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Is Emetophobia an Eating Disorder?

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Emetophobia is a specific phobia that causes people to fear vomit and/or various scenarios linked to the act of vomiting. The process of being sick is closely tied to the body’s gastrointestinal activities. As a result, those with emetophobia may develop a strained relationship with food and the act of eating.

The NHS defines an eating disorder as:

A mental health condition where you use the control of food to cope with feelings and other situations.


So, while emetophobia itself is not classed as an eating disorder, it can cause people to exhibit symptoms that fit into this definition. The link between emetophobia and eating disorders is made more cloudy by the fact that both of these areas are lacking in research. In this article, EmetoGo explores the information that is available to analyse whether emetophobia should be considered as, or may turn into, an eating disorder.

Emetophobia and food

It should be noted that not everyone who suffers from emetophobia will have an unhealthy relationship with food. However, a number of common symptoms of this phobia are linked to food control or restriction. These include:

  • Cutting out entire food groups like meat or dairy
  • Obsessively checking the freshness of food before consumption
  • Avoiding eating in public
  • Only consuming food they themselves have prepared
  • Limiting eating to certain hours in the day
  • Sticking to a small list of ‘safe foods

Let’s take a closer look at these habits…


In a 2011 study on abnormal eating behaviour in people with emetophobia, Professor David Veale et al., found that “restricting food ‘often’ or ‘always’ and abnormal eating behaviour occur in about one third of people with SPOV [specific fear of vomiting].”

The logic behind restricting food intake in this context is twofold. First, a lot of emetophobes dislike the sensation of feeling full because it can seem like your stomach is more likely to reject what is inside it if it feels even slightly uncomfortable. Secondly, restricting the amount of food eaten means that if the worst happens and they are sick, at least the experience should be short because there is not much to expel.

Food restriction is a particularly damaging symptom of emetophobia because it can really interfere with a person’s wellbeing and general day-to-day functioning. In the study mentioned above, emetophobes were asked to fill out a number of surveys and questionnaires. Those who restricted food intake “reported greater interference in their life (in particular, in relationships, work, social life, leisure activities, and home management) due to their SPOV.”

Obsessive behaviours

It is easy for habits to become obsessive, especially if we implement them to protect us from perceived harm. A person with emetophobia may start out by religiously observing ‘use by’ dates on food, and spiral into sniffing and rigorously checking anything and everything that they consume. Even if food has been deemed fresh enough to safely eat, some emetophobes will then cook it for far longer than necessary, in order to eradicate any potential germs.

Not only does such extreme caution make eating an arduous task, but it also rules out the ability to consume food that has not been submitted to these strict inspections. When you think about it, this really limits the type of events an individual can enjoy. After all, food plays a key role in many cultural and social activities, from weddings to a simple catch up with a friend over coffee and cake.

Can emetophobia cause an eating disorder?

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The issue of control

Emetophobia is distinct from common eating disorders like anorexia and bulimia in the sense that the motivation behind unhealthy eating patterns is different. A person with anorexia, for example, restricts their food intake because of a desire to lose weight. In contrast, emetophobes are focused on avoiding being sick, rather than anything to do with body image.

Despite this important difference, emetophobia and eating disorders share a common root cause: control. One of the most terrifying things about vomit for emetophobes is the fact that we often have little control over when it happens. In addition, once it does start happening, it is very hard to stop it in its tracks.

Faced with this fear-inducing prospect, an emetophobe can find comfort in one of the few things they are able to control—what goes into their stomach. Similarly, those with anorexia often grow up with a controlling authority figure, or develop the disorder during turbulent life periods like adolescence. In order to cope with turmoil or feelings of low self-esteem, they focus on an area where they can wield control, which ends up being their weight.

The irony is that this obsessive relationship with food ends up controlling the individual in question. In order to sustain these behaviours, one must spend an inordinate amount of time thinking about food or the avoidance thereof.

Emetophobia and anorexia

What is anorexia?

Anorexia is a mental health condition that causes people to become obsessed with losing weight. They achieve this by restricting food intake and/or exercising excessively. People with this eating disorder tend to have a very distorted body image, and so will continue to follow these behaviour patterns even when they are severely underweight.

How it relates to emetophobia

For emetophobes who display abnormal eating behaviour, losing weight is just a side effect of their desire to avoid vomiting. However, health professionals may diagnose them with anorexia if they do not believe that a fear of vomit is motivating food restriction. This is not as unfair as it sounds, as some people with anorexia will lie about the reasoning behind their behaviour in order to avoid receiving treatment.

Emetophobes and anorexics share certain feelings and behaviours:

  • A fear of being full
  • A sense of disgust at certain foods
  • Avoid eating in public or in front of others
  • Prefer to go to bed with an empty stomach
  • Anxiety that eliminates appetite
  • Fasting in response to panic attacks

These practices lead to shared health problems:

  • Excessive weight loss
  • Cardiovascular complications
  • Osteoporosis
  • Hair loss
  • Depression

Emetophobia and bulimia

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What is bulimia?

