Expert: Joanne - 4/23/2008

Question
QUESTION: Hi, my name is Lilian and for the past 4 months, I have not eaten a meal/snack but I have been chewing and spitting bread, crackers and cheese. I have actually cut down the chewing and spitting already. I have lost some weight during these 4 months but i was wondering is the chewing and spitting of dry foods considered almost negligible calories? I am quite worried. That said and I don't eat at all during the day or night. I don't chew and spit sugary foods like candy, chocs, ice-cream, creamy biscuits or even deep fried foods as I am scared that the sugar and oil in these foods can be accidently swallowed.

Also, I use laxatives a few times a week and throw up once every two days. What i get in my vomit is not much food; just a little bit i accidently swallow and the horrible taste of stomach acid. I also engage in exercise everyday for about 45-60 minutes on the treadmill. I have had anorexia since 16 years old and I am currently 22 years of age. I have had many relapses in the past. Also, i was wondering can one be underweight and still get their periods? I have read that stress, depression, over-exercise and other hormonal diseases like polycystic ovarian disease can cause menses to cease. How far is this true?

ANSWER: Lilian

Sorry I haven't replied to this sooner!

I can't find a definitive answer on this question.  I have been asked many times about it, but can't seem to find it anywhere!  Some say that you can't gain weight, and then others say you can, and well some of that is from their own personal experience.

I think that you need to seriously look for help and look for it soon.  Each of your habits are dangerous on their own, but put them together and you really are going to run into trouble!

It is possible to have your period when underweight, but it depends on how underweight you are!  If your fat percentage drops too low, then you tend to lose your period.  However, all the other causes you have mentioned are true possible causes, but in your case, I would think it would be highly likely that if you are suffering from this it is due to being malnourished!

Joanne

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

QUESTION: Thanks for answering my above question. Its just that i am very paranoid but its because i get hungry as i have not eaten a meal/snack or even a fruit or veg for the past 4 months! I read that only simple sugars like those found in honey can be absorbed in the mouth. So does that mean, I am absorbing little or neglible cals if i do it with the above foods? I have thrown up after chewing and spitting and i don't get much food coming back up. If i continue like this, can I lose more weight?

Answer
Lilian

I'd imagine you are absorbing some calories from the foods you mention.  You have to remember that complex carbohydrates begin to be broken down in the mouth by amylase, so there may be simple sugar that can be absorbed more easily at this point!  However, I have mentioned that I am struggling to find a definite answer to this question.  I would recommend bringing this up with a nutritionist or ED specialist.  They may have more information available to give you.

I'd imagine you will continue to lose weight, but it will slow, and you may actually experience weight gain!  Chewing and spitting causes more insulin to be released into the bloodstream, so more sugar that is absorbed will be taken up by the insulin and stored.

Four months without eating at all?!  YOU NEED TO GET HELP, AND YOU NEED TO GET IT NOW!!!!  Please think about the damage that you are causing your body.  What is the point in losing more weight if it means that you are going to be dangerously ill, or even dead?!  It is not attractive, and it does not make you happy!!!  It is never enough!  You need to think about why you are doing this, and think about what could make that better!

Joanne