6 Dangers of the Cotton Ball Diet

What Is the Cotton Ball Diet?

The cotton ball diet first came to prominence in 2013 after people began to report eating cotton balls in order to stay thin.¹ This trend in diet culture involves digesting cotton balls that have been dipped in a liquid, such as juice, making them easier to swallow. Once the cotton balls are swallowed, the hope is that a person will have little interest in eating too much of something else.

The cotton ball diet is not officially recognized by the DSM-V as an eating disorder, but it is an example of disordered eating. Unlike pica—a disorder characterized by ingesting inedible objects such as hair, dirt, or paint chips—a person who starts the cotton ball diet is not doing so due to nutritional deficiencies.²

What Is Disordered Eating?

While disordered eating is commonly seen within eating disorders, not every case of disordered eating qualifies as an eating disorder. For example, just because a person occasionally vomits after eating (possibly from the food not sitting right with them), that does not mean they are bulimic. However, disordered eating is concerning, and worth paying attention to.

Other examples of disordered eating may be significant calorie intake restriction, purging (whether by means of vomiting or laxative misuse), or extreme diets.³ People engage in these behaviors for many reasons, such as negative body-image, food addiction, or a desire for control. Whatever the case is, evaluating these habits is important, and they can easily go from disordered eating to an eating disorder.

6 Dangers of the Cotton Ball Diet

The cotton ball diet can lead to serious bodily harm. Some resulting issues can be short term, like constipation—others may be long-term and, in severe cases, even lead to death.

Here are six dangers of the cotton ball diet:

1. Malnutrition

Extreme dieting can lead to malnutrition. Some symptoms of malnutrition may be mild, such as skin rashes or sensitive gums. However, these effects can worsen over time, and lead to further health related complications.

Symptoms of malnutrition may include:⁴

• Pale and dry skin
• Bruising easily
• Rashes and/or changes in skin pigmentation
• Thin hair
• Achy joints
• Gums that bleed easily
• Swollen, shriveled, or cracked tongue
• Night blindness
• Increased sensitivity to light and glare

2. Failing to Reach Body-Image Goals

While this diet fad may at first result in weight loss, this progress may not satisfy your body goals. Your body will still carry fat, and you may continue to worry about how you look or what people think of you. It’s like the finish line keeps moving.

If this happens, you may think the answer is to lose more weight. To do that, you will try more and more extreme things. Even if you avoided serious consequences at first, over time you may start to engage in progressively worsening disordered eating habits.

3. Intestinal Obstruction & Choking Hazards

Intestinal obstructions occur when something restricts normal movement within the intestines. Normally, food is slowly broken down and ingested, leaving waste to be expelled out of the rectum. However, foreign objects such as cotton balls do not get broken down this way–the entire cotton ball is not a natural and edible substance.

This disruption can lead to a number of complications, such as discomfort or constipation, and in rare cases it can lead to death.⁵ In addition, cotton balls are difficult to swallow and may block your trachea from bringing air to your lungs!

Symptoms of an intestinal obstruction include:⁵

• Severe pain in your belly
• Severe cramping sensations in your belly
• Throwing up
• Feelings of fullness or swelling in your belly
• Loud sounds from your belly
• Feeling gassy, but being unable to pass gas
• Constipation (being unable to pass stool)

4. Anorexia Nervosa

An unhealthy preoccupation with losing weight or eating can lead to the development of anorexia nervosa. Reaching this point of disordered eating can severely damage your body, and will limit your body’s ability to grow and protect itself.⁶ The obsessive focus on weight or body image takes focus away from other important things like school or relationships with friends and parents. In many important ways it can take over your life.

Anorexia nervosa is characterized by the following symptoms.

Food or weight-related symptoms:

• Altered body image
• Low body weight
• Extreme fear of becoming fat
• Excessive physical activity
• Denial of hunger
• Fixation with food preparation
• Unusual eating behaviors

Physical symptoms:

• Poor nutritional status
• Dehydration
• Being very thin
• Stomach pain or bloating
• Constipation
• Lethargy or fatigue
• Unable to handle cold temperatures
• Fine, downy body hair (called lanugo)
• Dry or yellowish skin
• Thinning hair
• Brittle nails

Emotional symptoms:

• Withdrawal from social situations
• Loss of interest in sex
• Irritability
• Mood changes
• Depression

5. Isolation

Avoiding people or situations that may disapprove or challenge your dieting pursuits can narrow your environment, and cause you to shut down. This results in two significant challenges–it takes you away from helpful resources and adds to the sense of being alone.

