Expert: Meg - 4/26/2007

Question
QUESTION: Hi, i was wondering does chewing and spitting contribute to weight gain? If you are not eating anything the entire day but chew and spit out sweet stuff like biscuits, chocs, cakes can this absorb a lot of the calories and cause weight gain?

Also, last week my period returned after 6 months. I was under a lot of stress and depression earlier and my GP has increased my antidepressant to twice a day. I have noticed that i am less anxious and my mood is much better. I have also stopped taking laxatives. Does this mean i have gained weight since my period has returned? I have read that stress and depression can cause the period to cease. Can you still be underweight and get your period? Cos my clothes do not feel tighter so could i have gained weight?
ANSWER: Hello Lilian,

My apologies for the delay.  Sometimes, I have problems with my e-mail and do not receive the questions the first time they are sent.

In any case, thanks for your question and I hope that I can help at least a bit.  

In regards to chewing and spitting gaining weight, the answer is that I believe one does absorb *some* calories from doing it since some food gets swallowed and absorbed but it really depends on what you're chewing and spitting and how you're doing it.  That said, if you are not eating anything during the day and only C/S, you probably are not gaining weight as you're not getting enough calories period by doing this.  If you are gaining (or feeling like you're gaining), I would say that this is probably because you're malnourished and your eating disorder is causing you to feel this way.  

While I know this goes against what your ED is telling you (and I understand as I, too, struggled with C/S as I worked towards recovery), it is SO much better for you to eat small meals throughout the day than to wait and only c/s.  Doing this actually helps your metabolism get back to normal more quickly.  

As far as periods, that is so dependant on your individual body and its chemistry.  I've know girls who are very underweight and still get their period so it really doesn't say too much in terms of your having gained because you've gotten it.  Characteristically, doctors assume that once one's weight is regained and her body is healthy enough to bear a child, then her period will return-and in many cases this is true.  But, you are correct that stress and anxiety among other things can cause period loss and weight is only one small factor.  Since your clothes don't feel tighter, my guess is that you have not gained just because your period is back.  If anything, perhaps your body has just gotten used to being "sick" and has adapted by this point.  

I hope this helped at least a little and I wish you the best as you try to recover.  

Take care and please feel free to write again I've not answered your question fully or if there is anything else that I can help with.

Best,
Meg

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

QUESTION: Thanks for replying to my earlier question. Yes, i have increased my antidepressant medication and i have stopped taking laxatives. I actually feel much happier and less anxious. Could this have contributed to the return of my period? My clothes still do not feel tighter, they are still loose and baggy on me. Could it be that my period will come every 6 months (irregular menses)?

As for the chewing and spitting, i do it almost every day with sweet stuff like chocolates, biscuits and pastries. However, on most days i only consume one meal which ranges from 400-500 calories. Plus i engage in exercise for 1 hour (tennis and brisk wallking) 5 times a week. Could what i am eating and chewing and spitting cause me to gain weight? I normally rinse my mouth thoroughly after chewing and spitting and make sure i don't swallow a single morsel. I have read that only glucose can be absorbed through the tongue. Am i absorbing a negligible amount of calories by c/s?

Also, i have experienced some bloating after having stopped taking laxatives. I've read that withdrawal effects are bloating and water retention and flatulence. Is this true? I saw an increase in 3kg weight after having stopped taking laxatives. Is this due to water retention? Now i am frightened to step on a scale. I have contacted other eating disorder specialists regarding the withdrawal symptoms of laxatives stoppage and they said that the 3 kg weight gain is due to water retention as my body has been previously dehydrated. Can you help clarify this? Also, what is the estimate of the amount of calories required to maintain a weight of 35kg and 150cm inclusive of exercise 5 times a week for a period of 45 mins to 1 hour? Thanks if you can reply asap.


Answer
Hi Lilian,

Thanks for your question.  As far as to why your period has returned, it is possible that your stopping laxatives and your body being healthier from that has contributed to this.  Its also possible that your being happier and less stressed (from the antidepressants) are helping.  I've found that this differs from person to person and the best thing to do is to try to get as healthy as possible and stay that way so that you can have a more normal period and (if and when you choose) have children someday.  As far as your period being irregular, that again depends on your body.  Its possible that it will be irregular for awhile depending on how your body does with recovering and how much damage was done with your eating disorder.

From the information you've given, I would highly doubt that you are gaining weight from C/S.  That said, it is a destructive habit and more more facet of your eating disorder that I hope you can continue working on.

I would agree with the other experts that some water retention is normal with stopping laxatives.  I know that this can be uncomfortable but it should pass and your health (which will be positively impacted) by not taking laxatives is worth the small period of discomfort that you may experience.  

I'm not sure about your total calorie requirements as I'm terrible with metric conversions.  I would say that you probably would never want to go below 1600 calories to maintain your weight and you probably need a fair amount more than that given the amount of exercise you do.  However, to really know what is right for your body, I would recommend consulting with a nutritionist.

Hope this helps!

Best,
Meg