This behavior is extremely dangerous and can result in serious health consequences or death. The goal of consuming cotton balls dipped in liquid is to trick the palate into believing that a person is consuming food. Because the filler causes the stomach to feel full, people may consume fewer calories. The “cotton ball diet” is not recognized as an eating disorder in the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5). However, it represents a type of disordered eating that can be dangerous or even fatal.
What Is Disordered Eating?
Disordered eating often involves behaviors such as chronically restricting calories, binging and purging, or consuming non-food items as a way to feel full and reduce appetite. These disordered behaviors may occur as a way to cope with difficult emotions, lose weight, or gain a sense of control. While disordered eating behaviors don’t meet the diagnosis of an eating disorder, they can be dangerous and may contribute to the development of an eating disorder such as anorexia, bulimia, or binge eating disorder. Like eating disorders, disordered eating is often related to body dissatisfaction and a desire to lose weight. People who have eating disorders are also at a higher risk of having a co-occurring mental health condition such as depression or anxiety.
Risks of the Cotton Ball Diet
The cotton ball diet is dangerous for a number of reasons. Not only does consuming these non-food cotton balls soaked in juice deprive the body of essential nutrition, but it also creates other serious medical risks.
Choking Hazards and Intestinal Obstructions
Cotton balls are not food and there is a risk of choking if they are consumed. When swallowed, they can cause obstructions in the gastrointestinal system, just like a pipe getting clogged. When you consume something that cannot be digested, it mixes with mucus and other food particles to form a mass known as a bezoar. This bezoar can clog the digestive system, obstructing other food and liquids from passing through the body. Symptoms of obstruction can include:
Abdominal pain and swellingConstipationCrampsDiarrheaNausea
Toxicity
Cotton balls contain more than just the product that comes from a cotton plant. The fibers undergo processing, which involves the use of bleach and other substances. Many cotton balls are not produced from cotton at all and are instead made from bleached polyester. The chemicals found in these products are not meant for human consumption and can potentially have serious health effects.
Malnutrition
Malnutrition occurs when people consume too few calories and other important nutrients. It can lead to serious health problems including altered cellular metabolism, loss of body tissues, weakness, immunity problems, and an increased risk of infection. Symptoms of malnutrition include:
Bleeding gumsBruisingDifficulty concentratingDizzinessFatigueFeeling coldHair lossJoint painSensitivity to lightWeakness
Anorexia Nervosa
While consuming cotton balls to lose weight is not a distinct disorder, the behavior may occur as part of anorexia nervosa, which involves extreme calorie restriction in order to lose weight. The condition can lead to significant weight loss and may lead to other dangerous health effects including abnormal heart rhythms, osteoporosis, and organ failure.
Possible Explanations
Given the risks of the cotton ball diet, many people might wonder exactly why someone might engage in this dangerous behavior. Pressure to lose weight, diet culture, low self-esteem, and other factors may play a role.
Diet Culture and Dangerous Diet Behaviors
Diet culture and the glorification of the “thin ideal” plays a major role in dangerous disordered eating trends like the cotton ball diet. These ideals suggest that being thin is the only way to be beautiful. They also shame people whose body shape or size does not conform to the narrow range of body sizes typically portrayed in popular culture and social media. These attitudes contribute to low self-esteem, negative thinking, and an intense desire to lose weight. It can lead to an unhealthy relationship with food, disordered eating patterns, and even dangerous behaviors that endanger both physical and mental well-being.
Could Pica Play a Role?
The consumption of non-food substances that have no nutritional value may be a symptom of a rare but serious eating disorder called pica. People with this condition regularly consume non-food items such as paper, cloth, dirt, paint, clay, or ice. While the cotton ball diet involves consuming non-food items that have no nutritional value, weight loss is the intended goal. People with pica generally do not have a reason for their eating behavior. The condition may be connected to other mental health disorders such as intellectual disability, autism, and schizophrenia. Anecdotally, however, some professionals have reported that people with pica sometimes eat things like paper and clay in order to distract themselves from feelings of hunger.
Treatment
Eating disorders and disordered eating—including the cotton ball diet—are often treated with a combination of psychotherapy, nutritional education, psychosocial support, and sometimes medications. The specific treatment an individual may need depends on the nature and severity of their symptoms. The focus of treatment is to help change the thoughts and behaviors that contribute to disordered eating behavior. People also learn new coping skills and make lifestyle changes that can help support their recovery.
A Word From Verywell
If you are trying to lose weight, it is important to focus on eating a healthy diet and getting regular physical activity. The cotton ball diet is an extremely dangerous approach that you should never try. If you need help with weight management, your doctor may also be able to help by prescribing medications or other products that help promote weight loss when used in combination with diet and exercise. For more mental health resources, see our National Helpline Database.