It’s funny to mention that cutting people off makes you feel alone, because it may seem obvious! However, the heightened sensation of loneliness can only exacerbate disordered eating behaviors.

6. Developing Depression

What started as a small body-image issue, or a recognition of being overweight, can develop into something very dangerous.  Your goal to lose weight or change your body may continue to weigh on you. This accumulation of stresses and perceived failures can become part of a deep depression that stays with you for a long time.

Why Do People Try the Cotton Ball Diet?

There are many reasons why a person may choose to follow fads like the cotton ball diet. Some of these are possible to change easily, while other reasons must be confronted. Don’t give up if addressing these reasons scare you. There is always something to be done to help yourself.

Possible reasons for starting the cotton ball diet include:

Diet Culture

Diet culture promotes unhealthy body-image, glorifies unrealistic beauty standards, and creates pressure to conform to these standards. Essentially, diet culture is a form of peer pressure. This may look different for men versus women. For example, men may feel pressure to put on weight and be bigger, while women may feel pressure to lose weight, or pursue very thin waists and small clothing sizes.

Low Self-Esteem

Low self-esteem can contribute to many unhealthy behaviors, including the cotton ball diet. Feeling like you are fat or that you need to lose weight can compound other damaging thoughts and beliefs you have about yourself. Particularly in school or other social groups, it can be hard to know what to think about your body. There will always be ways we compare ourselves to others. These thoughts can lead to one seeking extreme solutions to their problems, such as the cotton ball diet.

Frustration With Puberty

Puberty is a difficult time for many reasons, and one thing that occurs during puberty is fat gain.⁷ Girls typically gain more fat mass than boys, but everyone experiences this change, and it is needed to support growth during this period. While feeling impatient about this phase can lead to self-esteem issues, it can also lead to issues such as body dysmorphia. One might even begin to obsessively engage in body checking, hoping they will look “better” than they did five minutes ago.

Expectations

We come to expect many things from ourselves in life. For example, when it comes to our body-shape, we may bank on fitting into a certain pant size. But, what happens if our body doesn’t fulfill these goals? All people will see their bodies change at some point, sometimes in surprising ways. If it happens, sometimes a person may seek drastic methods to prevent further change.

Anxiety

In terms of dieting, anxiety can lead you to seek extreme solutions to ward away possible “threats,” like getting made fun of, not being pretty enough, or feeling ashamed about your weight.

Bad Examples or Role Models

Whether it was a theater teacher saying you don’t look “right” for lead roles, or a model explaining her daily exercise routine, our role models can alter the ways we see ourselves. Some of these may direct you to check out pro ana websites or thinspo–both of which actually encourage eating disorders. Unfortunately, social media and eating disorders often go hand-in-hand.

When to Seek Professional Help

If the cotton-ball diet is appealing to you, please consider how therapy may be a benefit to you. Temptations to engage in fad diets may be strong, but a therapist is meant to support you unconditionally. If this information strikes a chord with you, it may be an indication to start looking for the right therapist.

Therapy options for disordered eating include:

• In-patient therapy: In-patient therapy provides residential treatment in case your body is in need of serious intervention to correct damage.
• Intensive out-patient (IOP): IOP is a treatment option with a large time commitment, sometimes as much as 20 hours a week or more. It is intended to offer an alternative to facility living, while still providing much of the education and therapy benefits that in-patient therapy can offer.
• Enhanced cognitive behavioral therapy (CBT-E): CBT-E is a commonly used and well-covered (by insurance) treatment approach for eating disorders.
• Group therapy: There are plenty of eating disorder group therapy options which can put you in contact with people experiencing similar situations as you.
• Out-patient treatment: Out-patient treatment typically includes a personal therapist, with whom you will likely meet once-a-week for maintenance or long-term care.