1 00:00:08,080 --> 00:00:10,800 Hi guys. Welcome to another episode of 2 00:00:10,920 --> 00:00:13,840 Recovery Talk. This is your host, Amali Lee 3 00:00:13,840 --> 00:00:17,320 speaking. And in this week's episode we 4 00:00:17,320 --> 00:00:21,160 are going to talk about chewing and spitting. 5 00:00:21,680 --> 00:00:26,640 I'm going to talk a bit about what this is, why it happens, 6 00:00:26,880 --> 00:00:31,760 the consequences, and also just some strategies for recovery. 7 00:00:32,000 --> 00:00:35,760 So chew and spit or chewing and spitting is sometimes 8 00:00:35,800 --> 00:00:43,040 abbreviated CHSP, and it means that someone is, as the term may 9 00:00:43,040 --> 00:00:46,680 suggest, chewing food and spitting it out without 10 00:00:46,680 --> 00:00:50,720 swallowing it. It is seen as a eating disorder 11 00:00:50,720 --> 00:00:55,080 or disordered eating symptom, rather than being a separate 12 00:00:55,080 --> 00:01:00,040 eating disorder or a separate diagnosable condition. 13 00:01:00,440 --> 00:01:04,160 The way that I view it personally, I view it a little 14 00:01:04,160 --> 00:01:08,320 bit similar to purging. I kind of see spitting as a 15 00:01:08,320 --> 00:01:11,160 purging behaviour. Now I understand that with chew 16 00:01:11,160 --> 00:01:14,880 and spit there often is a certain ritualistic behaviour to 17 00:01:14,880 --> 00:01:18,080 it that it can feel quite soothing and calming in a way 18 00:01:18,080 --> 00:01:22,480 that purging may or may not be. But I die. 19 00:01:22,560 --> 00:01:28,840 I personally define purging as attempts to get rid of food, get 20 00:01:28,840 --> 00:01:32,200 rid of calories. So I see that could be self 21 00:01:32,200 --> 00:01:36,840 induced vomiting, it could be laxative abuse, it could be 22 00:01:37,120 --> 00:01:40,240 spitting up the food. So that's at least how I in my 23 00:01:40,240 --> 00:01:42,640 brain conceptualise chew and spit. 24 00:01:43,240 --> 00:01:49,040 So chew and spit comes with so many misconceptions and a sense 25 00:01:49,040 --> 00:01:53,960 of trivialisation, I would say, where people don't realise that 26 00:01:53,960 --> 00:01:57,920 it actually has very real, not just mental consequences, but 27 00:01:57,920 --> 00:02:02,600 also physical consequences. And it also often comes with so 28 00:02:02,600 --> 00:02:06,000 much shame and secrecy. And I want to let you know that 29 00:02:06,000 --> 00:02:10,720 chewing spit in people with eating disorders is actually a 30 00:02:10,720 --> 00:02:14,480 relatively common behaviour, it's just not spoken about that 31 00:02:14,480 --> 00:02:17,240 often. They're also very different 32 00:02:17,240 --> 00:02:21,440 severity levels of chewing spit. So some people may dabble a bit 33 00:02:21,440 --> 00:02:24,800 in the behaviour, they do it occasionally and other people 34 00:02:24,800 --> 00:02:28,200 may have rituals where they do it for hours and hours a day. 35 00:02:28,960 --> 00:02:31,720 And this is similar to what we see with for example binge purge 36 00:02:31,720 --> 00:02:33,400 cycles. While some people may have an 37 00:02:33,400 --> 00:02:37,480 occasional binge purge session whilst other people their entire 38 00:02:37,480 --> 00:02:40,280 day morning to night is a binge purge. 39 00:02:40,840 --> 00:02:44,760 As a coach I have seen it all. You have nothing to be ashamed 40 00:02:44,760 --> 00:02:49,000 about, but it absolutely is something it is essential that 41 00:02:49,000 --> 00:02:54,240 you work on because chewing spit is not a healthy or harmless 42 00:02:54,640 --> 00:02:57,480 behaviour that you can engage in long term without any 43 00:02:57,480 --> 00:03:01,280 consequences in terms of your mental health, physical health 44 00:03:01,360 --> 00:03:04,440 and social health. So when it comes to the attitude 45 00:03:04,440 --> 00:03:07,080 a lot of people have towards chewing spit, I see an 46 00:03:07,080 --> 00:03:10,160 interesting parallel to early stage purging. 47 00:03:10,480 --> 00:03:14,120 So this is of course not the case for every person who 48 00:03:14,120 --> 00:03:19,240 purges, but a lot of times what I hear from people is that when 49 00:03:19,240 --> 00:03:23,160 they started to purge, they felt like they'd almost discovered a 50 00:03:23,160 --> 00:03:26,560 life hack, that they had discovered a way to enjoy the 51 00:03:26,560 --> 00:03:30,560 food without the consequences, that they had a built in delete 52 00:03:30,560 --> 00:03:32,920 button. And then of course as the 53 00:03:32,920 --> 00:03:36,120 purging goes on, you start realising, Oh well this wasn't 54 00:03:36,120 --> 00:03:38,480 the case. And I think a lot of people 55 00:03:38,480 --> 00:03:42,280 would chew and spit, are a bit stuck in that early stage 56 00:03:42,280 --> 00:03:47,120 purging mindset where they don't really see how harmful it is. 57 00:03:47,680 --> 00:03:51,040 And look, I'm not going to use this entire episode to try and 58 00:03:51,040 --> 00:03:54,840 scare you out of the behaviour, but I want you to at least make 59 00:03:54,840 --> 00:03:57,760 an informed decision if this is something you want to continue 60 00:03:57,760 --> 00:04:00,360 doing or something you feel ready to actually work on. 61 00:04:00,720 --> 00:04:03,560 Because of course, it's not a choice, but it is something you 62 00:04:03,560 --> 00:04:07,360 can choose to work on. And it absolutely is possible to 63 00:04:07,360 --> 00:04:11,480 stop the habit, break that loop. And I'll talk a bit more about 64 00:04:11,480 --> 00:04:14,800 how to do that later in episode. But first, I want to talk a bit 65 00:04:14,800 --> 00:04:18,000 about these consequences that I've been hinting towards for 66 00:04:18,000 --> 00:04:21,160 this episode. So why is chewing and spitting 67 00:04:21,160 --> 00:04:23,960 so harmful for your health? Well, first of all, when we talk 68 00:04:23,960 --> 00:04:26,840 about health, I like to talk about mental health, physical 69 00:04:26,840 --> 00:04:29,600 health, and social health. And these, of course, all 70 00:04:29,600 --> 00:04:31,360 overlap. They're not necessarily three 71 00:04:31,360 --> 00:04:34,480 very separate categories, but it is an important thing to keep in 72 00:04:34,480 --> 00:04:37,120 mind because I think a lot of times when people talk about 73 00:04:37,120 --> 00:04:39,720 health, they only talk about physical health. 74 00:04:40,240 --> 00:04:42,280 But social and mental health is very important. 75 00:04:42,800 --> 00:04:44,880 That being said, let's start with the physical health 76 00:04:44,880 --> 00:04:48,480 consequences of chewing spits. Because oh boy, there are many. 77 00:04:48,720 --> 00:04:51,680 And like I said earlier, people don't tend to realise because 78 00:04:51,680 --> 00:04:54,400 they're like, what's the harm? I'm just chewing on some food 79 00:04:54,400 --> 00:04:56,840 and spitting it out. Well, here's the thing. 80 00:04:57,600 --> 00:05:00,120 Our mouth is part of our digestive system. 81 00:05:00,440 --> 00:05:03,280 It's part of our whole metabolic system. 