Junior year was characterised by a different trauma—an addiction to the amphetamine-based stimulant Adderall, which I abused in response to academic pressure. As a result, chewing and spitting found itself in the metaphorical backseat of my psychiatric issues. Since Adderall decimated my appetite (an added bonus, I felt at the time), I simply never wanted to chew and spit. So I didn't, and the habit came to a halt without my thinking about it. I stopped using the Adderall after my junior year, and it felt like I'd just fallen out of the habit of using CHSP as a tool for myself.
Experts, too, feel that information is too scarce to make formal statements about how, why, and when chewing and spitting occurs in eating disorder patients. Evelyn Attia, M.D., Director of the Centre for Eating Disorders at New York Presbyterian Hospital and Professor of Psychiatry at Columbia University Medical Centre and Weill Cornell Medicine, explains, "We don't know enough about how many people engage in chewing and spitting, and whether the behaviour always, sometimes, rarely, or never exists together with other symptoms of a given disorder." One thing is clear: Chewing and spitting still exists in the shadows.