Chew and Spit (CHSP): a systematic review

Abstract

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.

Prevalence of chew and spit and its relation to other features of disordered eating in a community sample

“…In the present study, CHSP occurred in older individuals compared with that reported in our systematic review (M 5 24, SD 5 8) (Aouad et al, 2016). Differences are between individuals (male and female) that engage in CHSP (regardless of clinically diagnosable ED) and people from the HOS 2,016 representative sample (general population)-using unweighted data for CHSP.…”

“…This may be due to the younger ED samples used for studies identified in the review (Aouad et al, 2016;Guarda et al, 2004;Song, Lee, & Jung, 2015). Nonetheless, as older women are less likely to admit to, and seek treatment for, ED behaviors than younger counterparts, it may be speculated that CHSP behaviors were under-reported in the general population (Aouad et al, 2016;Guarda et al, 2004;Song et al, 2015). However, in our systematic review those with CHSP were younger than the general population (Median CHSP 5 39 vs.…”

“…Differences are between individuals (male and female) that engage in CHSP (regardless of clinically diagnosable ED) and people from the HOS 2,016 representative sample (general population)-using unweighted data for CHSP. Median pop 5 59) (Aouad et al, 2016). This may be due to the younger ED samples used for studies identified in the review (Aouad et al, 2016;Guarda et al, 2004;Song, Lee, & Jung, 2015).…”

“…Additionally, question G9 was modeled after a similar line of questioning utilized by other studies investigating CHSP (Aouad et al, 2016;Guarda et al, 2004;Makhzoumi et al, 2015). Questions listed in appendix 1 were developed by various organizations and academics that utilized the HOS in order to gather data, with reliability and validity being assessed as part of a pilot study.…”

“…was developed in order to understand (a) if participants engaged in CHSP and (b) if so, how often. Additionally, question G9 was modeled after a similar line of questioning utilized by other studies investigating CHSP (Aouad et al, 2016;Guarda et al, 2004;Makhzoumi et al, 2015).…”