82 00:05:03,480 --> 00:05:06,440 When you are putting food in your mouth and you start chewing 83 00:05:06,440 --> 00:05:10,920 it, your body is getting signals that woo Hoo food is coming in. 84 00:05:11,080 --> 00:05:15,040 So it starts acting accordingly. Your stomach starts preparing 85 00:05:15,040 --> 00:05:17,800 for food to come in. There are changes in things like 86 00:05:17,800 --> 00:05:20,200 your insulin levels, your blood sugar. 87 00:05:20,200 --> 00:05:22,640 Everything prepares for food to come in. 88 00:05:23,000 --> 00:05:25,160 And then what happens? Nothing. 89 00:05:25,880 --> 00:05:27,640 There's no food. Where's the food? 90 00:05:27,760 --> 00:05:30,680 And your body has essentially pushed all of these buttons 91 00:05:30,680 --> 00:05:33,840 preparing for the food to come in, and then nothing is 92 00:05:33,840 --> 00:05:35,920 happening. And now what? 93 00:05:36,240 --> 00:05:39,200 Your body can't just undo all of these processes in a split 94 00:05:39,200 --> 00:05:42,360 second. So for example, your insulin 95 00:05:42,360 --> 00:05:45,400 levels will go up in preparation for food. 96 00:05:46,280 --> 00:05:49,160 I know I've mentioned this before, but there's so much fear 97 00:05:49,160 --> 00:05:52,920 mongering and misinformation right now out there about blood 98 00:05:52,920 --> 00:05:56,160 sugar, insulin, glucose. And the cool thing about our 99 00:05:56,160 --> 00:05:59,480 bodies is that our bodies are really, really good at handling 100 00:05:59,480 --> 00:06:01,280 these things. Unless of course you have a 101 00:06:01,280 --> 00:06:03,360 condition like, let's say diabetes. 102 00:06:03,600 --> 00:06:06,400 Your body knows what to do to regulate your blood sugar. 103 00:06:06,560 --> 00:06:08,760 Your body knows how to send out insulin. 104 00:06:08,760 --> 00:06:10,600 Your cells know how to respond to that. 105 00:06:10,600 --> 00:06:13,760 But when you're starving yourself or when you're engaging 106 00:06:13,760 --> 00:06:17,600 in behaviours that are confusing the the body, then this whole 107 00:06:17,600 --> 00:06:19,240 system is going to go a bit out of whack. 108 00:06:19,840 --> 00:06:23,880 So here's what happens when you start chewing on a food. 109 00:06:24,320 --> 00:06:27,720 Your body releases insulin in preparation for the food to 110 00:06:27,720 --> 00:06:30,960 come. And then if nothing comes, you 111 00:06:30,960 --> 00:06:35,080 may experience that your blood sugar drops, which then makes 112 00:06:35,080 --> 00:06:38,120 you more hungry and then makes you crave more food. 113 00:06:38,440 --> 00:06:40,520 And think about this in the context of chewing spit. 114 00:06:41,040 --> 00:06:44,680 So you may be restricting your intake, which is typical for 115 00:06:44,680 --> 00:06:48,200 chewing spit. You crave a specific food. 116 00:06:48,280 --> 00:06:52,080 Let's say you crave A doughnut. You start chewing on that 117 00:06:52,080 --> 00:06:55,400 doughnut and then you think, oh if I just get a taste of it I 118 00:06:55,400 --> 00:06:58,280 will feel satisfied. But what actually happens is the 119 00:06:58,280 --> 00:07:02,760 complete opposite. You're triggering an increased 120 00:07:02,840 --> 00:07:05,320 hunger and craving response in the body. 121 00:07:05,760 --> 00:07:08,720 And then for people with chew and spit, this then may lead 122 00:07:08,720 --> 00:07:13,200 them to towards more urges to chew and spit and your body just 123 00:07:13,200 --> 00:07:16,200 never gets satisfied. It's like you're turning your 124 00:07:16,200 --> 00:07:19,560 hunger and craving hormones onto the highest volume. 125 00:07:19,920 --> 00:07:22,880 Whilst if you just had the doughnut, you would eat the 126 00:07:22,880 --> 00:07:27,000 doughnut, your body would process the food as it should 127 00:07:27,360 --> 00:07:28,920 and you would feel more satiated. 128 00:07:29,240 --> 00:07:33,400 Of course, yes, there are things like extreme hunger situations 129 00:07:33,400 --> 00:07:35,680 in recovery where people may feel like they never get 130 00:07:35,680 --> 00:07:39,160 satisfied, but that is a temporary response that you're 131 00:07:39,160 --> 00:07:41,560 going to have to go through when you've been experiencing 132 00:07:41,560 --> 00:07:44,160 restriction. It's not a permanent system 133 00:07:44,160 --> 00:07:48,600 error, but with you and spit, there is no end point unless you 134 00:07:48,600 --> 00:07:51,720 stop the behaviour. With extreme hunger, yeah, you 135 00:07:51,720 --> 00:07:54,800 may eat the doughnut and not feel completely satiated, but 136 00:07:54,800 --> 00:07:57,960 then if you have another doughnut and life keeps going on 137 00:07:57,960 --> 00:08:00,800 for some time and eventually it starts calming down and you get 138 00:08:00,800 --> 00:08:04,480 that satiation, but chew and spit doesn't give you that. 139 00:08:04,800 --> 00:08:09,320 So This is why chew and spit often can be so addictive, 140 00:08:09,320 --> 00:08:12,320 because the behaviour itself makes you want to do the 141 00:08:12,320 --> 00:08:16,440 behaviour more. Also, being on this constant 142 00:08:16,440 --> 00:08:21,160 insulin glucose roller coaster typically doesn't make people 143 00:08:21,160 --> 00:08:23,200 feel good. It can make you feel kind of 144 00:08:23,200 --> 00:08:27,040 groggy, quite tired, just quite off in general. 145 00:08:27,240 --> 00:08:30,560 And ironically, it's associated with weight gain. 146 00:08:31,080 --> 00:08:33,960 Why is that? Well, typically it's associated 147 00:08:33,960 --> 00:08:36,919 with restriction, which is then associated with bingeing. 148 00:08:37,280 --> 00:08:40,240 People may not only chew in spit, there might be one of the 149 00:08:40,240 --> 00:08:43,080 many behaviours that they're engaging in, but I would also 150 00:08:43,080 --> 00:08:47,600 theorise that having this perpetual dysregulation of the 151 00:08:47,600 --> 00:08:51,800 hormones that controls satiety, cravings, and also these 152 00:08:51,800 --> 00:08:54,520 hormones play a role in weight regulation as well. 153 00:08:54,840 --> 00:08:57,600 I would make a wild guess that that also is a bit of a 'cause. 154 00:08:57,600 --> 00:09:02,080 This is not to say that chew and spit automatically cause weight 155 00:09:02,080 --> 00:09:04,400 gain. We know this because we see it a 156 00:09:04,400 --> 00:09:06,520 lot in people who are quite underweight. 157 00:09:06,560 --> 00:09:10,000 But if we were to take a group of people and prescribe weight 158 00:09:10,000 --> 00:09:13,880 management strategies, chew and spit, it would not be listed as 159 00:09:13,880 --> 00:09:17,920 a very efficient one because of these metabolic shifts it tends 160 00:09:17,920 --> 00:09:20,200 to cause. And this is slightly similar to 161 00:09:20,200 --> 00:09:23,080 purging as well. We see a similar thing with that 162 00:09:23,560 --> 00:09:27,200 insulin, glucose response, increased cravings, blood sugar 163 00:09:27,200 --> 00:09:29,680 drop. And the good news is that you 164 00:09:29,680 --> 00:09:32,640 can actually get these things back on track with recovery. 