Emetophobia: why avoiding sickness keeps the fear going, and what small steps look like
Emetophobia is a fear of vomiting, or of seeing someone else be sick. What keeps it going is mostly the avoiding and checking: food rules, sell-by dates, skipped trips, keeping away from anyone who is ill, and constantly checking how your stomach feels. Small steps work on that by facing a wider range of things than most fears need, from the word itself to pictures, places and the feeling of being full, one manageable piece at a time.
What it looks like day to day
Most fears have an obvious trigger you can steer round. This one is quieter. The avoiding and checking runs all day, in small decisions nobody else notices.
Oxford Health NHS Foundation Trust describes people who "repeatedly check best-before dates of food, avoid cooking or eating certain foods, wash and clean themselves excessively to reduce the risk of contamination with disease, and seek reassurance from others." It also says people "monitor themselves or others for signs of illness." Professor David Veale, a London specialist whose page on this fear is one of the most detailed we found, lists the situations people tend to avoid: being near people who are ill, boats, planes, holidays abroad, fairground rides, alcohol, crowded places and public transport. Anxiety UK adds worries about pregnancy and about caring for loved ones when they are ill.
On how common it is, the sources differ, and it matters why. Oxford Health says a fear of vomiting "is estimated to affect up to 8% of the population", but gives no source for the figure. Veale's page draws a line between the two: about 8% for a fear of vomiting, and "about 0.1 to 0.2%" for the full phobia. Neither page cites a study, so take both as rough.
Why the checking keeps it going
Each check feels like it is keeping you safe. Veale's explanation of why it does the opposite is the clearest we found: these are "safety seeking behaviours" and they "maintain your fear as you never find out whether you need to use them or not."
So if you only ever eat food well inside its date, you never learn what happens when you eat something on the date. If you leave every room where someone mentions a stomach bug, you never learn you could have stayed.
The part people miss is the feeling of nausea itself. Anxiety can make you feel sick. Oxford Health lists nausea and light headedness among the physical feelings of anxiety that come with this fear. That sets up a loop. You feel worried, you feel a bit queasy, you take the queasiness as a warning, and you feel more worried.
Calming the feeling can quietly become another check. Veale's list of safety behaviours includes taking anti-sickness tablets or sucking a sweet. Scanning your stomach every few minutes, sipping water to settle it, or stepping outside until it passes can all play the same role. They feel like coping. Often they are the reason the fear never gets a chance to be proved wrong.
None of this means you have to drop everything at once. It means the checks are part of the ladder too, and you can take them away one at a time. We wrote more about this pattern in our guide to safety behaviours.
Why the ladder has more kinds of rungs
Words, pictures, sounds
- The word "vomit", written and said
- Cartoons, then photos
- A few seconds of sound, then short clips
Places and situations
- Eating out
- Buses, trains, travel
- Being near children or someone who is ill
Body sensations
- Feeling comfortably full
- Slight dizziness from a slow spin
- Feeling warm
Dropping a check
- Skip the sell-by date check
- Leave the mints at home
- Sit away from the door
Keep each step small enough that fear stays around 5 out of 10. Repeat it before moving on.
For a fear of dogs, most of the ladder is dogs: pictures, then a calm dog across the road, then a dog on a lead nearby. For a fear of vomiting there is no single thing to stand near. Specialists describe working on several kinds of step side by side.
Words, pictures, sounds and video. Allen Weg, writing for the International OCD Foundation, describes a self-help resource that "arranges letters, words, sentences, stories, drawings, photos, videos, and sounds of vomiting" into a graded sequence. Anna Christie, who runs the Emetophobia Help site and works with people on this fear, starts hers with "looking at the word 'vomit'", then other words, then imagining a scene where you would be a little afraid, and only later video, which itself starts with something as mild as a baby spitting up.
Situations. These are the things on Veale's avoid list: eating out, travel, being near children or people who are ill, a night where others are drinking.
Body sensations. This is the unusual one. Because the feeling of nausea is itself a trigger, the ladder can include bringing on similar feelings on purpose, in small doses. Weg describes people deliberately bringing on the physical feelings linked with nausea through exercises they control, such as spinning in place. Dr Jessica Bodie, who works at an anxiety centre at the University of Pennsylvania, gives "spinning in a chair, wearing a tight scarf in an overheated room, or eating past full" as examples.
Dropping a check. The same step done without the usual safety behaviour: the meal without the mints in your pocket, the bus ride without sitting by the door.
On pace, Christie says her clients' anxiety usually goes "up to about 5, maximum" on a 0 to 10 scale, and she warns that rushing through her material just to prove you "can" does not help.
