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Fear of Vomiting (Emetophobia)

Summary: On one hand, it is normal to dislike the thought of vomiting. On the other hand, for some people, the fear of vomiting (emetophobia) is so overwhelming that it ends up controlling their life. In order to avoid situations where there is the slightest possibility of vomiting, people can avoid going out, ending up housebound. As a result, they may end up unable to attend school, work, or participate in their community. The good news is that many services and supports can be helpful for overcoming emetophobia.
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J's Story

J. is a twenty-something who struggles with a fear of vomiting. She remembers the day it started in Gr. 9. She had been sick with the flu and ended up throwing up in class. Since then, her fears of vomiting have been getting gradually worse. She is able to go to her work but other than that, she is not able to leave home. She wishes so badly that she could just go out like others…

What is the Fear of Vomiting (Emetophobia)?

It is normal to dislike the thought of vomiting and in fact, having just enough fear of vomiting can be helpful.

It encourages one to 1) stay away from people who may be sick, and 2) take measures to avoid getting sick.

On the other hand, for a person with emetophobia, the thought of vomiting is so terrifying that it can end up controlling their life.

The person may:

  • Avoid going out, due to fear of vomiting
  • Avoid eating in public places (such as restaurants), or with other people
  • Avoid any place or situation where there is the slightest possibility that the person (or others) may vomit
  • Become upset even at the mere mention of the word ‘vomit,' or synonyms like ‘throw up', ‘barf,' ‘puke,' etc.
  • In some cases, individuals will severely restrict their eating out of fear of vomiting.

Types of Emetophobia

There are two types of emetophobia

  • Those who are mainly afraid of vomiting themselves
  • Those who are mainly afraid of others vomiting

Furthermore, people with emetophobia may be:

  1. Type 1 (anxiety-based), which refers to individuals who have an underlying anxiety condition. The anxiety leads to nausea, which then leads to more anxiety.
  2. Type 2 (nausea-based), which refers to individuals with medical conditions that cause nausea. This nausea leads to a secondary anxiety and phobia, which then continues to cause more symptoms.

Diagnosis of Emetophobia

Emetophobia is defined as the specific fear of vomiting and avoidance behaviors related to vomiting situations.

In the DSM-5, it is classified as a Specific Phobia: Other type: Vomiting (SPOV).

What Causes Emetophobia?

For many people, there is an event that triggers a fear of vomiting, such as:

  • A real-life event such as getting sick and feeling nauseous (e.g. having the flu or food poisoning),
  • Seemingly harmless events like watching something on TV.

In most cases, however, it seems that people cannot remember why they have the fear.

Emetophobia May Resemble Other Conditions

Eating disorder

People with emetophobia may have trouble eating, thus they may appear to have an eating disorder.

Social anxiety

People with emetophobia may be afraid to meet with others due to fear of vomiting.

Avoidant/restrictive food intake disorder (ARFID)

People with ARFID have troubles eating, often having sensory /motor issues.

Does Your Loved One Have Fears of Vomiting (Emetophobia)?

Is there a significant fear of vomiting in yourself or a loved one?

If so, start by going to see the primary care provider. They can check to see if there are any medical conditions that might be contributing to the symptoms of emetophobia.

If no medical cause can be found, it can be helpful to see a mental health professional who can help with learning how to cope with the vomiting fears.

Treatments for Emetophobia: Psychotherapy and Strategies

Cognitive behaviour therapy (CBT)

CBT explores a person's thoughts, feelings and behaviors to help them overcome emetophobia.

An individual with emetophobia may have the following

  • Cognitive distortions, E.g. "I can't get on the bus because I might throw up!"
  • Behaviours such as avoidance of situations where they may be vomiting.

Interventions may include:

  • Teaching coping thoughts (“cognitive restructuring”)
    • Unhelpful thoughts are replaced with more positive, helpful thoughts (e.g. "I'm not going to throw up on the bus. And even if I did, it’s not the end of the world!") to allow the person to face their fears.
  • Calming strategies
    • Examples include deep breathing.
  • Exposure to physical sensations
    • Many people worry that having physical symptoms will lead to vomiting.
    • As a result, the moment they experience even minor physical sensations, it may trigger the fears of vomiting.
    • In order to help with this, therapists can do interoceptive exposure exercises (i.e. exposure to stimuli produced by the body), such as spinning in circles, jumping jacks, breath holding, running in place, and push-ups.
  • Gradual exposure
    • Graded exposure is about exposing yourself to feared stimuli and situations.
    • In the past, therapists might have exposed clients to vomit or vomit-like stimuli, but more recently, it is felt unnecessary to do so.
    • More modern gradual exposure exposes clients to other activities / sensations that they avoid due to vomit concerns.
    • Example
      • Is the person triggered by buses? If so, there is a very gradual exposure such as 1) thinking about buses; 2) images / drawings of buses; 3) seeing a bus from a distance, etc.

Hypnosis, or hypnotherapy

A hypnotherapist helps the person reach a state of deep relaxation, which helps the person be able to overcome the severe anxiety that normally occurs with the fear of vomiting.


Is there mild nausea? Some people report acupressure can be helpful for nausea.

This technique involves pressing your middle/index fingers down on the groove between the two large tendons on the inside of the wrist (National Institutes of Health, 2008).

Treatment for Emetophobia: Medications

Are there ongoing symptoms despite non-medication treatments?

Doctors can prescribe medications such as:

  • Specific serotonin reuptake inhibitors (SSRIs).
    • Examples include fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), escitalopram (Cipralex)
  • Nausea-related medications.
    • Is there emetophobia plus nausea? Some individuals have reported anti-nausea medications may be helpful.
  • Examples
    • Metoclopramide.
    • Hydroxyzine (Atarax)
      • In a case report of a 15-yo female with emetophobia, anxiety and nausea, hydroxyzine was found helpful, along with an SSRI (Kannappan, 2020).


Self-Help Worksheets for Emetophobia

Useful Books

Living with Emetophobia: Coping with Extreme Fear of Vomiting, by Nicolette Heaton-Harris, 2007


Boschen M: Reconceptualizing emetophobia: a cognitive-behavioral formulation and research agenda, J. Anxiety Disorders, 21(3): 407-419, 2007.

Nausea and Acupressure, National Library of Medicine, The National Institutes of Health, Retrieved Jan 5, 2008 from

About this Document

Written by the eMentalHealth Team and Partners.


Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.

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Date Posted: Nov 4, 2008
Date of Last Revision: Nov 22, 2021

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