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Emetophobia: How to Overcome a Fear of Throwing Up

4 min read
Taylor Newendorp, MA, LCPC

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No one likes vomiting yet some people fear vomiting so intensely that they try to orient their lives to avoid it. 

The fear of throwing up can be so agonizing that it can contribute to debilitating life circumstances ranging from being unable to parent sick children to missing work or school for fear of encountering a sick classmate or colleague. 

To make sense of the fear of throwing up, here’s an explanation for its causes, symptoms, and treatment. 

What is emetophobia or the fear of throwing up? 

Emetophobia is a common specific phobia concerning the fear of throwing up, feeling sick, watching someone throw up, or seeing vomit. People who experience this phobia are embroiled in pure fear with their thoughts consumed with avoiding getting sick and seeing (or hearing) someone else getting sick. 

“That feeling of being out of control is so overwhelming to some people that it kind of runs their life. They’re overwhelmed with this notion that they could throw up,” says Dr. Patrick McGrath MD, NOCD’s Chief Clinical Director. 

It is estimated that over 10 million people have emetophobia in the United States alone. 
The good news is there are effective treatments for emetophobia that can alleviate distress and help regain control. 

First, let’s discuss how emetophobia is diagnosed. 

How is it diagnosed? 

Emetophobia is diagnosed through a diagnostic interview with a trained clinician who will ask about beliefs, behavior, history, and experiences. Keep in mind that emetophobia, like other specific phobias, may present in different ways for different people.

Diagnosing clinicians are generally looking for the following: 

  • Extreme fear response related to any instance of seeing, talking about, hearing, or experiencing vomit 
  • Active attempts to avoid throwing up at all costs with significant impact in patient’s life 

What are the symptoms of emetophobia?

People with fears of vomiting may find that they organize their days to avoid the following kinds of situations: 

  • Witnessing other people (or even animals) gag and/or vomit
  • Hearing people talking about times they’ve thrown up (in person, on social media, etc.)
  • Learning that people they know have the stomach flu or have gotten food poisoning
  • Feeling physically ill, especially feeling nauseous, “woozy,” sweaty, or having heartburn
  • Experiencing other illnesses like diarrhea, acid reflux,  or intestinal bugs of any kind
  • Smelling unpleasant odors, or things that may smell like vomit
  • Trying a new food they have not had before
  • Seeing vomit 
  • Watching scenes in movies/TV shows involving vomit
  • Thinking about times they’ve been sick to their stomach in the past
  • Words and phrases like vomit, puke, hurl, blow chunks, and throw up
  • Burping, hiccuping, coughing, or choking on food or liquids
  • Bumpy car rides, plane travel, sea travel, or similar experiences

Is emetophobia a form of OCD or is it caused by general health anxiety?

Understanding what differentiates emetophobia from Obsessive Compulsive Disorder is important. Dr. McGrath says practitioners determine if people have emetophobia or a combination of emetophobia and OCD by examining if someone feels obliged to perform specific rituals and compulsions to avoid throwing up. An example of compulsion might be rarely going outside to avoid throwing up or only going outside if they can tap a table three times before doing so. 

For the fear of throwing up to be OCD-related, rituals might look like only eating certain foods at certain times to maintain stomach health and avoid distress, or only going out with a mask on may indicate someone’s fear of throwing up can be tied to OCD for some people. 

What causes emetophobia?

According to Dr. McGrath causes range from personal preference to the inability to tolerate the loss of control. He says, “The causes can be anything from disgust over smell to being unable to stop once you start.” 

Other causes may include: 

  • Family history of phobias 
  • Mental health conditions such as anxiety or OCD
  • A past unpleasant incident involving vomit 

How to overcome emetophobia with treatment

The fear of throwing up can be treated with ERP therapy where a therapist will work with you one-on-one to change the way you relate to your fear by trying different exposures. 

Exposures performed in ERP therapy to treat a fear of vomit may include:

  • Fake vomit 
  • Recording oneself making vomiting sounds 
  • Vomiting videos 

NOCD clinicians have treated countless patients with emetophobia. Dr. Patrick McGrath in particular has treated emetophobia for over 20 years and says ERP is a “fantastic” treatment for emetophobia. He says, “We teach people that they can be surrounded by the sights, sounds, and smells of people throwing up, and it doesn’t mean they are going to throw up themselves.”

If you’re struggling with OCD, you can schedule a free 15-minute call today with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. 

One additional resource people struggling with fear of vomiting might visit is Emetophobia Help, an organization run by emetophobia survivor and counselor Anna Christie. 

Dr. McGrath says, “Emetophobia, is, for many people, the ultimate loss of control.” Through exposure to one’s fears, ERP therapy for emetophobia helps people cope with the loss of control which can often underline the phobia. 

We look forward to working with you to help you find relief.