Expert: Leigh-Anne Persing, PA-C - 4/23/2008

Question
QUESTION: Hi, I have a question. I was wondering, if one does not eat at all during the day and night but chews and spits only bread, crackers and cheese is that considered neglible calories? I have read that certain foods like honey can be absorbed through the mouth. I do not do it with candies, biscuits, fried foods, ice-cream or anything that is sugary or easily swallowed. I also engage in about an hour's exercise on the treadmill daily and I use laxatives every alternate day. I have been chewing and spitting for the past 4 months to get the 'taste' but hopefully not the calories. Throughout the 4 months, I have lost weight.

How far is the chewing and spitting myth true? I am actually a medical student and I have learnt that food only gets absorbed in the small intestine but sugar can be absorbed in the mouth eg: glucose gel used to treat diabetics suffering from hypoglycemia. I also throw up occasionally although I do not get much food coming out. I hope you can answer my question regarding the chewing and spitting of dry foods and whether or not it can cause weight loss in regards to my circumstances.

ANSWER: Lilian-

Obviously you are not getting the full amount of calories in the food item when you chew and spit. You are getting a small amount though since digestion begins in the mouth. Just as with those that binge and purge, you are still getting about 60% of the calories in the food you have eaten even though you are vomiting it back up. So you are going to lose weight if you are not getting all the calories.

Also, with regards to the laxative abuse- you are depleting your body of fluid. You are losing water weight through this, not true weight. Not only will your bowels become dependent on laxatives, but when/if you do stop taking them you may have a difficult time with fluid retention and constipation. I would encourage you to try to slowly wean yourself from the laxatives. It can cause dangerous electrolyte imbalances that could cost you your life. That combined with the vomiting, exercise, and lack of caloric intake sets you up for terrible consequences. I'm sure I don't have to tell you that though since your a med student. Ask yourself this question... how can you expect to take care of other people if you can't event ake care of yourself? Please find some help for yourself, even if it's only the school counselor.

Take care and please let me know if I can be of any further help.

Leigh-Anne

---------- FOLLOW-UP ----------

QUESTION: Thanks for answering my question. How can I be getting 60% of the calories if i am not swallowing it? I have actually vomited after chewing and spitting and i don't get much food coming back out. I thought only simple sugars like honey can be absorbed in the mouth. I have not consumed anything in the past 4 months not even a meal/snack or fruit or veg. If i continue like this, can i lose MORE weight?

Answer
I meant you would be getting approximately 60% of calories if you were binging and purging. I'm not sure of the percentage for chewing and spitting. Furthermore, it seems to me that you are seeking ways to "enahnce" your eating disorder, and that is not what I am here for. I cannot give advice that is going to be promoting disordered eating behaviors.