Inside Emetophobia: Living With Fear of Vomiting

It's safe to say nobody likes vomiting. But while it's not a pleasant experience by any means, few of us really give much thought to it - except maybe when we've had a few too many drinks or when stomach flu is doing the rounds.

But for around 2%-7% of the population, vomiting) provokes anxiety so severe they'll do anything to avoid it . This specific fear of vomiting is known as emetophobia. Though much about the condition remains unknown, research is beginning to explore the debilitating impact it can have on sufferers.

Emetophobia affects everyone differently . For some, this fear centres around vomiting themselves, while for others it's a fear of seeing somebody else vomit. Many also experience a combination of both fears. Some people can also pinpoint a specific traumatic event related to their phobia, while for others there is no distinct cause.

Emetophobia can also have varying degrees of impact on a person's life - ranging from mild to debilitating, according to a recent review my colleagues and I published.

The most common characteristic of emetophobia is avoidance. People with the condition often steer clear of situations where they think vomit might be a risk. Many avoid public transport, crowded places, theme parks, dining at restaurants or consuming alcohol. Some even go so far as refraining from saying or typing the word "vomit."

This fear and avoidance can even influence long-term life decisions - with some people avoiding pregnancy and children due to concerns with morning sickness and the illnesses (such as stomach flu) that kids are prone to.

Not only can these avoidance behaviours affect social and professional life, they can also have an impact on physical health. For example, some people with emetophobia restrict their diet or avoid certain foods - such as meat, due to perceived risk of Salmonella (a food-borne illness that can cause vomiting). This can result in nutrient deficiencies and becoming underweight .

People have also been shown to engage in compulsive behaviours such as hand washing, magical thinking (the belief that certain habits or specific thoughts can stop vomiting from happening) and excessive cleaning to avoid being sick. These symptoms overlap with other psychiatric disorders - specifically anorexia nervosa and obsessive-compulsive disorder. This has often led to misdiagnosis, with patients referred to services who are not specialised in treating emetophobia.

Another common and often overlooked symptom of emetophobia is nausea - with the majority of people experiencing feelings of sickness on a daily basis, despite having no underlying medical condition. As emetophobia goes hand-in-hand with a preoccupation with vomiting, there's usually a heightened awareness of bodily sensations which can cause anxiety.

Everyday mundane experiences such as feeling overly full after a meal or getting a headache from too much screen time can trigger the automatic thought: "I am going to be sick." This creates a vicious cycle, as the more attention a person gives to these sensations, the more likely they are to misinterpret them as signs of illness. This in turn reinforces and entrenches the fear.

Treating emetophobia

A lack of research into emetophobia means treating the condition currently remains a hurdle.

Cognitive behavioural therapy (CBT) seems to be the most evidence-based treatment investigated so far. This treatment approach aims to change thought patterns and behaviour. For emetophobia, this involves changing beliefs about vomiting and slowly reducing avoidance habits through exposure - such as visiting feared places and reducing excessive hand-washing.

Although some studies have shown promising results from using CBT for emetophobia, these studies only investigated a small number of participants. This means it's difficult to draw firm conclusions about the treatment's effectiveness until larger studies have been done.

Another option is exposure therapy, which has been tried and tested on people suffering from other phobias and has shown great outcomes . Exposure therapy involves gradually facing feared situations with the help of a therapist to teach the brain these things are not dangerous and reduce overall fear.

But it's worth noting that although exposure therapy is recommended for other phobias, only 6% of people with emetophobia would be willing to try it. This doesn't make exposure therapy a very accessible option for the majority of people struggling with this disorder.

Further complicating matters is the fact that people with emetophobia often avoid places such as GP surgeries and hospitals because of the risk of seeing someone who is unwell or catching a vomiting bug. This means they struggle to access what help might be available.

There's a clear need for increased awareness of this condition, from both the general public and doctors. Awareness can help limit misdiagnosis, show sufferers treatment is available and reduce misconceptions.

Emetophobia is more than simply not liking vomit. It can affect every aspect of life. Our continued research aims to explore effective treatment options for this complex disorder.

Molly Sheila Harbor does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.