Some people use vomiting as an attempt to regain control after breaking any rules they may have around food (for example, eating more than they planned). This can lead to a cycle of eating and vomiting.

The cycle of vomiting  

For some people, vomiting can be triggered by things that are not related to weight and shape. For example, being bullied at school or being rejected by others. Vomiting can then become a habit and get out of control. Our brain does not like starving, so will respond in many different ways. Lots of people’s brains will make them very hungry and drive them to eat. This can cause feelings of failure, guilt and shame: continuing the cycle of vomiting then compulsive eating.

(DreamsTime Images, 2023)

Vomiting and the brain

Vomiting confuses your body and brain. When we eat, our brain prepares for nutrition and our bodies prepare the hormones to digest food. This includes insulin, which allows energy to travel into our cells. If you vomit, the food your body expects just doesn’t arrive and it can lead to low blood sugar and feeling shaky, anxious, and weak.

After vomiting, your brain goes into a state of famine where it feels starved of nutrition. The hormonal starvation changes increase the likelihood of gaining weight. Some people report an immediate sense of relief after vomiting, but longer-term their mental health, anxiety, mood, and sleep become worse (Centre for Clinical Interventions, 2022).

Impact on physical health

If you are vomiting regularly, it can affect your physical health in numerous ways (Centre for Clinical Interventions, 2022):

• Gastric (stomach) acids enter your mouth and erodes away the enamel on your teeth. This leaves your teeth vulnerable to erosion, brittleness and being oversensitive to temperature.
• Parotid (salivary) glands can swell up, making your cheeks look puffy.
• Gastric acid can also cause your fingers and knuckles to become calloused.
• The muscle between your oesophagus and stomach becomes damaged which can lead to heartburn, acid reflux and food coming back up.
• Small amounts of food in your stomach can feel uncomfortable as the digestive system can become dysregulated.
• Your ability to identify hunger and fullness can become impaired.
• Electrolytes (such as sodium and potassium) in the blood can become imbalanced, which can cause fainting, digestive problems, confusion, changes in blood pressure, heart palpitations, seizures, and cardiac arrest.

Impact on mental health 

Sometimes, people lie about vomiting or vomit in odd places to try and hide what they are doing. Keeping secrets in this way can impact relationships with friends and family, functioning at school, and the ability to do activities that you usually enjoy.

People may experience guilt, shame, anxiety, or low mood which can cause feelings of worthlessness and a lack of control. These feelings can trigger a binge, which then may lead to vomiting, and the cycle keeps going.

Remember, if you challenge your beliefs about vomiting, you can reverse the cycle of eating then purging.

Vomiting and the endocrine system 

Regular eating:

(Swan, 2011)

Eating and vomiting:

(Lasschuijt, Mars, de Graaf, & Smeets, 2020)

We know from other young people that recovery from these difficulties is possible with the right help and support.

It can be really difficult to tell people about vomiting. Try and find an adult you trust and remember that they are there to help you and not judge.