An example ladder
This is one example, not a plan to copy. Your own rungs will depend on what you already avoid. Rate your fear 0 to 10 before and after each one. If a rung would push you well past a 5, split it into something smaller first.
| Rung | Kind of step | Example |
|---|---|---|
| 1 | Word | Write the word "vomit" on a sticky note and leave it on your desk for a day |
| 2 | Word | Say it out loud, then read a short paragraph that uses it a few times |
| 3 | Picture | Look at a cartoon drawing of someone being sick for 30 seconds |
| 4 | Situation | Eat a food you have been avoiding that is in date, at home, in a small portion |
| 5 | Dropping a check | Eat a normal meal without checking the date on the packet first |
| 6 | Body sensation | Eat until comfortably full, then sit with the feeling for ten minutes without sipping water or going outside |
| 7 | Situation | Eat a simple meal in a café, sitting where you normally would not |
| 8 | Body sensation | Spin slowly in a desk chair for 20 seconds and notice the dizziness settle on its own |
| 9 (optional) | Sound or video | Listen to a few seconds of retching sound, or watch a short film scene where a character is sick |
| 10 (optional) | Situation | Take a bus or train ride without the usual sweet or tablet in your pocket |
The last two are optional for a reason. Plenty of people get their life back without ever reaching them. If you only ever do rungs 1 to 6, keep doing them until they are boring, and that still counts.
A few rules that apply all the way up:
- Do the same rung several times before moving on. One go rarely teaches your brain much.
- Don't start the body sensation rungs if you have a medical condition that makes spinning, heat or eating a lot a bad idea. Ask your GP first.
- Calming tricks during the step, such as checking your stomach every minute, are worth noticing. If you can, leave one out next time.
When to see your GP first
This matters more than anything else on this page.
If you are eating much less than you need, have cut out whole food groups, are losing weight, or the fear has got to the point where you can't leave the house, see your GP before starting any self-guided steps. Veale's page warns that some people "restrict their food believing that a range of food may cause vomiting" and "may then become very underweight." An NHS children's mental health page on restrictive eating lists "fear of choking or vomiting" as one of the signs, and says to "seek urgent help if you have rapidly lost weight for longer than a few weeks, lost weight over three months, or think your eating is out of control."
What to say can be simple. Tell your GP you are afraid of being sick, then say what it is stopping you doing: what you have stopped eating, whether your weight has changed, and where you no longer go. Anxiety UK "strongly advises" people to speak to their GP. Veale's page says your GP "may refer you" on to your local NHS Talking Therapies service. The NHS also lets you refer yourself to Talking Therapies for phobias without seeing a GP, but says problems with eating usually need a GP referral, which is another reason to go to the GP first if food is the issue.
A self-guided app is not the right first step if eating is heavily restricted. That needs someone who can keep an eye on your health while the fear is worked on.
Where Conquer Fear fits
Conquer Fear is our app, so read this part as interested rather than neutral.
You name a goal and the fear in the way, and it writes a ladder of small real-world steps for that exact fear, so a fear of vomiting gets vomiting steps rather than the nearest general anxiety ladder. It shows one step at a time and asks you to rate fear 0 to 10 before and after. If a step feels too big, there is a "Make it smaller" option that splits it. A step you turned up to but did not finish still gets logged. Our vomiting fear page shows example first steps.
Here is where it is not the answer. It does not contain pictures, sounds or videos, so for those rungs you would find your own material. It does not teach breathing or any physical technique. It is iOS only and needs a connection. And it is not the place to start if your eating or weight is already a worry. See your GP first.
If none of that rules you out, the free tier covers one ladder and its first three steps. You can find it on the App Store.
Sources
All checked 24 October 2026.
- Oxford Health NHS Foundation Trust, What is emetophobia / specific phobia of vomiting?: https://www.oxfordhealth.nhs.uk/ohspic/problems/emetophobia/
- Professor David Veale, emetophobia page: https://www.veale.co.uk/emetophobia/
- Anxiety UK, Emetophobia: https://www.anxietyuk.org.uk/emetophobia/
- Allen H. Weg, Emetophobia: Fear of Vomiting as an Expression of OCD, International OCD Foundation, OCD Newsletter, Fall 2017: https://iocdf.org/expert-opinions/emetophobia-fear-of-vomiting-as-an-expression-of-ocd/
- Jessica Bodie, answer on choking and vomiting phobias, Psychwire: https://psychwire.com/free-resources/q-and-a/yio8dk/treating-choking-and-vomiting-phobias
- Anna Christie, posts tagged exposure, Emetophobia Help: https://emetophobiahelp.org/tag/exposure/
- Avon and Wiltshire Mental Health Partnership NHS Trust, ARFID (children and young people): https://www.awp.nhs.uk/camhs/conditions/eating-issues/avoidant-restrictive-food-intake-disorder-arfid
- NHS, NHS Talking Therapies: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies/
Conquer Fear is a self-help tool inspired by exposure principles. It isn't therapy or medical care, and it is not intended to diagnose, treat, cure or prevent any disease. If fear or anxiety is affecting your daily life, check with your GP or a qualified professional.