Emetophobia (Fear of Vomiting)

What is emetophobia?

Emetophobia is a mental health condition in which you experience an intense fear of vomiting, barfing or throwing up.

Vomiting isn’t something that people enjoy doing. But after an illness, most people don’t think about it. If you have emetophobia, you’re constantly worried about vomiting and it can take over your thoughts. This fear impacts your life beyond just feeling afraid. It can prevent you from relaxing, participating in social activities or eating complete, nutritious meals.

Emetophobia is a “specific phobia” in the Diagnostic and Statistical Manual of Mental Disorders. Specific phobias cause anxiety and panic attacks after exposure or anticipated exposure to the thing or situation you’re afraid of.

If you feel like you have to vomit or witness vomiting, you may be afraid of:

• Not being able to stop vomiting.
• Embarrassment or shame.
• Having an underlying medical condition.
• Losing control.

How common is emetophobia?

Emetophobia is rare. It affects 0.1% of people around the world. It’s more common among women and people assigned female at birth (AFAB) than men and people assigned male at birth (AMAB).

What are the symptoms of emetophobia?

If you have emetophobia, when you hear about, see or experience nausea or vomiting, you may feel the following:

• Anxious.
• Nervous.
• Distressed.
• Panicked.
• Overwhelmed.

This can cause the following symptoms:

• Increased heart rate.
• Sweating.
• Shaking.
• An upset stomach.
• A tight feeling in your chest.
• Lightheadedness, dizziness or fainting.

If you have emetophobia, you might do certain things to address your fear. Since you may not feel in charge of your body when you vomit, you might feel at ease if you prepare for any situation that might involve vomiting. These behaviors could include:

• Locating a bathroom and staying close to it.
• Sleeping with a trash can next to your bed.
• Avoiding long car rides, being near the water (especially on a boat) or riding thrill rides (like a roller coaster).
• Not taking medications that list nausea or vomiting as a possible side effect.

What are the signs of emetophobia?

Signs of emetophobia include avoiding:

• New foods and beverages.
• Restaurants or foods that previously caused vomiting.
• Words to describe vomiting, like “barf” or “puke.”
• People with illnesses or places where ill people go (like hospitals).
• Eating foods when you’re not at home.
• Socializing or traveling.
• Becoming pregnant, due to the risk of morning sickness.

You may also:

• Wash your hands often.
• Frequently check for signs of an illness, like taking your temperature.
• Limit what foods you eat and how much.
• Overcook food to destroy traces of bacteria.
• Throw away foods close to the expiration date.
• Wince or close your eyes when someone mentions vomiting.

What causes emetophobia?

Most cases of emetophobia happen after a negative experience with vomiting. For example, you might develop emetophobia if you:

• Vomited in public or in front of someone else.
• Had an illness (like the stomach flu, food poisoning or alcohol poisoning) that caused a lot of vomiting.
• Choked on food.

Emetophobia can also develop when you experience other related mental health conditions like obsessive-compulsive disorder (OCD) or an eating disorder.

What triggers emetophobia?

Triggers are things or events that cause symptoms. Triggers of emetophobia may include:

• Feeling nauseous.
• Seeing someone else vomit.
• Hearing or saying words related to vomiting.
• Being in a new place, because you don’t know where the nearest bathroom is.
• Being around foods or beverages that previously caused vomiting.

Emetophobia is a vicious cycle. This means the symptoms you fear (nausea and vomiting) occur together with your anxiety about it. This can make the symptoms feel worse.

What are the complications of emetophobia?

Complications of emetophobia may include:

• Malnutrition and/or dehydration.
• Other phobias (like agoraphobia).
• Eating disorders (anorexia nervosa or avoidant/restrictive food intake disorder).
• Social isolation.
• Depression.

How is emetophobia diagnosed?

Your primary care physician may refer you to see a mental health provider. A mental health provider (a psychologist or psychiatrist) will diagnose emetophobia.

A provider will diagnose emetophobia through a thorough series of questions about your history, experiences and symptoms. Usually, your persistent fear and anxiety about vomiting happen for at least six months in order to be diagnosed with emetophobia.

Your healthcare provider will likely use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a publication by the American Psychiatric Association, to diagnose emetophobia. Your provider will also rule out any other physical or mental health conditions that could be causing your symptoms.