165 00:09:33,200 --> 00:09:35,680 Of course, sometimes in recovery may feel like things can get 166 00:09:35,680 --> 00:09:37,760 worse before better. You may feel like your blood 167 00:09:37,760 --> 00:09:39,760 sugar is all over the place for a period of time. 168 00:09:40,040 --> 00:09:43,720 But you at least are giving your body a chance to heal these 169 00:09:43,720 --> 00:09:47,400 systems that have been put out of whack by repeated restriction 170 00:09:47,400 --> 00:09:49,600 and by repeatedly confusing the body. 171 00:09:50,160 --> 00:09:54,720 So we also typically see disturbances and things like 172 00:09:54,720 --> 00:09:58,240 Grilan and lactin. So Grilan is the hunger hormone 173 00:09:58,240 --> 00:10:00,200 of the body. Again, similar thing like I 174 00:10:00,200 --> 00:10:03,280 spoke about with insulin and blood sugar levels. 175 00:10:03,640 --> 00:10:06,880 The hormones spikes, your body expects food but nothing 176 00:10:06,880 --> 00:10:09,240 happens. And then leptin, which is your 177 00:10:09,240 --> 00:10:12,280 satiety hormone, it's not triggered. 178 00:10:12,560 --> 00:10:15,120 Leptin gets triggered usually when you eat so that you feel 179 00:10:15,120 --> 00:10:19,880 more satiated but nothing is happening, no food is coming in. 180 00:10:19,920 --> 00:10:23,360 So there is none of that satiation feeling. 181 00:10:24,080 --> 00:10:28,840 So to summarise it very quickly and easily, chew and spit 182 00:10:28,840 --> 00:10:33,600 confuses your metabolism, confuses your body, confuses 183 00:10:33,600 --> 00:10:36,840 your hunger signals, it makes you perpetually hungry. 184 00:10:37,120 --> 00:10:40,680 Again, not everyone experiences this, but this is a very common 185 00:10:40,680 --> 00:10:44,720 side effect which then makes the behaviour more tempting. 186 00:10:45,000 --> 00:10:49,200 And This is why some people can go hours and hours and hours and 187 00:10:49,200 --> 00:10:51,440 just chew and spit, chew and spit, chew and spit. 188 00:10:52,200 --> 00:10:56,680 Whilst even in the most extreme of extreme hunger, it typically 189 00:10:56,680 --> 00:10:59,960 is one point where someone kind of just lays down and it's like, 190 00:11:00,080 --> 00:11:03,400 I'm done now, at least I'm done for a little bit and then I'm on 191 00:11:03,400 --> 00:11:07,000 again. You are so much better off just 192 00:11:07,000 --> 00:11:10,040 swallowing the food. Yes, even if the food is 193 00:11:10,040 --> 00:11:13,720 so-called quote unquote unhealthy, your body knows what 194 00:11:13,720 --> 00:11:16,840 to do with the doughnut. It does not know what to do when 195 00:11:16,840 --> 00:11:19,280 it thinks it's getting a doughnut and nothing is coming 196 00:11:19,280 --> 00:11:22,040 in. You are not tricking your body, 197 00:11:22,040 --> 00:11:25,320 doing something mad, some magical life hack to undo 198 00:11:25,320 --> 00:11:28,480 eating. You are just putting yourself in 199 00:11:28,480 --> 00:11:31,080 a very unpleasant situation, even though there is that 200 00:11:31,080 --> 00:11:34,200 instant reward of the behaviour. And that takes me to the next 201 00:11:34,200 --> 00:11:37,680 point of why it's harmful. Well, it becomes a habit. 202 00:11:37,840 --> 00:11:40,560 It becomes something that gives you a sense of reward. 203 00:11:40,760 --> 00:11:43,280 And people often confused us with food addiction. 204 00:11:43,280 --> 00:11:46,480 They think that because they're in this chew and spit cycle and 205 00:11:46,480 --> 00:11:49,240 they can't seem to stop, it's the food's fault. 206 00:11:49,480 --> 00:11:52,760 They're just addicted to food. They can't control themselves. 207 00:11:53,000 --> 00:11:55,880 Or maybe it is that they're addicted to sugar because they 208 00:11:55,880 --> 00:11:59,800 may tend to grab rotate towards sugary foods or very processed 209 00:11:59,800 --> 00:12:03,600 foods. And I always say this, people 210 00:12:03,600 --> 00:12:07,560 with eating disorders tend to blame what is caused by the 211 00:12:07,560 --> 00:12:11,280 absence of food by the presence of food. 212 00:12:11,440 --> 00:12:15,600 The good news is that the main reason why you crave the 213 00:12:15,600 --> 00:12:20,320 behaviour so much is wait for it because you're hungry. 214 00:12:21,000 --> 00:12:24,920 Yes, there is that addictive element to the behaviour, but 215 00:12:24,920 --> 00:12:28,160 this is what I also see with binge and purge for example. 216 00:12:28,240 --> 00:12:31,520 Once you let go of the restriction driving the 217 00:12:31,520 --> 00:12:35,720 behaviour, your urges lessen significantly to the point where 218 00:12:35,720 --> 00:12:39,320 you may try to do the behaviour because you're craving a little 219 00:12:39,320 --> 00:12:42,120 dopamine hit, but it's just not hitting the same anymore. 220 00:12:42,400 --> 00:12:45,360 I've seen this so many times working with clients where 221 00:12:45,360 --> 00:12:48,400 someone may be having a really bad day and they're like, oh, I 222 00:12:48,400 --> 00:12:50,920 want to do something that gives me joy and comfort. 223 00:12:51,000 --> 00:12:52,720 So then they try to binge and purge. 224 00:12:52,720 --> 00:12:58,000 Or they may try to chew and spit and it's like, oh, it's not 225 00:12:58,000 --> 00:13:00,880 hitting the same anymore. And that's why learning other 226 00:13:00,880 --> 00:13:03,800 soothing behaviours that are healthier and more sustainable. 227 00:13:03,800 --> 00:13:06,200 It's such an important part of recovery. 228 00:13:06,640 --> 00:13:10,840 But you absolutely have to target the underlying 229 00:13:10,840 --> 00:13:12,680 restriction that drives the behaviour. 230 00:13:13,000 --> 00:13:17,160 It is very rare to hear someone just randomly start chewing and 231 00:13:17,160 --> 00:13:20,360 spitting with 00 restrictive elements. 232 00:13:20,760 --> 00:13:23,920 And considering you're listening to a podcast about restrictive 233 00:13:23,920 --> 00:13:26,120 eating disorders, I really doubt that's you. 234 00:13:26,560 --> 00:13:30,480 And even if that is you, you still are going to have to let 235 00:13:30,480 --> 00:13:33,040 go of the restriction. Allow yourself to swallow the 236 00:13:33,040 --> 00:13:35,640 food. So I've already spoken a bit 237 00:13:35,640 --> 00:13:38,720 about the metabolic consequences of chewing spit and how it 238 00:13:38,720 --> 00:13:43,080 essentially prepares your body for food to come. 239 00:13:43,480 --> 00:13:46,080 But then no food is happening and then your body gets quite 240 00:13:46,080 --> 00:13:49,880 confused metabolically and how this can ironically Dr more 241 00:13:49,880 --> 00:13:52,880 hunger and cravings, thus driving more chewing spit 242 00:13:52,880 --> 00:13:56,440 behaviours. But there is also the digestive 243 00:13:56,440 --> 00:13:58,720 part, and this is very, very important. 244 00:13:59,000 --> 00:14:05,040 So there is something called the cephalic phase of digestion, and 245 00:14:05,040 --> 00:14:08,480 this is the anticipatory stage of digestion. 246 00:14:08,760 --> 00:14:12,080 So in a way, our stomach is kind of part of our mouth because 247 00:14:12,080 --> 00:14:17,120 digestion begins in the mouth. So what happens here is that 248 00:14:17,120 --> 00:14:20,760 you're producing spits, digestive enzymes in the mouth 249 00:14:20,760 --> 00:14:25,400 and stomach are then released and then the stomach acid begins 250 00:14:25,400 --> 00:14:27,680 to secrete. Same thing. 