Bulimia is a mental health condition that causes people to go through cycles of bingeing (eating excessive amounts of food in a short space of time) and purging (by making themselves vomit or abusing laxatives). People with this eating disorder tend to be very critical of their own bodies, but may not appear to be severely underweight or overweight.

How it relates to emetophobia

Now, on the surface, these two disorders might seem completely incompatible. How could someone who fears vomit be compelled to force themselves to bring on the bodily function in a compulsive way? The fact is, it’s not as uncommon as you may assume.

For starters, there are different versions of emetophobia. Many sufferers are anxious about vomiting themselves, but some emetophobes find the prospect of other people vomiting far more terrifying. For this particular group, having control over when they themselves vomit can be strangely satisfying. An anonymous user posting on Reddit’s emetophobia community explains:

I thought if anyone knew I had both [emetophobia and bulimia] they would think I was crazy!! Somehow I think (…) I’m empowered that something I have spent my life fearing for my life I now have control over! [sic]

In other cases, bulimia can cause a person to develop emetophobia, particularly if the purging process is interpreted as a traumatic event. For example, vomiting may become intertwined with feelings of fear and shame, which leads to a phobia of the act itself.

Whatever the case, the co-existence of these two disorders is incredibly dangerous. Sufferers are at high risk of causing long term gastrointestinal damage. These behaviours also take a serious toll on an individual’s mental health.


It is because of the various shared characteristics discussed above that emetophobes are sometimes misdiagnosed as having eating disorders like anorexia. This is further complicated by the fact that motivations behind restrictive eating may change as a disorder develops.

Yet another issue is that emetophobia is not a well known condition. A 2011 study by Vandereycken found that, amongst a group of eating disorder specialists, 29.7% had never heard of emetophobia and 61.3% agreed that it required more attention. This is despite the fact that emetophobia is more common than many people think.

The three most commonly diagnosed eating disorders are anorexia, bulimia and binge eating disorder. If an individual does not fit enough of the criteria to receive a diagnosis of any of these (which is the case for some emetophobes), they may be labelled as having an atypical eating disorder. More specifically, this could be:

  • OFSED (other specified feeding or eating disorder)
  • ARFID (avoidant restrictive food intake disorder)

Of course, you may also be diagnosed with emetophobia, especially if you present a range of symptoms alongside those relating to food.

The problem with restricting food when you have emetophobia

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Aside from the obvious physical and mental health problems that food restriction can cause, it is somewhat counterintuitive if you have emetophobia. That is, it can have the opposite of the desired effect, which in this case is reducing sickness.

Veale’s study on abnormal eating (referenced above) found that emetophobes who restricted their food intake actually felt more unwell than those who did not: “The SPOV-R group reported symptoms of nausea significantly more often than the SPOV-NR group.” This makes sense as your body needs fuel to function properly, which is why we begin to feel under the weather if we push through tasks with an empty stomach.

In addition, limiting the types of food you eat can lead to nutritional deficiencies. It is recommended that humans eat a varied diet, in order to get all of the vitamins and minerals they require. If you cut out a lot of meat, fruits and vegetables, for example, you may develop an iron deficiency, which causes symptoms such as light-headedness and—yes—nausea. A lack of nutrients can also result in a weakened immune system, which makes people more vulnerable to various illnesses.

Finally, restricting food can cause an unhealthy level of weight loss. This can result in a range of health issues and, in extreme cases, death. In Veale’s study, for example, 8.5% of the emetophobia sufferers had a BMI lower than 18.5 (which is officially considered underweight). This is a much higher percentage than in the general adult population, where only 1.6% of people fit this category.

Tips for improving your relationship with food if you have emetophobia

1. If you have a list of ‘safe foods’, make sure you always have them in the house.

2. Aim to add 1 new food to your diet every month.

3. Supplement your diet with vitamins to ensure you are getting the nutrients you need.

4. If eating anything is a struggle, ease yourself in with bland soups or smoothies.

5. Keep a food diary to remind yourself that most things you try do not actually make you ill.

6. Don’t rush the eating process to get it over with. Take small bites and chew properly.

7. If there are some restaurants that you trust, make a point to treat yourself to meals out.

Overcoming disordered eating caused by emetophobia

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For those with abnormal eating behaviours linked to emetophobia, treatment aimed at traditional eating disorders may not be useful. In fact, targeting the phobia itself could hold the key to overcoming restrictive eating habits.

EmetoGo offers a range of therapies designed to help people manage their emetophobia and gain back control of their lives. Our experienced therapists provide a calm, non-judgmental space where you can discuss what’s troubling you and gain the confidence and knowledge to make a change. Whether you prefer in-person therapy, online therapy, or a mix of the two, we have you covered.

To get started, simply fill out a contact form and we’ll soon be in touch to explain how we can help.

Need help for an eating disorder?

If you have lost a considerable amount of weight as a result of emetophobia and/or an eating disorder, you may require medical intervention. Contact your doctor or check out the Beat website. There you can find a free to use helpline and other support from eating disorder specialists.