Chewing and spitting out food among eating‐disordered patients

Kovács, Dóra; Mahon, Jennifer N.; Palmer, Robert L.

doi:10.1002/eat.10073

Cited by 16 publications

(8 citation statements)

References 7 publications

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“…Results of ED patients who CHSP were compared to those who do not CHSP. Questionnaires addressed demographics, ED symptoms and frequenciesFrequency and overall number of nine types of current and lifetime ED behaviours were assessed using a researcher developed questionnaire, BDI, EDI-2, NEO-FFI.Patients with consecutive admissions to an integrated inpatient partial hospital treatment program for EDs who agreed to participate in an outcome studyIP and POPKovacs, Mahon, and Palmer [38]To study the prevalence and association of CHSP in a series of patients with AN, BN, and EDNOS710 adult patients (Mean age not specified) were diagnosed according to the criteria outlined in the DSM-III-RCross-Sectional Study. ED patients who CHSP were compared between ED subtypes (AN, BN, and EDNOS) and those who did not engage in CHSPClinical Eating Disorder Rating Instrument (CEDRI), defined binging (DSM-III-R definition), subjective overeating, and subjective distortion of body image.Inpatient ED Service of the Leicester General Hospital between 1991 and 1998IPDurkin, Swanson, Crow, Mitchell, Peterson, and Crosby [35]To promote cohesion between existing CHSP literature (CHSP is trans-diagnostic) from an out-patient perspective972 outpatients (Mean age = 24.6, IQR = 20.66–31.10)Cross-Sectional Study.…”

Section: Resultsmentioning

confidence: 99%

“…In a cross-sectional study, Kovacs et al [38] found that people with EDNOS ( N = 344) and AN ( N = 124) who reported CHSP showed more severe eating behaviour pathology compared to participants with BN and CHSP ( N = 242). In contrast, participants with BN and CHSP reported a greater distortion of body image compared to their AN and EDNOS counterparts.…”

Section: Resultsmentioning

confidence: 99%

“…With the exception of diuretic and laxative misuse, the disordered behaviours of binge eating and dietary restriction were very common (ranging over 70 %) in people with lifetime or current CHSP [32, 34, 36, 38]. Both Durkin et al [35] and Guarda et al [32] reported that CHSP appears to be more common in younger individuals with eating disorders.…”

Section: Discussionmentioning

confidence: 99%

“…One possible reason for this is that CHSP crosses ED diagnostic boundaries. Studies included in this systematic review indicate that CHSP is likely to be a trans-diagnostic behaviour [34, 36, 38]. Therefore, it is the recommendation of the authors of the present systematic review that clinicians consider inquiring about CHSP in all people presenting with an ED (or disordered eating).…”

Section: Discussionmentioning

confidence: 99%

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Chew and Spit (CHSP): a systematic review

et al. 2016

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BackgroundThis systematic review is an evaluation of the empirical literature relating to the disordered eating behaviour Chew and Spit (CHSP). Current theories postulate that CHSP is a symptom exhibited by individuals with recurrent binge eating and Bulimia Nervosa.AimsThe review aimed to identify and critically assess studies that have examined the distribution of CHSP behaviour, its relationship to eating disorders, its physical and psychosocial consequences and treatment.MethodsA systematic database search with broad inclusion criteria, dated to January 2016 was conducted. Data were extracted by two authors and papers appraised for quality using a modified Downs and Black Quality Index.ResultsNine studies met the inclusion criteria. All were of clinical samples and majority (n = 7) were of low quality. The pathological action of chewing food but not swallowing was reported more often in those with restrictive type eating disorders, such as Anorexia Nervosa, than binge eating type disorders. CHSP also was reported to be an indicator of overall severity of an eating disorder and to appear more often in younger individuals. No studies of treatment were found.ConclusionsConclusions were limited due to the low quality and small numbers of studies based on clinical samples only. Further research is needed to address gaps in knowledge regarding the physiological, psychological, social, socioeconomic impact and treatment for those engaging in CHSP.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Chew and Spit (CHSP): a systematic review

et al. 2016

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“…This change presumably reflects the perception that these behaviors, which have been observed among individuals with both AN-type and BN-type disorders, are no longer of sufficient importance, in terms of their prevalence and/or clinical significance, to warrant specific mention, although there appears to be little in the way of empirical evidence to support such an assumption [71,72]. …”

Section: Reviewmentioning

confidence: 99%

Classification of bulimic-type eating disorders: from DSM-IV to DSM-5

Mond

2013

J Eat Disord

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Proposed changes to the classification of bulimic-type eating disorders in the lead up to the publication of DSM-5 are reviewed. Several of the proposed changes, including according formal diagnostic status to binge eating disorder (BED), removing the separation of bulimia nervosa (BN) into purging and non-purging subtypes, and reducing the binge frequency threshold from twice per week to once per week for both BN and (BED), have considerable empirical evidence to support them and will likely have the effect of facilitating clinical practice, improving access to care, improving public and professional awareness and understanding of these disorders and stimulating the additional research needed to address at least some problematic issues. However, the omission of any reference to variants of BN characterized by subjective, but not objective, binge eating episodes, and to the undue influence of weight or shape on self-evaluation or similar cognitive criterion in relation to the diagnosis of BED, is regrettable, given their potential to inform clinical and research practice and given that there is considerable evidence to support specific reference to these distinctions. Other aspects of the proposed criteria, such as retention of behavioral indicators of impaired control associated with binge eating and the presence of marked distress regarding binge eating among the diagnostic for BED, appear anomalous in that there is little or no evidence to support their validity or clinical utility. It is hoped that these issues will be addressed in final phase of the DSM-5 development process.

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