251 00:14:27,680 --> 00:14:30,240 Like I said, your body is preparing for the food to come. 252 00:14:30,240 --> 00:14:32,720 So your stomach is like, OK, we are ready, we're prepared. 253 00:14:32,720 --> 00:14:36,680 We've got the stomach acid flowing and then nothing. 254 00:14:37,080 --> 00:14:41,080 And having a stomach full of stomach acid, that's like 255 00:14:41,120 --> 00:14:45,800 anticipatory waiting for food to come, but with no food to like 256 00:14:45,880 --> 00:14:49,240 dig its hands into, it's going to be very uncomfortable. 257 00:14:49,400 --> 00:14:52,280 And add on top of that, if you have a restrictive eating 258 00:14:52,280 --> 00:14:55,720 disorder, there's a very high chance you have digestive 259 00:14:55,720 --> 00:14:59,160 symptoms already. Not everyone, but a majority. 260 00:14:59,520 --> 00:15:03,800 So the consequences of this cephalic face confusion, AKA 261 00:15:03,880 --> 00:15:08,200 stomach ready for food, no food coming in can be, for example, 262 00:15:08,200 --> 00:15:11,600 stomach pain, discomfort, cramps. 263 00:15:11,880 --> 00:15:15,520 You may feel more bloated, more gassy, you may feel quite 264 00:15:15,520 --> 00:15:18,440 nauseous. And then there also is acid 265 00:15:18,440 --> 00:15:22,000 reflux because your stomach is producing more stomach acid to 266 00:15:22,000 --> 00:15:24,920 break down the food, but there is no food coming. 267 00:15:25,240 --> 00:15:28,120 And then what are we going to do with all of this stomach acid? 268 00:15:28,520 --> 00:15:31,240 And then some people with restrictive eating disorders, 269 00:15:31,240 --> 00:15:35,240 they may already have weakness in essentially the the muscles 270 00:15:35,240 --> 00:15:39,360 that control stomach acid and prevents it from coming back up 271 00:15:39,360 --> 00:15:42,440 your mouth. This can be due to purging. 272 00:15:42,440 --> 00:15:47,360 It can be due to just loss of body tissue, loss of muscle, 273 00:15:47,360 --> 00:15:49,800 loss of, you know, eating disorders, restricted eating 274 00:15:49,800 --> 00:15:52,000 disorders. You're going through severe 275 00:15:52,000 --> 00:15:54,520 restriction, everything breaks down. 276 00:15:54,600 --> 00:15:58,080 You're not just losing body fat, you're also losing organ tissue. 277 00:15:58,280 --> 00:16:01,240 So they can be damaged to essentially the part of your 278 00:16:01,240 --> 00:16:04,800 body that prevents your stomach acid from flowing up your mouth 279 00:16:04,800 --> 00:16:06,760 all the time. And this is of course not the 280 00:16:06,760 --> 00:16:09,320 case for every person who choose and spits. 281 00:16:09,760 --> 00:16:14,000 Coming to the point of organ tissue loss is of course more 282 00:16:14,000 --> 00:16:16,680 associated with severe and prolonged restriction. 283 00:16:16,800 --> 00:16:18,920 But in the context of restrictive eating disorder, 284 00:16:18,920 --> 00:16:22,880 that is a very real possibility because you are at some point 285 00:16:22,880 --> 00:16:25,920 going to lose more than quote unquote just body fat. 286 00:16:25,920 --> 00:16:29,560 It's going to start taking a hit on your muscles and organs. 287 00:16:29,800 --> 00:16:34,520 And if the muscles in your oesophagus is weak, that's that 288 00:16:34,520 --> 00:16:37,760 can cause some issues, can also cause a sensation of 289 00:16:37,760 --> 00:16:41,880 regurgitating food involuntarily, not very nice. 290 00:16:42,440 --> 00:16:45,840 And if you're someone who can quote unquote purge on command, 291 00:16:45,920 --> 00:16:49,840 that is not a flex. That is a big red flag. 292 00:16:49,840 --> 00:16:54,040 Something is not OK anyhow. So chew and spit increase the 293 00:16:54,040 --> 00:16:57,120 stomach acid, which can then increase acid reflux for some 294 00:16:57,120 --> 00:17:01,040 people, which is very, very uncomfortable and also very 295 00:17:01,040 --> 00:17:03,680 harmful for the teeth because you're getting this acid that 296 00:17:03,680 --> 00:17:06,599 erodes the teeth. And this takes me to the next 297 00:17:06,599 --> 00:17:11,920 physical consequence of chew and spit, cavities, eating all day 298 00:17:11,920 --> 00:17:15,720 long, chewing and spitting. Chewing and spitting is not good 299 00:17:15,720 --> 00:17:17,960 for your teeth. And some people may listen to 300 00:17:17,960 --> 00:17:20,480 this and be like, Oh yeah, but what about recovery? 301 00:17:20,520 --> 00:17:23,839 What about extreme hunger? Yes, but this is a shorter 302 00:17:23,839 --> 00:17:26,280 period. And also your body is actually 303 00:17:26,280 --> 00:17:28,600 getting the nutrients. It's getting the energy from 304 00:17:28,600 --> 00:17:31,960 that food which helps your teeth because when you are 305 00:17:31,960 --> 00:17:36,160 significantly restricting, your body may eventually start trying 306 00:17:36,160 --> 00:17:40,960 to get get energy, get nutrients from your teeth and your bone. 307 00:17:41,440 --> 00:17:48,080 So even if you have amazing dental health, just the act of 308 00:17:48,080 --> 00:17:50,000 restriction itself can harm your teeth. 309 00:17:50,320 --> 00:17:52,720 So if you're someone in recovery, yeah, even though you 310 00:17:52,720 --> 00:17:55,240 may be on a little bit of a sugar binge at the moment, 311 00:17:55,480 --> 00:17:58,040 you're not going to eat that way forever and you're actually 312 00:17:58,040 --> 00:18:00,360 giving your body energy to rebuild itself. 313 00:18:00,520 --> 00:18:02,760 Might be some calcium in that chocolate as well. 314 00:18:03,040 --> 00:18:05,480 But this is what I said with chewing spit, there's not 315 00:18:05,480 --> 00:18:08,280 necessary an endpoint unless you stop the behaviour. 316 00:18:08,400 --> 00:18:12,480 So then you have constant food on the teeth that can trigger 317 00:18:12,480 --> 00:18:16,800 cavities and then you have potentially acid reflux acid 318 00:18:16,800 --> 00:18:22,160 coming up eroding the teeth. I mean if you think recovery 319 00:18:22,160 --> 00:18:25,880 treatment is expensive, wait until you see dental treatments. 320 00:18:26,240 --> 00:18:29,880 People tend to think that purging through self induced 321 00:18:29,880 --> 00:18:32,760 vomiting is the only thing that harms teeth and eating 322 00:18:32,760 --> 00:18:34,760 disorders, but that's not the case. 323 00:18:35,200 --> 00:18:40,040 Being depleted of nutrients, acid reflux or chew and spit 324 00:18:40,040 --> 00:18:42,200 behaviours can also be very, very harmful. 325 00:18:42,640 --> 00:18:47,440 The good news is that dentists are often very kind and mindful 326 00:18:47,440 --> 00:18:50,120 about this. They see these things a lot, 327 00:18:50,400 --> 00:18:53,120 they're not there to judge you and they have seen worse than 328 00:18:53,120 --> 00:18:55,640 you. But you do not want your teeth 329 00:18:55,640 --> 00:19:00,640 to be broken prematurely and get a very expensive dental bill. 330 00:19:00,880 --> 00:19:05,840 So take that also as a reason to stop chew and spit behaviours or 331 00:19:05,840 --> 00:19:07,640 self induced vomiting for that sake. 332 00:19:08,200 --> 00:19:11,280 Then there also is just a completely obvious physical 333 00:19:11,280 --> 00:19:16,320 consequence of chewing food but not swallowing the food. 334 00:19:16,320 --> 00:19:19,480 If that then leads you to not getting in enough food and 335 00:19:19,480 --> 00:19:23,760 nutrients, then of course we're looking at the classical side 336 00:19:23,760 --> 00:19:27,480 effects of restriction under eating, weight suppression, 337 00:19:27,640 --> 00:19:30,680 nutritional depletion. But that's not necessarily 338 00:19:30,680 --> 00:19:33,640 exclusive to chew and spit. So I'm not going to go too much 339 00:19:33,640 --> 00:19:35,520 in depth on that in this episode. 