Unhappy Meal

Mary Roach wrote the very funny (and very morbid) book examining cadavers, Stiff. In this Salon article, she examines what it would take to eat yourself to death.

How to eat yourself to death.

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By Mary Roach

Dec. 3, 1999 | Thanksgiving evening, between the second yam and the first piece of pie, a thought crossed my mind. Actually, it was a series of thoughts, and it went like this: Is it possible to eat yourself to death? If I keep on eating, will my stomach eventually burst? How much food would it take?

I am not the first person to have had these thoughts. The first person, so far as I am able to verify, was a Frenchman named E. Revilloid. The year was 1885. Revilloid not only had these thoughts, but undertook to answer them in a scientific manner, filling up a stomach (removed from its deceased gentilhomme owner) until it burst. The rupture threshold was determined to be 4,000 cc, or about four quarts. Six years later, a German physician by the name of Key-Aberg repeated the experiment. (The German of yesteryear was a hearty eater, a fact borne out in a ghastly 1929 Annals of Surgery article. The paper summarizes 14 cases of fatal overeating, including a 17-year-old female done in by a "large portion of sauerkraut.")

Key-Aberg's experiment differed from his French predecessor in that he left the stomachs inside their (dead) owners. He presumably felt that this would better approximate the realities of a hearty meal, for rare indeed is the dinner party attended by disengaged, free-standing stomachs. To that same end, he is said to have made a point of composing his corpses in the sitting position. Again, 4,000 cc was the reported cutoff.

As fans of the eating sections in old Guinness books of world records will surmise, this figure has been surpassed on numerous occasions. Some stomachs, by way of heredity or prolonged daily gourmandism, are roomier than average. Orson Welles had one such stomach. According to the owners of Pink's hot dog stand in Los Angeles, the voluminous director once sat down and finished off 18 hot dogs.

The all-time record holder would appear to be a 23-year-old London fashion model whose case was described in the April 1985 issue of Lancet. At one fateful meal, the young woman managed to put away 19 pounds of food: one pound of liver, two pounds of kidney, a half pound steak, one pound of cheese, two eggs, two thick slices of bread, one cauliflower, 10 peaches, four pears, two apples, four bananas, two pounds each of plums, carrots and grapes, and two glasses of milk. Whereupon her stomach blew up and she died. (The human gastrointestinal tract is home to trillions of bacteria, which, should they escape the confines of their stinky, labyrinthine home, can create a massive and often fatal systemic infection.)

Runner-up goes to a 31-year-old Florida psychologist who was found collapsed in her kitchen surrounded by "an abundance of foodstuffs, broken soft drink bottles and an empty grocery bag," to quote a lavishly if repellently illustrated article in a 1986 American Journal of Forensic Medicine and Pathology. In her purse was a hospital form from several hours earlier, indicating that she had consumed five pounds of hot dogs, three boxes of crackers and two quarts of milk before driving herself to the emergency room and complaining of abdominal pain. The staff dutifully pumped nearly two quarts of material from her stomach, whereupon she returned home, only to start all over again -- this time with lethal results. The Dade County medical examiner's report itemized the fatal last meal: "8700 cc of poorly masticated, undigested hot dogs, broccoli and cereal suspended in a green liquid that contained numerous small bubbles." The green liquid remains a mystery, as does the apparent widespread appeal of hot dogs among modern-day gorgers.

Not surprisingly, both these women were bulimics. Bulimics make up the preponderance of stomach rupture deaths recorded in medical literature, second only to dogs and followed closely by the mentally retarded, who have, as one author put it, a "tendency to wolf down large quantities of food." (One such patient was killed by a too-eagerly dispatched serving of beets, some of which he literally inhaled. "Terminal aspiration of beets" was listed as the mechanism of death.) Not included in the ranking is a certain tribe of New Guinea natives whose traditions include the ceremonial ingestion of vast quantities of partly cooked pork, leading to a sometimes fatal condition known as "pig bel."

What is surprising about the two bulimic women is that they survived as long as they did. The shriveled stomachs of people who have been starving tend to rupture more easily. The model, for example, had been interspersing her binges with three- to four-day bouts of complete starvation. The end of World War II saw a disquieting number of former prisoners of war perish from gastrointestinal overload when presented with unlimited quantities of food. It didn't take much. The surgeon commander of the Polish Navy described four such cases in a 1947 issue of the British Medical Journal, with one of the men succumbing from a relatively unnoteworthy two quarts of soup, one quart of coffee, a half pound of bread and some potatoes over the course of a day.

Not all people who eat themselves to death die of a ruptured stomach. The Florida psychologist died of asphyxia, her grossly distended stomach having protruded so far up and out of its customary terrain that the lungs were terminally compromised. Either way, you haven't long for regrets. The ruptured stomach victims in the reports typically died within a matter of hours. Of 31 cases reviewed in one 1941 journal article, only two recovered.

Lest you spend your postprandial hours this holiday season worrying about whether your stomach has quietly ruptured, rest assured that you will know if it happens. Case studies quote patients reporting a sensation of "giving way," a "bursting noise" or "sudden explosion."

A final word of caution. Should you find yourself closing in on the four-quart mark, do not seek relief in a glass of Alka-Seltzer. In 1941, a 51-year-old woman capped a weeklong hyperphagic binge by sitting down to a prodigious meal of macaroni, meat balls, cheese, tomatoes, potatoes, bread, pie, three glasses of grape juice and several shots of whisky -- nearly four quarts of foodstuffs in all. Suffering from "heavy feelings" in her abdomen, she sought to relieve her discomfort with a few teaspoons of sodium bicarbonate in water. Almost immediately, she doubled up with severe stomach pain, the gas from the fizz having apparently stretched the stomach to its breaking point. Within 14 hours, the woman died. The case study, reported in the December 1941 Annals of Surgery, is accompanied by a detailed half-page illustration of her stomach, replete with a gaping five-inch-long rupture, that is enough to put anyone off his supper. Well, almost anyone.