In general, phobias have at least four criteria for diagnosis, including:

• Intense and unreasonable fear: Your fear of vomiting is persistent and out of proportion to an appropriate level of fear.
• Anticipatory anxiety: You tend to dwell on or dread future situations or experiences that could involve nausea and vomiting.
• Avoidance: You actively avoid vomiting and things that might lead to it. You may go to extreme lengths to try to avoid vomiting.
• The phobia interferes with day-to-day activities: Your fear limits your everyday life in some way.

How is emetophobia treated?

Treatment for emetophobia may include:

• Cognitive behavioral therapy.
• Exposure therapy.
• Medications.

Emetophobia cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a form of talk therapy to help you manage the thoughts and behaviors around your fear. Through conversation with a mental health professional, you’ll discuss:

• Your history with the fear to determine why it makes you anxious.
• Techniques to manage anxiety when it happens (like breathing and relaxation exercises).
• Ways to adapt in situations that you prefer to avoid (like traveling or socializing).
• How to feel safe around your fear and confront challenging situations where your fear is present.

CBT takes time and patience. It can be difficult to open up to a new person to discuss your feelings. You’ll confront uncomfortable situations and memories that you’d rather not think about. Remember that your mental health provider is there to support you and help you reach your goals.

Emetophobia exposure therapy

Exposure therapy is a way to reduce your fear by slowly reintroducing you to your triggers in a controlled setting. This reduces your anxiety and desensitizes you to the fear of vomiting over time. Exposure therapy for emetophobia may include:

• Saying or hearing the word “vomit” or words associated with it, like “throwing up.”
• Spinning around in a circle to induce nausea (if a healthcare provider approves it).
• Going to a public place that you previously avoided.
• Watching a television show or movie that features vomiting.

Exposure therapy happens in steps. You won’t be able to move on to the next step until you feel comfortable with the first one. The final step of exposure therapy for emetophobia is simulated vomiting. A healthcare provider won’t make you vomit. Instead, they’ll provide you with textured or mushy food (like creamed corn or baked beans). You’ll take a spoonful of the food item and then spit it out into a toilet or trash can to mimic what vomiting would feel like. This is often the most difficult part of exposure therapy. You’ll likely practice exposure therapy techniques in addition to cognitive behavioral therapy.

What medications treat emetophobia?

Medications aren’t usually used to treat specific phobias like emetophobia. But sometimes, medications can temporarily help relieve symptoms of fear and anxiety to treat your phobia when you’re going through psychological therapy or in situations that are unavoidable. These medications may include:

• Psychotropic medications (like benzodiazepines and antidepressants).
• Gastrointestinal medications (antiemetics) to reduce an upset stomach or nausea.

Talk to your healthcare provider about the possible side effects of these medications and follow their instructions to take these medications as directed.

How soon after treatment will I feel better?

You may start to feel better after beginning therapy or taking medications as prescribed. Your phobia won’t go away overnight. It could take several months before you feel comfortable with your fear enough to face it. There isn’t a set amount of time for each person to feel better after treatment for emetophobia.

Can emetophobia be prevented?

There’s no known way to prevent emetophobia.

What’s the outlook for emetophobia?

Having a phobia may seem overwhelming, but treatment can help you reduce your fear and anxiety. Treatment can lead to an improved prognosis. Your care team will teach you ways to adjust your thinking and behaviors around vomiting. Without treatment, emetophobia can impact your mental and physical health in addition to your ability to socialize and engage with your loved ones.

When should I see a healthcare provider?

If you notice a fear is taking over your thoughts, behaviors and your ability to feel well, talk to a healthcare provider. Treatment is available for emetophobia.

What questions should I ask my healthcare provider?

• What caused my fear?
• What type of treatment do you recommend?
• What are the side effects of the medication you prescribed?
• How often do I need to participate in therapy?
• What should I do if exposure therapy makes me feel worse?

A note from Cleveland Clinic

It’s normal to be grossed out by vomiting. Sometimes, a negative experience with vomit changes the way you feel about it and it can take over your thoughts and behaviors. If you feel that your fear is preventing you from engaging in specific activities or interfering with your physical and mental well-being, contact a healthcare provider. Treatment for emetophobia is very effective to help you feel better.