340 00:19:35,840 --> 00:19:39,320 So to summarise, chew and spit. Very bad for your metabolic 341 00:19:39,320 --> 00:19:43,080 health, very bad for hunger and appetite regulation. 342 00:19:43,320 --> 00:19:48,520 Not an efficient way to actually deal with your cravings, tends 343 00:19:48,520 --> 00:19:52,720 to just make you crave it more, gets quite addictive and is 344 00:19:52,720 --> 00:19:57,440 insanely expensive. So this also goes to binge purge 345 00:19:57,440 --> 00:20:01,240 behaviours. Buying a bunch of food and not 346 00:20:01,240 --> 00:20:03,160 actually eating it is very expensive. 347 00:20:03,520 --> 00:20:06,080 I'm not going to make too big of a point on that because I know 348 00:20:06,080 --> 00:20:08,120 that a lot of people would chew and spit. 349 00:20:08,120 --> 00:20:09,960 They're very ashamed for this reason. 350 00:20:09,960 --> 00:20:12,440 They're angry at themselves for spending that money. 351 00:20:12,600 --> 00:20:15,960 They may have some rigidity around money to begin with, but 352 00:20:15,960 --> 00:20:18,000 it is something that has to be said. 353 00:20:18,320 --> 00:20:22,600 Think about all the money that you have spent on spitting. 354 00:20:23,360 --> 00:20:26,560 And then lastly, like I mentioned, the digestive side 355 00:20:26,560 --> 00:20:30,560 effects. When you are deprived in terms 356 00:20:30,560 --> 00:20:34,680 of being in an energetic deficit, in terms of having a 357 00:20:34,680 --> 00:20:37,880 restrictive eating disorder, your stomach is already 358 00:20:37,880 --> 00:20:42,160 struggling and adding this on top of that is going to be 359 00:20:42,160 --> 00:20:45,720 really bad. Constipation, bloating, pain, 360 00:20:45,760 --> 00:20:51,480 nausea, reflux, cramps. Recovery is your best chance at 361 00:20:51,480 --> 00:20:55,120 reversing as much as possible. Of that, some things are 362 00:20:55,120 --> 00:20:59,240 completely reversible. Other things may not be 100% 363 00:20:59,240 --> 00:21:02,760 reversible, such as dental health, for example, But you can 364 00:21:02,760 --> 00:21:04,840 stop the damage from progressing. 365 00:21:05,040 --> 00:21:09,080 And with many of these things, you can partly or fully reverse 366 00:21:09,080 --> 00:21:12,560 the harm. And now there also is the mental 367 00:21:12,560 --> 00:21:14,920 and the social consequences of the behaviour. 368 00:21:14,920 --> 00:21:17,080 And I think when we're talking about health, we have to include 369 00:21:17,080 --> 00:21:19,360 that as well. Because even if you were someone 370 00:21:19,360 --> 00:21:23,760 who had zero health consequences from shoe and spit, you felt 371 00:21:23,760 --> 00:21:27,440 great, everything was good. You didn't notice any, for 372 00:21:27,440 --> 00:21:30,080 example, shifts in your cravings and hunger. 373 00:21:30,240 --> 00:21:32,640 You found that you felt like you have the behaviour under 374 00:21:32,640 --> 00:21:35,040 control, which by the way probably not the case. 375 00:21:35,440 --> 00:21:38,360 Your stomach was great, teeth all good. 376 00:21:38,480 --> 00:21:39,920 You were also multi millionaires. 377 00:21:39,920 --> 00:21:42,000 You didn't really care about spending that much money on 378 00:21:42,000 --> 00:21:43,520 chewing food and spitting it out. 379 00:21:43,560 --> 00:21:46,280 There still is the mental and social health impacts. 380 00:21:46,720 --> 00:21:51,480 So mentally, anything that you're doing, because it feeds 381 00:21:51,480 --> 00:21:55,200 into your eating disorder, it is going to keep you more stuck in 382 00:21:55,200 --> 00:21:57,440 the eating disorder. And you're going to have to ask 383 00:21:57,440 --> 00:22:00,000 yourself, is that how I want to spend the rest of my life? 384 00:22:00,360 --> 00:22:04,880 And This is why when I work with clients, we also often focus on 385 00:22:04,880 --> 00:22:08,800 behaviours that may seem quite minor and benign. 386 00:22:08,800 --> 00:22:11,840 By the way, true and spit is not minor and benign, but I'm just 387 00:22:12,400 --> 00:22:14,280 explaining this so you can understand where I'm coming 388 00:22:14,280 --> 00:22:16,520 from. For example, we may work on 389 00:22:16,520 --> 00:22:20,000 things like breaking perfectionism around food and 390 00:22:20,000 --> 00:22:22,080 eating. So having a meal that's kind of 391 00:22:22,080 --> 00:22:26,040 imperfect, eating a chocolate bar in a busy crowd instead of 392 00:22:26,040 --> 00:22:30,480 in a ritualistic way at home, Allowing yourself to use like a 393 00:22:30,480 --> 00:22:34,240 random spoon rather than the holy spoon that you have to use 394 00:22:34,240 --> 00:22:37,000 at every meal and freak out if someone takes. 395 00:22:37,440 --> 00:22:40,920 And this is not necessarily a nutritional rehabilitation. 396 00:22:40,920 --> 00:22:43,920 Like I mean, if you eat your chocolate bar ritualistically at 397 00:22:43,920 --> 00:22:48,920 home alone and disturbed in a perfect manner versus if you eat 398 00:22:48,920 --> 00:22:52,400 it in the busy train station, your body still gets the same 399 00:22:52,400 --> 00:22:55,080 calories. But one of them helped really 400 00:22:55,080 --> 00:22:59,360 rewire your fears and take you closer to where you want to be. 401 00:22:59,400 --> 00:23:05,320 So even if chewing spits were not anyway harmful, it still 402 00:23:05,440 --> 00:23:09,000 would be one of those sneaky eating disorder behaviours 403 00:23:09,000 --> 00:23:12,480 that's really worth targeting. Now it is harmful, which is just 404 00:23:12,480 --> 00:23:15,720 another reason to target it. But even if it weren't, you get 405 00:23:15,720 --> 00:23:17,760 what I'm saying? Because I think this is actually 406 00:23:17,760 --> 00:23:19,640 where a lot of people are stuck in. 407 00:23:19,640 --> 00:23:24,800 The eating disorder is doing seemingly small harmless things, 408 00:23:25,600 --> 00:23:28,680 not knowing that there's those small things that together are 409 00:23:28,680 --> 00:23:33,320 like little bricks that build the person that you're in which 410 00:23:33,320 --> 00:23:35,600 you and spit. They're also often there's a lot 411 00:23:35,600 --> 00:23:40,920 of shame because let's face it, it's not necessarily like a 412 00:23:40,920 --> 00:23:44,560 behaviour that you're proud of. Anything disorder in general can 413 00:23:44,560 --> 00:23:48,360 come with shame, but with the restriction there tends to be a 414 00:23:48,360 --> 00:23:51,520 bit more of a, what can I say, people tend to be more 415 00:23:51,520 --> 00:23:54,240 comfortable admitting that they're engaging in restrictive 416 00:23:54,240 --> 00:23:57,120 behaviours than that they're engaging in things like chew and 417 00:23:57,120 --> 00:24:01,480 spit or even things like purging as well, binge purge sessions. 