In the bulimic community, the weight-loss strategy known as “chewing and spitting” (or CHSP) is by far the least popular. Only 8 percent of bulimic patients seen at the Eating Disorders Clinic at the University of Minnesota reported having engaged in CHSP more than three times a week—usually resorting to it only if they were unable to make themselves vomit, or because regurgitated stomach acid was damaging their teeth or esophagus. Rarely would the study’s author, Jim Mitchell, encounter a patient “whose sole problem is chewing and spitting.”
Of all the unflattering and untrue stories printed in the tabloids about Elton John over the years, this one drove him to sue: “Rock star Elton John’s weight has plunged . . . thanks to a bizarre new habit of eating food then spitting it out.” The article, which ran in London’s Sunday Mirror in 1992, described him at a holiday party at his manager’s home, spitting chewed shrimp into a napkin, commenting gaily, “‘I love food, . . . but what’s the point of swallowing it, you can’t taste it as it goes down your throat.’” The editors admitted to having fabricated the story but didn’t feel John had been defamed. The jury disagreed, awarding the singer ￡350,000—about $570,000—in damages.
Disgust and shame don’t fully account for the unpopularity of CHSP. This does: chewing without swallowing is not eating. It doesn’t scratch the itch. That’s the point of swallowing it, made-up Elton: satisfaction. As regards eating, Mitchell told me, there’s an imaginary line at the esophagus. “Everything happening above the neck—smelling, tasting, seeing—drives you toward eating, and everything below drives you toward stopping.” Chewing causes saliva to be secreted, which dissolves the food and brings more of it in contact with the taste buds. Taste receptors recognize salts, sugars, fats, the things bodies need to thrive, and impel us to stock up. As the stomach fills and satiety grows, the head pipes down. Presently the plate is pushed away. When you chew food without swallowing it, the line at the neck is never crossed. The head keeps up its clamor.
Which brings us to another reason the incidence of CHSP is so low. It’s expensive. Some of the women Mitchell interviewed would catch and release several dozen doughnuts at a go, flushing twenty-plus dollars down the toilet.
JIANSHE CHEN CAN tell you the flow speed of a high-viscosity bolus.* He knows the shear strength of a ricotta-cheese bolus, the deformability of Nutella, the minimum number of chews required to ready a McVitie’s Digestive biscuit for the swallow (eight). On the Internet I found a copy of Chen’s PowerPoint on the “dynamics of bolus formation and swallowing,” so I too know these things. What I don’t know is the point of it all. Chen made the mistake of putting his University of Leeds e-mail address on the website.
He wrote back right away. You get the sense oral processing experts are not, generally speaking, besieged by media inquiries. The aim of the work, he said, is to “provide guidance on how to formulate foods for safe eating by disadvantaged consumers.” Bolus formation and swallowing depend on a highly coordinated sequence of neuromuscular events and reflexes. Disable any one of these—via stroke, degenerative neurological condition, tumor irradiation—and the seamless, moist ballet begins to fall apart. The umbrella term is dysphagia (from the Greek for “disordered eating,” which may or may not explain flaming Greek cheese appetizers).
Most of the time, while you’re just breathing and not swallowing, the larynx (voice box) blocks the entrance to the esophagus (food tube). When a mouthful of food or drink is ready to be swallowed, the larynx has to rise out of the way, both to yield access to the esophagus and to close off the windpipe and prevent the food from being inhaled. To allow this to happen, the bolus is held momentarily at the back of the tongue, a sort of anatomical metering light. If, as a result of dysphagia, the larynx doesn’t move quickly enough, the food can head down the windpipe instead. This is, obviously, a choking hazard. More sinisterly, inhaled food and drink can deliver a troublesome load of bacteria. Infection can set in and progress to pneumonia.