos, Calif., notes that people of any weight and body mass index may binge, purge or diet excessively.

“I have worked with plenty of restricting average-sized and fat patients *****ally should be diagnosed with anorexia nervosa," said Dr. Burgard, a founder of Health at Every Size, an approach that focuses on health rather than weight. “But there is confusion based on the current D.S.M. whether they meet the criteria for the diagnosis if they are not at a low B.M.I. — even if their current weight is extremely low for them individually and they’re showing signs of starvation."

Perhaps the most difficult part of treating Ednos is that “normal" eating is such an elusive concept. Thinness tends to be the ideal, no matter what lengths people go to get there.

“What Ednos really demonstrates," said Dr. Johnson, at Laureate in Tulsa, “is that we don’t have empirically derived diagnoses in psychiatry.

“Think about the diagnosis of depression. When does someone have a clinical syndrome versus a mood fluctuation? At what point should it be regarded as a condition that needs treatment? When you talk about food habits, it becomes extraordinarily complicated, because everybody has a relationship with food, and it’s usually a somewhat complicated one."

I echo what others have said.

I also have to add in that you can indeed dump off of sugar even without swallowing it.  Diabetics are given oral glucose by putting it in between their gum and cheek and it is absorbed via the mucousal lining.  Now, theoretically, only a "bite" of something probably wouldn't be enough to cause dumping...but in theory, it could happen.

Good girl for thinking about it, for worrying about it, and for putting yourself "out here", and for hopefully listening to the responses....that takes guts.

~P