418 00:24:01,680 --> 00:24:06,000 And I don't think there is anything more shameful with chew 419 00:24:06,000 --> 00:24:09,080 and spit than restriction. But let's just face it, people 420 00:24:09,080 --> 00:24:12,640 don't tend to feel that way and walking around with that level 421 00:24:12,640 --> 00:24:17,480 of shame, doing something that just feels quite like it doesn't 422 00:24:17,480 --> 00:24:21,520 align with your values. I often see this in people who, 423 00:24:21,520 --> 00:24:24,880 like I mentioned the money part, people who may be quite frugal, 424 00:24:25,240 --> 00:24:29,200 people who don't like to waste resources, maybe people who are 425 00:24:29,200 --> 00:24:33,080 quite conscious of things like economy, the environment, which 426 00:24:33,120 --> 00:24:37,320 then reinforces that guilt and shame of quote unquote, wasting 427 00:24:37,320 --> 00:24:39,680 food. I also sometimes see people who 428 00:24:39,680 --> 00:24:43,880 normally eat one way, so for example, vegetarian, vegan, or 429 00:24:43,880 --> 00:24:48,200 following a very specific eating style will let go of those rules 430 00:24:48,200 --> 00:24:50,880 only when they're chewing and spitting or bingeing and 431 00:24:50,880 --> 00:24:53,520 purging, which then creates even more shame. 432 00:24:53,520 --> 00:24:57,560 So it just feels like a clash in how you want to be perceived and 433 00:24:57,560 --> 00:25:00,480 perceive yourself versus what you're actually doing. 434 00:25:01,160 --> 00:25:06,440 It also takes a lot of time, and it's not a time, It's not a 435 00:25:06,440 --> 00:25:09,960 usage of time that people tend to be very grateful that they 436 00:25:09,960 --> 00:25:13,800 did. I am so happy that I spent hours 437 00:25:13,800 --> 00:25:18,200 upon hours chewing and spitting. Said no one ever. 438 00:25:18,560 --> 00:25:21,360 And look, everyone have different ways of regulating 439 00:25:21,360 --> 00:25:24,640 their emotions, but chew and spit is not an efficient 440 00:25:24,640 --> 00:25:27,320 behaviour because it actually doesn't really regulate your 441 00:25:27,320 --> 00:25:29,600 emotions per SE. You kind of just trade one 442 00:25:29,600 --> 00:25:33,000 emotion with another and you trade it with something that is 443 00:25:33,000 --> 00:25:36,600 actually harming you. The feeling you get after 444 00:25:36,600 --> 00:25:40,080 spending a day chewing and spitting versus the feeling you 445 00:25:40,080 --> 00:25:43,800 get spending a day maybe reading, puzzling, doing some 446 00:25:43,800 --> 00:25:46,680 cleaning, those are two very different feelings. 447 00:25:46,800 --> 00:25:48,760 And you know, I probably don't even have to tell you this 448 00:25:48,760 --> 00:25:50,400 because you probably feel this already. 449 00:25:50,560 --> 00:25:54,360 And for some people, the chewing and spitting can come, can go so 450 00:25:54,360 --> 00:25:59,360 out of control that it starts to really take a hit on their 451 00:25:59,360 --> 00:26:03,160 social life. They may lose interest in being 452 00:26:03,160 --> 00:26:07,560 with friends or going out or getting a job, studying, seeking 453 00:26:07,560 --> 00:26:10,520 a romantic partner because chewing and spitting is what 454 00:26:10,520 --> 00:26:13,320 their brain is so wired towards doing. 455 00:26:13,600 --> 00:26:16,640 You may, for example, have friends over and you're just 456 00:26:16,640 --> 00:26:19,960 waiting for them to leave so that you can engage in your chew 457 00:26:19,960 --> 00:26:23,680 and spit rituals. Or you may be at uni or at work 458 00:26:23,680 --> 00:26:26,840 and all you can think about is coming home and go chew and 459 00:26:26,840 --> 00:26:29,680 spitting instead of maybe doing something after work or school 460 00:26:29,680 --> 00:26:34,760 that you are passionate about. Because a malnourished brain, it 461 00:26:34,760 --> 00:26:37,360 is going to be gravitating towards food. 462 00:26:37,360 --> 00:26:41,560 It's a survival instinct and it's like pouring water into a 463 00:26:41,560 --> 00:26:43,360 strainer. You're just not going to fill 464 00:26:43,360 --> 00:26:46,240 up. And when talking with people who 465 00:26:46,240 --> 00:26:50,360 have managed to stop the behaviour, they very rarely look 466 00:26:50,360 --> 00:26:53,600 back at the time they're chewing and spitting as like the the 467 00:26:53,720 --> 00:26:57,640 prime season of their life. Like woo Hoo highlights. 468 00:26:57,920 --> 00:27:01,160 I really would recommend the 10 out of 10 you should try too. 469 00:27:01,440 --> 00:27:05,240 And this is despite the fact that it can feel soothing, can 470 00:27:05,240 --> 00:27:08,560 give you a dopamine release. Many things can be soothing and 471 00:27:08,560 --> 00:27:10,640 give you a dopamine release. That doesn't mean that they're 472 00:27:10,640 --> 00:27:12,960 good, sustainable, healthy things to do. 473 00:27:13,560 --> 00:27:16,720 And recovery is not about not getting any of those nice, 474 00:27:16,720 --> 00:27:20,200 soothing, rewarding feelings. It's more about getting them in 475 00:27:20,200 --> 00:27:23,720 a healthier way and getting them in a more sustainable way. 476 00:27:24,360 --> 00:27:27,840 Because do you want to only get that from food? 477 00:27:28,320 --> 00:27:30,520 Isn't it better to get it from a hug? 478 00:27:30,560 --> 00:27:33,440 From a fun video game? From having a crush? 479 00:27:33,440 --> 00:27:37,800 Being so hyper focused on a hobby that you can't really 480 00:27:37,800 --> 00:27:41,120 think of anything else? From having those beautiful 481 00:27:41,120 --> 00:27:44,320 moments of calm and presence with someone you care about, 482 00:27:44,440 --> 00:27:46,840 even if you're just doing something really small, like a 483 00:27:46,840 --> 00:27:50,840 small everyday thing. The eating disorder takes away 484 00:27:50,920 --> 00:27:55,160 the joy in those small moments and it instead just wires your 485 00:27:55,160 --> 00:27:58,200 brain to find food as the most rewarding thing. 486 00:27:58,720 --> 00:28:01,760 Of course, food will be the most rewarding thing when you're 487 00:28:01,760 --> 00:28:03,920 starved, but that's not what life is about. 488 00:28:04,560 --> 00:28:09,560 So you decided that you want to save your gut, your teeth, your 489 00:28:09,560 --> 00:28:15,360 metabolism, your social life, your money, your mental health, 490 00:28:15,360 --> 00:28:19,280 and actually start to work on this chew and spit trap that 491 00:28:19,280 --> 00:28:21,040 you're in. Where do you start? 492 00:28:21,520 --> 00:28:24,560 Well, first of all, share it with your treatment team. 493 00:28:25,080 --> 00:28:27,960 If they're not super familiar with the behaviour, you can of 494 00:28:27,960 --> 00:28:30,720 course explain it a bit. If they are familiar with 495 00:28:30,720 --> 00:28:34,640 similar behaviours such as binge purge, that can be a helpful 496 00:28:34,640 --> 00:28:36,920 comparison. If you feel that it is a good 497 00:28:36,920 --> 00:28:40,240 comparison for you, of course. And you may be surprised to hear 498 00:28:40,240 --> 00:28:42,520 that they probably have heard of it before. 