Individuals affected by eating disorders take dieting to the extreme in attempts to control their weight and shape. Many engage in dangerous practices, including severe caloric restriction, compulsive exercise and self-induced vomiting. Subtle signs may also indicate disordered eating habits. One in particular is excessive chewing of sugarless gum. What was traditionally intended for breath freshening has become a method of weight control among the diet obsessed, the majority of whom are female. While sugarless gum is generally regarded as safe, even promoted for dental health when chewed in moderation, the excessive consumption commonly seen in those with eating disorders warrants concern.
Individuals affected by an eating disorder consume on average four times more sugarless chewing gum per week than the average person, as reported in the May 2006 issue of the "International Journal of Eating Disorders." A number of reasons have been suggested as to why those with eating disorders chew such large amounts of gum, the primary explanation being the nutritional profile of gum. Sugarless chewing gum contains an insignificant number of calories and is devoid of all other nutrients, including carbohydrates and fat. The lack of food energy makes sugarless gum appealing to those who are drastically restricting their caloric intake.
In extreme efforts to reduce energy intake, individuals with eating disorders often substitute sugarless chewing gum for food. Physiologically, the act of chewing gum temporarily satisfies hunger pangs, but the effect is short-lived. The act of chewing signals to the body that food is on the way, initiating the production of salivary enzymes and gastric acid. Yet when food is not provided these substances are not degraded immediately and their presence prolongs the feeling of hunger. This feeling triggers a person with an eating disorder to pop another piece of gum into her mouth, hoping to alleviate the discomfort.
Gum chewing is also used to deal with the social pressures of eating. Meal times can be especially stressful for someone with an eating disorder if attention is drawn to how much or how little she eats. While picking at food, she may consistently chew gum in an attempt to appear as though she is in fact eating a regular meal.
Gum Chewing and Brain Signals
Brain chemistry encourages individuals with eating disorders to continually reach for another stick of gum. As described in the May 2006 issue of the "Journal of International Eating Disorders," a semistarvation state, such as is common in anorexia nervosa, produces a heightened sensitivity to taste and smell, referred to as orosenory stimulation. Because the fear of weight gain prevents the person with an eating disorder from consuming an adequate amount of food to satisfy this craving, gum chewing is substituted.
The physical act of chewing may itself contribute to excessive use of gum in people with eating disorders. A 2005 study published in the "Journal of Medical and Dental Sciences" found the rhythmic nature of gum chewing to increase serotonin production. Serotonin, a brain neurotransmitter that increases feelings of well-being, is often disrupted in people with depression, anxiety and eating disorders. Thus for these indivduals, an increase in serotonin production serves as a positive reinforcement for repeated gum chewing.
In addition to the physical and emotional consequences of eating disorders, specific dangers are associated with excessive gum chewing. Sugarless chewing gums are often sweetened with sorbitol, a sugar alcohol lower in energy than regular sugar due in part to its poor absorption within the small intestine. Sorbitol is a laxative, and when consumed in excessive quantities it can cause a host of gastrointestinal problems, including bloating, abdominal pain and chronic diarrhea. The dangers of excessive sorbitol intake were highlighted in an article appearing in the January 2008 publication of the "British Medical Journal." Severe intestinal issues were directly related to study participants' excessive intake of sorbitol, often upwards of 30 g per day, or the amount of sorbitol found in approximately 24 pieces of sugar-free gum. The fact that those with eating disorders commonly abuse laxatives to promote weight loss further compounds the dangers of excessive sugarless gum chewing. Dehydration and electrolyte imbalances resulting from abuse of laxatives can prove fatal.
Constant chewing of gum can lead to jaw problems, including temporomandibular joint (TMJ) disorders, causing chronic pain.
Neither chewing gum excessively nor in moderation supports normal eating practices for people with eating disorders. The artifical sweetness and orosensory stimulation provided by sugarless chewing gums does not allow for normal hunger regulation and may disrupt the learned association between food sweetness and caloric density.
Is This an Emergency?
- "Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR," Fourth Edition; American Psychiatric Association; June 2000
- "Journal of Medical and Dental Sciences"; Prolonged rhythmic gum chewing suppresses nociceptive response via serotonergic descending inhibitory pathway in humans; Mohri Y, et al.; 2005
- "British Medical Journal"; Severe weight loss caused by chewing gum; Bauditz J, et al.; 2008