The tapeworm diet, the feeding tube diet, the air diet -- Brandi Koskie, managing editor of the website Diets in Review, said she thought she'd seen every crazy food fad out there. But then came the cotton ball diet.
The diet, as described in chat rooms, on YouTube videos and elsewhere on the Web, involves gobbling up to five cotton balls dipped in orange juice, lemonade or a smoothie in one sitting. The idea is to feel full without gaining weight. Some dieters chow down on the fluffy fillers before a meal to limit their food intake, while others subsist on cotton balls exclusively.
"Nothing good can come of this. Absolutely nothing," said Koskie, who has been tracking diet trends for more than nine years.
One thing that strikes Koskie is that, unless you're dining on an expensive organic brand, most cotton balls aren't made of cotton. They're bleached, polyester fibers that contain a lot of chemicals.
"Your clothing is also made of polyester, so swallowing a synthetic cotton ball is like dipping your T-shirt in orange juice and eating it," she said.
Dr. Ovidio Bermudez, the chief medical officer at the Eating Recovery Center in Denver, said he agreed that downing synthetic cotton balls is similar to eating cloth, or even buttons or coins. Beyond the risk of choking and malnutrition, the practice might lead to an obstruction of the intestinal tract, a trapped mass called a bezoar, said Bermudez.
"The most common causes of bezoars are swallowing indigestible matter like hair or too much vegetable fiber. Cotton balls could certainly create similar problems," Bermudez said.
Over time, the cotton balls could build up and create several blockages or a full obstruction. Either of these conditions could be life-threatening, Bermudez said.
Models have been suspected of eating cotton balls for years, said Lynn Grefe, president and CEO of the National Eating Disorder Association. Eddie Murphy's model daughter, Bria Murphy, talked about this on "Good Morning America" earlier this year, telling the hosts that she'd heard about girls eating cotton balls soaked in orange juice because they were under pressure to stay slim.
More recently, tween and teenage girls seem to be catching onto the cotton ball diet. Koskie said there were YouTube videos devoted to people trying the cotton ball diet, many of them made by girls in the 9- to 16-age range, she said.
Grefe said she didn't consider the cotton ball diet a diet at all, but rather an unhealthy, disordered form of eating behavior.
"When we talk about something like this we certainly aren't talking about health anymore," she said. "We're talking about weight and size and certainly something that is potentially very, very dangerous."
Karmyn Eddy, co-director of the eating disorders clinical and research program at Massachusetts General Hospital in Boston, said eating cotton balls is a form of pica, which is the practice of eating nonfood items. Typically, pica is a craving for something inedible that's driven by the lack of a particular nutrient. But Eddy said she's seen it take the form of an eating disorder. She believes this is the case with the cotton ball diet.
"I've had patients in my practice eat things like paper and clay for the same reason -- they're trying to distract themselves from hunger and prevent weight gain," she said.
"It's certainly a misguided practice, and I find it alarming for young girls to be doing this who don't have the information to understand what they are doing to their bodies."
Koskie said she hasn't seen much talk about the diet on her site's message boards or social media accounts yet. But now that there's been a buzz about the practice elsewhere on the Internet, she expects that to change. As the holidays get closer, she said, dieters grow more desperate to shed unwanted pounds, and they're more likely to try riskier behaviors to get there.