499 00:28:42,720 --> 00:28:45,320 They probably have worked with someone who've had that 500 00:28:45,320 --> 00:28:47,680 behaviour before. And if they say they haven't, 501 00:28:47,680 --> 00:28:50,920 that's probably because the people haven't opened up to them 502 00:28:50,920 --> 00:28:53,800 about the behaviour yet. So that's an important step one, 503 00:28:53,880 --> 00:28:57,920 open up so that you can receive help and support, and also so 504 00:28:57,920 --> 00:29:01,160 that you can alleviate some of that shame and secrecy, because 505 00:29:01,240 --> 00:29:04,600 shame drives secrecy and secrecy drives shame. 506 00:29:05,040 --> 00:29:08,560 Remember that you're experiencing a pretty common 507 00:29:08,560 --> 00:29:11,880 behavioural response to restriction, which takes me to 508 00:29:11,880 --> 00:29:14,920 the next point. You are going to have to focus 509 00:29:14,920 --> 00:29:19,880 on regular consistent meals and try to also implement some of 510 00:29:19,880 --> 00:29:22,480 those foods that you tend to chew and spit on. 511 00:29:23,160 --> 00:29:25,880 Again, there's parallels here to bingeing and purging because 512 00:29:25,880 --> 00:29:28,960 that's typically the advice for binge purge is to implement 513 00:29:28,960 --> 00:29:34,240 regular consistent meals and to also implement those quote 514 00:29:34,240 --> 00:29:37,720 unquote forbidden foods that you gravitate towards in a binge. 515 00:29:38,360 --> 00:29:41,800 You want to show your brain that all foods fit, that there's not 516 00:29:41,800 --> 00:29:45,160 one type of foods that you can only have in your mouth and then 517 00:29:45,160 --> 00:29:48,000 spit out, that you can swallow all types of food. 518 00:29:48,520 --> 00:29:51,720 If you're eating is erratic, If you wake up and you're like, I 519 00:29:51,720 --> 00:29:53,800 don't know if I'll have breakfast or not, I'll see how I 520 00:29:53,800 --> 00:29:55,520 feel. Oh, I don't know if I'll have 521 00:29:55,520 --> 00:29:57,520 lunch or not. I'll just go with the flow. 522 00:29:57,680 --> 00:29:59,080 Oh, I'm not really feeling hungry. 523 00:29:59,080 --> 00:30:00,680 Oh, now in the evening I'm super hungry. 524 00:30:00,880 --> 00:30:04,160 If that is your eating cycle, it's going to be very hard to 525 00:30:04,160 --> 00:30:09,560 stop chewing spit behaviours. Meal regularity is essential. 526 00:30:09,960 --> 00:30:12,600 Have your meals, snacks in between. 527 00:30:12,760 --> 00:30:16,880 Don't go too long between meals, Don't skip any meals. 528 00:30:17,080 --> 00:30:21,120 You're going to have to work on proper refeeding because if 529 00:30:21,120 --> 00:30:24,280 you're not refed, how are you going to stop chewing spits? 530 00:30:24,760 --> 00:30:27,360 And yeah, you may say I'll just use my willpower and stop. 531 00:30:27,360 --> 00:30:30,560 Well, doesn't really work that way because if you're still 532 00:30:30,560 --> 00:30:32,280 restricting, is that really willpower? 533 00:30:32,680 --> 00:30:35,920 Isn't real willpower doing what feels scary and leaning into 534 00:30:35,920 --> 00:30:38,560 recovery? So in terms of stopping the 535 00:30:38,560 --> 00:30:42,880 behaviour, some people manage to go cold Turkey, especially if 536 00:30:42,880 --> 00:30:45,760 they combine it with proper refeeding. 537 00:30:46,160 --> 00:30:48,880 Of course, this is the best. If you can do that, that's 538 00:30:48,880 --> 00:30:51,200 awesome. But if you find that that's just 539 00:30:51,200 --> 00:30:54,640 not happening, it's just not realistic for you, then you can 540 00:30:54,640 --> 00:30:58,000 at least work on gradually reducing the behaviour. 541 00:30:58,360 --> 00:31:01,560 That can be reducing the amount of times you're doing it, 542 00:31:01,680 --> 00:31:05,160 reducing the amount of time you're spending doing it, when 543 00:31:05,160 --> 00:31:07,680 you're doing it. Or it could be something like, 544 00:31:07,680 --> 00:31:11,200 OK, I'm going to swallow at least half of the food and then 545 00:31:11,200 --> 00:31:14,320 only spit out half. But what's important here is 546 00:31:14,320 --> 00:31:18,400 that you're gradually reducing with the goal to actually stop 547 00:31:18,400 --> 00:31:21,240 the behaviour. And as with a lot of things in 548 00:31:21,240 --> 00:31:24,760 recovery, I tend to find that there can sometimes be two types 549 00:31:24,760 --> 00:31:27,560 of people here. Person one is the person who has 550 00:31:27,560 --> 00:31:29,760 a bit of a black and white mindset with recovery, where if 551 00:31:29,760 --> 00:31:33,360 they can't do perfectly from day one, there's no point eating. 552 00:31:33,360 --> 00:31:36,080 The sort of loves this mindset because it gives you such a 553 00:31:36,080 --> 00:31:38,240 quick, easy excuse to go backwards. 554 00:31:38,800 --> 00:31:41,240 Of course, it often comes camouflage as being about 555 00:31:41,240 --> 00:31:44,480 wanting to do recovery right when it's not really about that. 556 00:31:44,880 --> 00:31:49,160 Usually it's one thing wanting to do it well and wanting to go 557 00:31:49,160 --> 00:31:50,640 all in and just really go for it. 558 00:31:50,640 --> 00:31:53,120 That's awesome. Do that if you can. 559 00:31:53,520 --> 00:31:56,280 But if you find that it comes from a place of black and white, 560 00:31:56,280 --> 00:31:58,920 thinking of if I can't do perfect, I won't do that. 561 00:31:58,920 --> 00:32:03,720 All something to work, something worth being a bit mindful of. 562 00:32:04,000 --> 00:32:07,000 And in that case, being a bit more nuanced, being a bit more 563 00:32:07,000 --> 00:32:09,640 like, OK, I'll give it a try to stop. 564 00:32:09,760 --> 00:32:13,280 But if I can't do that, I'll gradually reduce and then maybe 565 00:32:13,280 --> 00:32:15,200 down the line I'll try and stop again. 566 00:32:15,880 --> 00:32:19,280 But then there is another type of person who may have bit more 567 00:32:19,280 --> 00:32:25,080 of a tendency towards endlessly dragging things out and reducing 568 00:32:25,080 --> 00:32:27,720 your behaviour slightly and thinking that, oh, I'm all good 569 00:32:27,720 --> 00:32:29,520 Now. If that's you, you're probably 570 00:32:29,520 --> 00:32:31,160 going to need to push yourself a bit harder. 571 00:32:31,160 --> 00:32:33,480 You're probably going to need in treatment to be a bit more 572 00:32:33,480 --> 00:32:36,200 upfront, like, hey, OK, we need to work on this, you know? 573 00:32:36,360 --> 00:32:41,680 So don't let the slow and steady and gradual be a reason for your 574 00:32:41,680 --> 00:32:44,120 eating disorder, to slow it down so much that you're barely 575 00:32:44,120 --> 00:32:47,840 moving. So when it comes to specific 576 00:32:47,840 --> 00:32:52,160 foods, people may wonder, well, should I keep the foods that I 577 00:32:52,160 --> 00:32:58,000 chew and spit on in the house? And I would say ideally yes, but 578 00:32:58,040 --> 00:33:01,080 if you know that it's just not happening, you're 100% going to 579 00:33:01,080 --> 00:33:05,120 chew and spit on them, then it is OK to gradually implement 580 00:33:05,120 --> 00:33:07,480 them more in smaller quality quantities. 