Choi Jun-hee's 41-kg frame sparks 'chew-and-spit' debate — diet trick or eating disorder warning sign?

Influencer Choi Jun-hee posted a video of herself chewing and swallowing food in an apparent bid to head off accusations of "chew-and-spit" behavior. Thin public figures are often met with skepticism about whether they actually eat, but health experts say chew-and-spit is far more than a diet shortcut — it can be a warning sign of deep anxiety around food and weight.

Choi recently uploaded the video to her SNS account with a caption reading, "I ate everything on live because I was worried people would accuse me of chewing and spitting." The term refers to the practice of chewing food and then spitting it out rather than swallowing.

On the surface, chew-and-spit may look like a way to enjoy the taste of food while avoiding the calories. In practice, however, it is not a healthy approach to weight management. The behavior tends to recur when a person's desire to eat collides with a fear of gaining weight — a sign that anxiety, not choice, is driving the pattern.

Medically, the behavior is known as "chew and spit." Research reviews describe it as a problematic weight-control behavior in which food is chewed but not swallowed, noting it is reported more frequently in restrictive eating disorders and may indicate their severity.

One reason chew-and-spit is considered dangerous is that it rarely stays a one-time act. What begins as a temporary measure to cut calories can, with repetition, give way to obsessive thoughts about food, mounting guilt, and secretive behavior. Once food becomes a source of anxiety and control rather than pleasure, even ordinary meals can feel overwhelming.

Research has linked chew-and-spit to more severe eating disorder symptoms. A 2015 study of eating disorder patients found that those who engaged in chew-and-spit showed more severe eating disorder symptoms and higher rates of suicidal behavior than those who did not.

Engaging in chew-and-spit does not automatically mean a person has a specific diagnosis. But if someone repeatedly avoids eating, feels intense guilt after meals, or takes extreme measures because of a fear of weight gain, the possibility of an eating disorder warrants attention.

Eating disorders are not simply about wanting a thin body. The US National Institute of Mental Health (NIMH) describes them as conditions involving severe disruptions to eating behavior alongside distressing thoughts and emotions about food, weight, and body shape. Common types include anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Repeated chew-and-spit can lead to nutritional imbalances. When the behavior substitutes for actual eating, the body is deprived of the energy, protein, fat, vitamins, and minerals it needs. Possible consequences include fatigue, dizziness, hair loss, irregular menstruation, constipation, and a weakened immune system.

The risks are compounded when a person is already underweight and continues to restrict food intake. The NIMH warns that anorexia nervosa can lead over time to serious health problems, including anemia, muscle wasting and weakness, osteoporosis, low blood pressure, slowed breathing and pulse, and damage to the brain and heart.

Chew-and-spit can also set the stage for binge eating. Severely restricting food intake intensifies hunger and preoccupation with food, which can eventually cause a person to lose control and eat large amounts at once. The guilt that follows often triggers compensatory behavior, creating a cycle of restriction and bingeing.

Purging — eating and then deliberately vomiting — carries similar risks. It is one of the compensatory behaviors associated with bulimia nervosa. The Mayo Clinic describes bulimia as a condition tied to distorted body image and notes that complications can include acid reflux, gastrointestinal problems, severe tooth decay, and gum disease.

Repeated vomiting is particularly damaging to dental health. The American Dental Association reports that the risk of tooth erosion is five to seven times higher in people with eating disorders who self-induce vomiting. Repeated exposure to stomach acid dissolves tooth enamel, leading to sensitivity, cavities, and gum problems.

Chew-and-spit and purging differ in method but share a common thread: eating stops being a way to nourish the body and becomes an anxious act of weight control. As the behaviors repeat, meals themselves can become frightening, and secretive eating, spitting, or vomiting tends to increase.

There are warning signs to watch for. Frequently going to the bathroom immediately after meals, obsessing over calorie counts, rigidly avoiding certain foods, or letting the number on the scale dictate one's mood are all causes for concern. The National Eating Disorders Association lists excessive chewing, ritualistic eating habits, intense preoccupation with food and weight, and secretive bingeing as potential warning signs of an eating disorder.

Healthy weight management starts not with how much food a person can avoid, but with how consistently the body receives the nutrition it needs. Including carbohydrates, protein, fat, and vegetables in each meal — and not skipping or excessively delaying meals — is fundamental.

Anyone who finds these behaviors difficult to control on their own should seek professional help. Eating disorders are not a matter of willpower; they are health conditions that require treatment. The Mayo Clinic notes that bulimia treatment typically combines psychotherapy, nutritional counseling, and medication, and that avoiding meal-skipping and extreme dieting is an important part of recovery.

The reactions of those around a person also matter. Pressing someone with comments like "Do you actually eat?" or "Are you spitting it out?" can heighten their anxiety. Equally harmful is praising an extremely thin physique or encouraging others to emulate it. A healthier approach focuses not on a number on the scale but on stable eating habits, overall condition, and health indicators.

Choi's decision to eat on camera to preempt criticism is understandable as a way to defuse controversy. But the more important issue is not whether any particular person is actually swallowing their food — it is whether society properly understands why behaviors like chew-and-spit and purging are dangerous in the first place.

Wanting to eat but fearing weight gain, feeling intense guilt after meals, hiding one's eating behavior — these can already be signals the body is sending. Food is not a punishment or a reward; it is the foundation of survival and recovery. If chewing and spitting or purging becomes a repeated pattern in the name of weight loss, it should be recognized not as dieting, but as a sign that treatment and healing are needed.

If you're thinking about self-harm or suicide, dial the Suicide Prevention Hotline at 109, available 24 hours a day, seven days a week. Please request a translator for English-language services.