Chewing and spitting: A marker of psychopathology and behavioral severity in inpatients with an eating disorder

Chewing and spitting out food is a frequent behavior in hospitalized patients with eating disorders (ED). Personality characteristics of those who frequently chew-spit (CHSP), the amount of food consumed during CHSP episodes, associated sense of loss of control overeating (LOC), and clinical response to hospital-based treatment have not been examined and were the focus of this study. Participants (. N=. 324) were inpatients on a behavioral ED specialty unit. A third of the sample (. n=. 107) reported engaging in CHSP in the 8. weeks prior to admission with 21% (. n=. 69) reporting CHSP at least once per week. Those who engaged in the behavior at least weekly (CHSP. +) were compared to those with less frequent or no CHSP (CHSP. -) on demographic and clinical indices and on the EDI, BDI, and the NEO-FFI. Participants were also asked if their CHSP behavior involved a binge-like amount of food (≥. 1000. kcal) or was associated with LOC. The CHSP. + group was more likely to have purging diagnoses. After controlling for purging diagnosis, CHSP. + were found to engage in more restricting, diet pill and laxative use, and excessive exercise, and endorsed greater drive for thinness, body dissatisfaction, depression, and neuroticism than CHSP. -. Among all CHSP. + participants, LOC was present in 70% and a minority (. n=. 10, 18%) endorsed recent CHSP on binge-like amounts of food. This behavior should be assessed routinely in all patients, as it appears associated with increased eating behavior severity and increased psychiatric comorbidity at hospital admission.