581 00:33:07,760 --> 00:33:11,760 So for example, buying one smaller chocolate bar, eating it 582 00:33:11,760 --> 00:33:14,680 without spitting it out versus buying like a multi pack, but 583 00:33:14,680 --> 00:33:18,520 then with the goal of later down the line being able to have the 584 00:33:18,520 --> 00:33:21,040 multi pack in the house without chewing and spitting on it. 585 00:33:21,480 --> 00:33:24,760 But I would definitely encourage to implement as much food as you 586 00:33:24,760 --> 00:33:28,880 can, including so-called trigger foods, because we know that food 587 00:33:28,880 --> 00:33:32,320 restraint is not going to be your friend in this process. 588 00:33:32,840 --> 00:33:35,480 Restraint is probably what got you here to begin with. 589 00:33:35,800 --> 00:33:38,640 So you're going to have to lessen the control. 590 00:33:38,760 --> 00:33:41,760 And if you get a bit of reactive hunger, that's fine. 591 00:33:41,800 --> 00:33:44,760 That's normal. Your body has been so used to 592 00:33:44,760 --> 00:33:48,280 you eating or chewing on certain foods without actually 593 00:33:48,280 --> 00:33:50,440 swallowing them. And once you actually do 594 00:33:50,440 --> 00:33:53,040 swallow, yeah, that's probably going to feel quite nice and 595 00:33:53,040 --> 00:33:56,400 rewarding because let's face it, just chewing the food, it 596 00:33:56,400 --> 00:33:57,640 doesn't hit the spot the same way way. 597 00:33:57,960 --> 00:34:03,720 And it's so important not to see the goal as not putting any food 598 00:34:03,720 --> 00:34:07,880 in your mouth. The goal is not to spit out the 599 00:34:07,880 --> 00:34:10,239 food. So eating more is not a sign of 600 00:34:10,239 --> 00:34:12,520 failure. And if you're undernourished, 601 00:34:12,520 --> 00:34:15,080 coming from out of place of eating disorder recovery, it's a 602 00:34:15,080 --> 00:34:18,000 normal part of the process. Just make sure that you have 603 00:34:18,000 --> 00:34:22,280 those regular consistent meals, that you're not avoiding sitting 604 00:34:22,280 --> 00:34:26,960 down and having like a proper meal, and that you're not saving 605 00:34:26,960 --> 00:34:31,320 up calories for later, which then of course can worsen the 606 00:34:31,320 --> 00:34:34,800 urges to chew and spit because you get very hungry. 607 00:34:34,800 --> 00:34:37,360 Then you don't always notice that until you start eating. 608 00:34:37,719 --> 00:34:41,480 Working with the dietitian that knows eating disorders, very 609 00:34:41,480 --> 00:34:44,239 important point needs to know about eating disorders, needs to 610 00:34:44,239 --> 00:34:47,800 be eating disorders specialised can be very helpful here, as can 611 00:34:47,800 --> 00:34:51,840 working with a therapist, a coach, someone who knows the 612 00:34:51,840 --> 00:34:54,800 behaviour and someone who can be there and support you 613 00:34:54,800 --> 00:34:57,000 practically going through recovery. 614 00:34:57,160 --> 00:34:59,200 And you're going to have to lean into trust here. 615 00:34:59,360 --> 00:35:03,800 I know I spoke about this in the last episode I did together with 616 00:35:03,800 --> 00:35:07,720 coach Louisa where we spoke about body image as a recovered 617 00:35:07,720 --> 00:35:09,400 person. And one of the points that I 618 00:35:09,400 --> 00:35:13,400 made that was a little bit of from body image was that 619 00:35:13,400 --> 00:35:18,200 oftentimes what makes recovery hard is that you don't yet have 620 00:35:18,200 --> 00:35:21,080 that trust with your body because that trust takes time 621 00:35:21,080 --> 00:35:24,760 and experience to build and you kind of have to go into it blind 622 00:35:24,760 --> 00:35:27,080 a bit. You may have all of these worst 623 00:35:27,080 --> 00:35:29,240 case scenarios of what would happen if you didn't spit the 624 00:35:29,240 --> 00:35:31,720 food out, if you instead swallowed it, if you actually 625 00:35:31,720 --> 00:35:34,760 listen more to your hunger, if you stop suppressing your 626 00:35:34,760 --> 00:35:37,680 weight, etcetera, etcetera. But you're going to have to feel 627 00:35:37,680 --> 00:35:41,560 the fear and do it anyways. So if you can't trust that your 628 00:35:41,560 --> 00:35:44,880 body will figure it out, try to instead think, how would a 629 00:35:44,880 --> 00:35:47,320 version of me that did have that trust behave? 630 00:35:48,600 --> 00:35:51,760 A few other things that can be helpful aside from the things 631 00:35:51,760 --> 00:35:55,520 I've already spoken about can be write down the pros and cons 632 00:35:55,520 --> 00:35:57,360 left of The Chew and spit behaviour. 633 00:35:57,920 --> 00:36:01,560 That can be quite helpful to put it in perspective of how 634 00:36:01,560 --> 00:36:04,480 inconvenient the behaviour is. Because when you're in the 635 00:36:04,480 --> 00:36:07,120 behaviour and maybe you're getting the reward and comfort, 636 00:36:07,120 --> 00:36:09,360 you may be like, oh, this is great, what's the issue? 637 00:36:09,720 --> 00:36:13,240 Then when you actually can sit down in a clear moment and be 638 00:36:13,240 --> 00:36:15,920 like, OK, what are the consequences? 639 00:36:16,080 --> 00:36:20,040 And think about your mental, physical and social consequences 640 00:36:20,080 --> 00:36:23,160 of the behaviour. If you can't think of a specific 641 00:36:23,160 --> 00:36:26,160 consequence of that exact behaviour of chewing and 642 00:36:26,160 --> 00:36:28,920 spitting, think about consequences of your eating 643 00:36:28,920 --> 00:36:31,600 disorder in general. And can you really fully recover 644 00:36:31,600 --> 00:36:33,480 from an eating disorder when you're still chewing and 645 00:36:33,480 --> 00:36:36,600 spitting? It's a bit like, can you still 646 00:36:36,600 --> 00:36:38,200 be drinking when you stop drinking? 647 00:36:38,920 --> 00:36:42,160 What? No you can't fully recover while 648 00:36:42,160 --> 00:36:44,280 still doing eating disorder stuff. 649 00:36:44,600 --> 00:36:47,680 So remember that for full recovery it's a non negotiable 650 00:36:47,680 --> 00:36:50,400 to target the behaviour because typically what drives the 651 00:36:50,400 --> 00:36:53,000 behaviour? I mean it's several things but a 652 00:36:53,000 --> 00:36:56,800 big driver tends to be the fear of what would happen if you 653 00:36:56,800 --> 00:36:59,880 swallow the food, the fear of weight gain, the fear of 654 00:37:00,120 --> 00:37:02,840 trusting your body, the fear of leaning into your hunger. 655 00:37:03,040 --> 00:37:07,520 It absolutely is the behaviour we're targeting and recovery is 656 00:37:07,560 --> 00:37:11,920 100% possible. All right, guys, I hope you 657 00:37:11,920 --> 00:37:15,040 enjoy this episode. If you're enjoying this podcast, 658 00:37:15,040 --> 00:37:18,320 make sure that you leave a rating, give the podcast a 659 00:37:18,320 --> 00:37:22,080 follow, share with a friend and you can also follow me on 660 00:37:22,080 --> 00:37:26,160 Instagram at Amali Lee and my website for coaching and other 661 00:37:26,160 --> 00:37:30,480 enquiries is letsrecover.co.uk. See you guys in the next 662 00:37:30,480 --> 00:37:31,040 episode.