Expert: Joanne - 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

I have just answered your first question, and was going to mark this as a repeat question until I read the second part!

You can absorb small sugars in the mouth as far as I'm aware, but don't take that as gospel!

I actually wanted to reply to your comment about being a medical student though!

I, too, am a medical student, and yes I have been through the eating disorder while at med school, but believe me, they do not mix!  You do risk getting caught - and you have to remember that you are in a building full of people that are likely to notice it more than your general population!  They are also likely to have come across other students in your position, even if they haven't in their clinical practice!

Please get help before it gets to that point!  Med schools can be sympathetic, but they can also be the least understanding people as well!  Throughout medical school, you are being judged as to whether you will be a capable, competent and safe Dr.  They can use illnesses such as eating disorders against you if you do not look as though you are trying to beat it.

If any of your medical friends were to know what was going on, they most likely would be obliged to tell on you!  They have to prove that they would have patients best interests at heart, and that is by making sure that people that could be dangerous to them can not practice!  Can you imagine putting them in that position?!

Having an eating disorder makes you a risk to potential patients through your own physical health, and most likely, soon to be lack of!  But you are also a risk to them due to your psychological help.  With an eating disorder, you ability to think logically and rationally is impaired, making you a potential danger when there are important clinical judgements needing to be made!

Please think about speaking to someone as soon as possible!  Your school may have people available for things like this!  Eating disorders can be extremely common amongst medical students due to the high achieving thing, etc, but what matters most is which ones can overcome their problems!

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

QUESTION: Sorry but i didn't seem to get a reply from you so I don't know whether u answered my first question in regards to chewing and spitting. Could you help clarify whether the cals absorbed from chewing and spitting dry foods like those above are little or neglible calories? I have vomited in the past after c/s and i do not get much food coming back up. I agree with you that sugars like honey and those found in candies can be absorbed but wat about dry foods? I can't really help c/s since i have not eaten a meal/snack or even a fruit or veg for the past 4 months so i get hungry; hence resort to c/s. I have thrown up in the past and i don't get much food coming back up.

I know that having an ED is a burden on my medical career and yes, i have sought help in the past. It is something that i am not proud of and there are a few friends of mine in medicine who are aware of my situation. I am aware that i run the risk of exposing my ED to the faculty and that it may jeopardise my studies. At the moment, i am just too terrifed to recover.

Answer
Lilian

Be truthful with your faculty, and get help!  You will be respected for admitting to having a problem and having the courage to try and beat this!

If it wasn't for my faculty being so understanding and offering me help when I needed it, I doubt that I would be here, alive, never mind studying!  Faculty members recognised the signs in me and confronted me with it, and it was a relief, but I think they would have appreciated it more if I had gone to them first!

I had a friend that became really ill with anorexia, and in the end classmates went to staff and basically told on her.  Things seemed to go slightly worse for her as she wasn't as willing to accept their help and lied about it more!

Think about what you are doing!  I don't know what stage you are at in your studies, but I was in pre-clinical years when this happened.  This is a much easier time to get the help that you need!  Once you are doing clinical training, you will struggle more, and are more likely going to need to take time out for recovery.  The consultants that you are likely to work with at this stage may not as empathetic either.  You are much more likely to get help and empathy from staff within the actually medical school than those you work with on the wards.  

Joanne