Eating Disorders Symptoms What Is the Cotton Ball Diet? A look at the physical and mental dangers of this diet. By Kristen Fuller, MD Kristen Fuller, MD Kristen Fuller is a physician, a successful clinical mental health writer, and author. She specializes in addiction, substance abuse, and eating disorders. Learn about our editorial process Updated on June 30, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Margaret Seide, MD Medically reviewed by Margaret Seide, MD LinkedIn Margaret Seide, MS, MD, is a board-certified psychiatrist who specializes in the treatment of depression, addiction, and eating disorders. Learn about our Medical Review Board Fact checked Verywell Mind content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Karen Cilli Fact checked by Karen Cilli Karen Cilli is a fact-checker for Verywell Mind. She has an extensive background in research, with 33 years of experience as a reference librarian and educator. Learn about our editorial process Print Image Source / Getty Images Table of Contents View All Table of Contents What Is Disordered Eating? Risks Possible Explanations Treatment The cotton ball diet is a dangerous fad diet that involves dipping cotton balls in liquids including juices and smoothies and then consuming them. The purpose of this is to cause the stomach to feel full while restricting calories in order to lose weight. The “diet” reportedly originated in the modeling and figure skating industries, but also appeared in online videos made by pre-teen and teenage girls who were recommending the behavior as a way to lose weight. 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 Disordered eating involves abnormal and unhealthy eating behaviors that do not meet the diagnostic criteria for an eating disorder. 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. Difference Between Disordered Eating and Eating Disorders 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 Intestinal obstruction is a medical emergency that requires surgery to prevent tissue death, infection, or even death. 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. Anorexia also has the highest mortality rate of any mental health condition. 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. The bottom line is that the cotton ball diet is not a safe way to lose weight—it is a dangerous form of disordered eating that may be a sign of an eating disorder. It poses serious health risks and can be fatal. 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. An Overview of Eating Disorder Treatments 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. If you or a loved one are coping with an eating disorder, contact the National Eating Disorders Association (NEDA) Helpline for support at 1-800-931-2237. For more mental health resources, see our National Helpline Database. 7 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Quick VM, Byrd-Bredbenner C, Neumark-Sztainer D. Chronic illness and disordered eating: a discussion of the literature. Advances in Nutrition. 2013;4(3):277-286. doi:10.3945/an.112.003608 Brechan I, Kvalem IL. Relationship between body dissatisfaction and disordered eating: Mediating role of self-esteem and depression. Eat Behav. 2015;17:49-58. doi:10.1016/j.eatbeh.2014.12.008 Edakubo S, Fushimi K. Mortality and risk assessment for anorexia nervosa in acute-care hospitals: a nationwide administrative database analysis. BMC Psychiatry. 2020;20:19. doi:10.1186/s12888-020-2433-8 Jackson MS, Adedoyin AC, Winnick SN. Pica disorder among African American women: A call for action and further research. Social Work in Public Health. 2020;35(5):261-270. doi:10.1080/19371918.2020.1791778 National Eating Disorders Association. Pica.) ABC News. Dangerous diet trend: The cotton ball diet. Dooley-Hash S. Acute care of eating disorders. Behavioral Emergencies for Healthcare Providers. doi:10.1007/978-3-030-52520-0_19 By Kristen Fuller, MD Kristen Fuller is a physician, a successful clinical mental health writer, and author. She specializes in addiction, substance abuse, and eating disorders. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Eating Disorders Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.