Behavioral medicine treatment of ruminative vomiting and associated weight loss in an adolescent with autism.

A 15-year-old boy with autism kept throwing up on purpose after meals. Doctors call this ruminative vomiting. He lost so much weight he needed hospital care.

The team mixed four parts: fill his stomach first (satiation), cut certain foods, change meal settings, and watch for early signs. They tracked vomiting and weight every day for four months.

Vomiting dropped to almost zero within days. The teen regained all lost weight and stayed stable through the four-month check-up.

No extra drugs or tubes were needed. The parents learned the plan and kept it going at home.

Bacon-Prue et al. (1980) tried simpler tricks—toy play plus ignoring puking—in a teen with Down syndrome. Their vomiting also stopped, but the 1994 package added diet and setting tweaks for autism.

Cooper et al. (2023) later showed just giving sugar-free gum for clean intervals can do the same job. Their gum plan is easier to carry, yet both studies hit near-zero rumination.

Chawner et al. (2019) reviewed 36 feeding studies and found most winners used more than one tool, just like the 1994 case.

If you have a client who vomits on purpose, you now have two solid choices: the full 1994 combo or the 2023 gum shortcut. Start with gum if you need something fast and parent-friendly. Keep the satiation-diet plan in your pocket for kids who also need weight gain or have tricky food allergies. Either way, measure daily and teach caregivers the cue-spotting steps so the gain sticks after you leave.